Selective Fetal Growth Restriction in Dichorionic Twin Pregnancies: Diagnosis, Natural History, and Perinatal Outcome

Antonakopoulos, Nikolaos
Pateisky, Petra
Liu, Becky
Kalafat, Erkan
Thilaganathan, Baskaran
Khalil, Asma
This study aims to evaluate the natural history, disease progression, and outcomes in dichorionic twins with selective fetal growth restriction (sFGR) according to different diagnostic criteria and time of onset. Dichorionic twins seen from the first trimester were included. sFGR was classified according to the Delphi consensus, and was compared to the outcomes of those classified by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) diagnostic criteria. Early sFGR occurred before 32-weeks, and late sFGR after 32-weeks. Disease progression, neonatal outcomes such as gestation at delivery, birthweight, neonatal unit (NNU) admission, and morbidities were compared. One-hundred twenty-three of 1053 dichorionic twins had sFGR, where 8.4% were classified as early sFGR, and 3.3% were late sFGR. Disease progression was seen in 36%, with a longer progression time (5 vs. 1 week) and higher progression rate (40% vs. 26%) in early sFGR. Perinatal death was significantly higher in the sFGR than the non-sFGR group (24 vs. 16 per 1000 births, p = 0.018), and those with early sFGR had more NNU admissions than late sFGR (p = 0.005). The ISUOG diagnostic criteria yielded a higher number of sFGR than the Delphi criteria, but similar outcomes. sFGR have worse perinatal outcomes, with early onset being more prevalent. Use of the Delphi diagnostic criteria can reduce over-diagnosis of sFGR and avoid unnecessary intervention.
Journal of Clinical Medicine


Performance of Antenatal Diagnostic Criteria of Twin-Anemia-Polycythemia Sequence
Liu, Becky; Kalafat, Erkan; Bhide, Amar; Thilaganathan, Basky; Khalil, Asma (2020-09-01)
This study aims to elicit the validation performance of different diagnostic criteria and to evaluate the disease course and perinatal outcomes of pregnancies complicated by twin anemia polycythemia sequence (TAPS). Monochorionic diamniotic (MCDA) twin pregnancies who received serial middle cerebral artery (MCA) peak systolic velocity (PSV) measurements without non-TAPS-related demise or major anomalies were included. Course of disease, antenatal intervention, additional ultrasound features, and perinatal o...
Transcriptomic network analysis of brain aging and alzheimers disease
Parvizi, Poorya; Somel, Mehmet; Tunçbağ, Nurcan; Department of Biology (2017)
Multiple studies have investigated aging brain transcriptomes to identify for age-dependent expression changes and determine genes that may participate in age-related dysfunction. However, aging is a highly complex and heterogeneous process where multiple genes contribute at different levels depending on individuals’ environments and genotypes. Both this biological heterogeneity of aging, as well as technical biases and weaknesses inherent to transcriptome measurements, limit the information gained from a s...
Meta analysis of alzheimer’s disease at the gene expression level
İzgi, Hamit; Somel, Mehmet; Department of Biology (2017)
In this study, publicly available microarray gene expression datasets are used to investigate common gene expression changes in different postmortem brain regions in Alzheimer’s Disease (AD) patients compared to control subjects, and to find possible functional associations related to these changes. The hypothesis is that pathogenesis of the disease converges into common patterns of dysregulation/alteration or dysfunction in molecular pathways across different brain regions in AD. In total, I studied 13 dat...
Predictive accuracy of Southwest Thames Obstetric Research Collaborative (STORK) chorionicity-specific twin growth charts for stillbirth: a validation study
Kalafat, E.; Sebghati, M.; Thilaganathan, B.; Khalil, A. (2019-02-01)
Objective Twin pregnancy is associated with a 2-3-fold increased risk of stillbirth compared with singleton pregnancy. Despite the fact that the growth pattern in twins has been shown to be different from that in singletons, it is controversial whether twin-specific growth charts should be used routinely. A major goal of prenatal ultrasound is to identify fetuses with growth restriction at risk of stillbirth. The main aim of this study was to compare the performance of chorionicity-specific twin charts with...
Genetic aspects of human male infertility: the frequency of chromosomal abnormalities and Y chromosome microdeletions in severe male factor infertility
Vicdan, A; Vicdan, K; Gunalp, S; Kence, Aykut; Akarsu, C; Isik, AZ; Sozen, E (Elsevier BV, 2004-11-10)
Objective: The main purpose of this, study is to detect the frequency and type of both chromosomal abnormalities and Y chromosome microdeletions in patients with severe male factor infertility and fertile control subjects. The association between the genetic abnormality and clinical parameters was also evaluated. Methods: This study was carried out in 208 infertile and 20 fertile men. Results of 208 patients, 1 19 had non-obstructive azoospermia and 89 had severe oligoasthenoteratozoospermia (OAT). Seventee...
Citation Formats
N. Antonakopoulos, P. Pateisky, B. Liu, E. Kalafat, B. Thilaganathan, and A. Khalil, “Selective Fetal Growth Restriction in Dichorionic Twin Pregnancies: Diagnosis, Natural History, and Perinatal Outcome,” Journal of Clinical Medicine, 2020, Accessed: 00, 2020. [Online]. Available: