Vanlieferinghen Sarah, Anselem Olivia, Le Ray Camille, Shen Yao, Marcellin Louis, Goffinet François
Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris, 53 avenue de l'observatoire, 75014 Paris, France; Universitary Hospital Departement (DHU) Risks in pregnancy, Paris, France.
Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris, 53 avenue de l'observatoire, 75014 Paris, France; PremUP Foundation for scientific cooperation in connection with pregnancy and prematurity, 53 avenue de l'observatoire, 75014 Paris, France; Universitary Hospital Departement (DHU) Risks in pregnancy, Paris, France.
PLoS One. 2015 Apr 13;10(4):e0123067. doi: 10.1371/journal.pone.0123067. eCollection 2015.
To compare the prognostic value of fetal Doppler in dichorionic twins and singletons by measuring the interval between diagnosis of an abnormal Doppler flow and birth in fetuses who are small for gestational age (SGA).
Comparative retrospective study using a prospectively collected database.
A level 3 maternity unit in France.
Fetuses from singleton and dichorionic pregnancies who are SGA (vascular or unexplained), defined by an abdominal circumference (AC) measurement below the 10th percentile and confirmed by a birth weight below the 10th percentile.
Fisher's exact and Chi-2 tests were used to compare frequencies, and the Mann-Whitney-Wilcoxon test was used to compare medians in non-Gaussian distributions.
Both neonatal outcomes and intervals between the first Doppler abnormality and birth were compared in the groups of dichorionic twins and singletons.
Obstetric and neonatal outcome were similar in the 104 SGA dichorionic twins and 170 SGA singletons. Abnormalities of umbilical artery Doppler, regardless of type, appeared at the same frequency in both groups (52.9%) but were identified earlier in twins (25 versus 28 weeks, p = 0.02). Among fetuses with abnormal Doppler flow, the interval between the finding and birth was significantly longer in the twins than the singletons (44 vs 15 days, p<0.01).
The prognostic value of an abnormal Doppler finding for the course of a pregnancy may be different in dichorionic twins and singletons. The management of women carrying SGA twins and the information provided to them should take these results into account.
通过测量小于胎龄儿（SGA）中异常多普勒血流诊断与出生之间的间隔时间，比较胎儿多普勒对双绒毛膜双胎和单胎的预后价值。
使用前瞻性收集的数据库进行比较性回顾研究。
法国一家三级产科单位。
单胎和双绒毛膜妊娠的小于胎龄儿（血管性或不明原因），通过腹围（AC）测量低于第10百分位数定义，并经出生体重低于第10百分位数证实。
采用Fisher精确检验和卡方检验比较频率，采用Mann-Whitney-Wilcoxon检验比较非高斯分布中的中位数。
比较双绒毛膜双胎组和单胎组的新生儿结局以及首次多普勒异常与出生之间的间隔时间。
104例双绒毛膜双胎SGA和170例单胎SGA的产科和新生儿结局相似。两组脐动脉多普勒异常（无论类型）出现的频率相同（52.9%），但在双胎中发现更早（25周对28周，p = 0.02）。在多普勒血流异常的胎儿中，双胎中发现异常至出生的间隔时间显著长于单胎（44天对15天，p<0.01）。
异常多普勒检查结果对妊娠过程的预后价值在双绒毛膜双胎和单胎中可能不同。管理携带SGA双胎的孕妇并向她们提供的信息应考虑这些结果。
