American Journal of Obstetrics and Gynecology
Meeting paperSMFM paperPlacental pathology, birthweight discordance, and growth restriction in twin pregnancy: results of the ESPRiT Study
Section snippets
Materials and Methods
The Evaluation of Sonographic Predictors of Restricted Growth in Twins (ESPRiT) Study was a prospective, multicenter, observational study of twin pregnancies carried out by the Perinatal Ireland Research Consortium at 8 tertiary-level obstetric units in Ireland from May 2007 through October 2009. The ESPRiT Study was set up with the primary aim of establishing a level of birthweight discordance in twin pregnancies that would serve as an independent predictor of adverse perinatal outcome. The
Results
Of 1001 twin pairs recruited to the ESPRiT Study, 66.7% (n = 668) had complete placental pathological examination data available for analyses. Of these, 21.1% (n = 141) were monochorionic and 78.9% (n = 527) dichorionic. Table 1 illustrates the clinical characteristics of the cohort. Monochorionic twins were delivered at an earlier mean gestational age and were on average 302 g lighter than their dichorionic counterparts. The relative frequency of both birthweight discordance of ≥20% and
Comment
It is now well established that twin pregnancies with evidence of growth discordance are at increased risk for perinatal mortality and morbidity.5 Placental histological examination is vital in the evaluation of intrauterine growth restriction. Studies in singletons have shown morphological changes in villus structure in placentas of fetuses affected by intrauterine growth restriction.8, 10, 11 The abnormalities in villus development are a consequence of defective trophoblast invasion and
Acknowledgments
We wish to acknowledge the contributions of the following individuals: Fiona Cody and Hilda O'Keeffe, Rotunda Hospital, Dublin; Cecelia Mulcahy, National Maternity Hospital, Dublin; Dr Casie Staehr and Emma Doolin, Coombe Women and Infants University Hospital, Dublin; Phyl Gargan, Royal Victoria Maternity Hospital, Belfast; Annette Burke, Galway University Hospital; Dr Richard Horgan and Marion Cunningham, Cork University Maternity Hospital; Debbie McCartan, Our Lady of Lourdes Hospital,
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Supported by a research grant from the Health Research Board of Ireland.
The authors report no conflict of interest.
Cite this article as: Kent EM, Breathnach FM, Gillan JE, et al. Placental pathology, birthweight discordance, and growth restriction in twin pregnancy: results of the ESPRiT Study. Am J Obstet Gynecol 2012;207:220.e1-5.