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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
Literature confusing on topic because of variable definitions of discordant twin growth (DTG), fetal growth restriction (FGR)
DTG: Estimated fetal weight (EFW) difference 20% vs. 25%
Or at least 1 twin with FGR
Or 1 twin with FGR + 25% difference birth weight, not EFW
Or FGR + abnormal Doppler
FGR: EFW < 10th vs. < 5th vs. < 3rd percentiles
Or AC < 5th percentile
Per American College Obstetricians and Gynecologists practice bulletin, DTG is most commonly defined as 20% difference in EFW between larger and smaller fetuses
Percentage difference in EFW = EFW larger - EFW smaller/EFW larger x 100
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Reporting Tips
Selected References
Halling C et al: Neuro-developmental outcome of a large cohort of growth discordant twins. Eur J Pediatr. ePub, 2015
Allaf MB et al: Does early second-trimester sonography predict adverse perinatal outcomes in monochorionic diamniotic twin pregnancies? J Ultrasound Med. 33(9):1573-8, 2014
Cohen A et al: The influence of prolonged preterm premature rupture of the membranes on neonatal outcome of the presenting and non-presenting twin. Eur J Obstet Gynecol Reprod Biol. 181:28-31, 2014
D'Antonio F et al: Second-trimester discordance and adverse perinatal outcome in twins: the STORK multiple pregnancy cohort. BJOG. 121(4):422-9, 2014
Inklaar MJ et al: Cerebral injury in monochorionic twins with selective intrauterine growth restriction: a systematic review. Prenat Diagn. 34(3):205-13, 2014
Johansen ML et al: Crown-rump length discordance in the first trimester: a predictor of adverse outcome in twin pregnancies? Ultrasound Obstet Gynecol. 43(3):277-83, 2014
Lewi L et al: Growth discordance. Best Pract Res Clin Obstet Gynaecol. 28(2):295-303, 2014
Nakayama S et al: Perinatal complications of monochorionic diamniotic twin gestations with discordant crown-rump length determined at mid-first trimester. J Obstet Gynaecol Res. 40(2):418-23, 2014
Byers BD et al: Twin pregnancies discordant for single umbilical artery. J Reprod Med. 58(5-6):241-5, 2013
D'Antonio F et al: Crown-rump length discordance and adverse perinatal outcome in twins: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort. Ultrasound Obstet Gynecol. 41(6):621-6, 2013
Harper LM et al: Significance of growth discordance in appropriately grown twins. Am J Obstet Gynecol. 208(5):393.e1-5, 2013
Breathnach FM et al: Fetal growth disorders in twin gestations. Semin Perinatol. 36(3):175-81, 2012
Kent EM et al: Placental pathology, birthweight discordance, and growth restriction in twin pregnancy: results of the ESPRiT study. Am J Obstet Gynecol. 207(3):220, 2012
Breathnach FM et al: Definition of intertwin birth weight discordance. Obstet Gynecol. 118(1):94-103, 2011
Alam Machado Rde C et al: Early neonatal morbidity and mortality in growth-discordant twins. Acta Obstet Gynecol Scand. 88(2):167-71, 2009
Lewi L et al: Clinical outcome and placental characteristics of monochorionic diamniotic twin pairs with early- and late-onset discordant growth. Am J Obstet Gynecol. 199(5):511, 2008
Bagchi S et al: Birth weight discordance in multiple gestations: occurrence and outcomes. J Obstet Gynaecol. 26(4):291-6, 2006
Kingdom JC et al: Discordant growth in twins. Prenat Diagn. 25(9):759-65, 2005
Rustico MA et al: Managing twins discordant for fetal anomaly. Prenat Diagn. 25(9):766-71, 2005
Adegbite AL et al: Neuromorbidity in preterm twins in relation to chorionicity and discordant birth weight. Am J Obstet Gynecol. 190(1):156-63, 2004
Blickstein I et al: Neonatal mortality rates among growth-discordant twins, classified according to the birth weight of the smaller twin. Am J Obstet Gynecol. 190(1):170-4, 2004
Blickstein I et al: Birthweight discordance in multiple pregnancy. Twin Res. 6(6):526-31, 2003
Branum AM et al: The effect of birth weight discordance on twin neonatal mortality. Obstet Gynecol. 101(3):570-4, 2003
Kalish RB et al: First trimester prediction of growth discordance in twin gestations. Am J Obstet Gynecol. 189(3):706-9, 2003
Caravello JW et al: Sonographic examination does not predict twin growth discordance accurately. Obstet Gynecol. 89(4):529-33, 1997
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
Literature confusing on topic because of variable definitions of discordant twin growth (DTG), fetal growth restriction (FGR)
DTG: Estimated fetal weight (EFW) difference 20% vs. 25%
Or at least 1 twin with FGR
Or 1 twin with FGR + 25% difference birth weight, not EFW
Or FGR + abnormal Doppler
FGR: EFW < 10th vs. < 5th vs. < 3rd percentiles
Or AC < 5th percentile
Per American College Obstetricians and Gynecologists practice bulletin, DTG is most commonly defined as 20% difference in EFW between larger and smaller fetuses
Percentage difference in EFW = EFW larger - EFW smaller/EFW larger x 100
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Reporting Tips
Selected References
Halling C et al: Neuro-developmental outcome of a large cohort of growth discordant twins. Eur J Pediatr. ePub, 2015
Allaf MB et al: Does early second-trimester sonography predict adverse perinatal outcomes in monochorionic diamniotic twin pregnancies? J Ultrasound Med. 33(9):1573-8, 2014
Cohen A et al: The influence of prolonged preterm premature rupture of the membranes on neonatal outcome of the presenting and non-presenting twin. Eur J Obstet Gynecol Reprod Biol. 181:28-31, 2014
D'Antonio F et al: Second-trimester discordance and adverse perinatal outcome in twins: the STORK multiple pregnancy cohort. BJOG. 121(4):422-9, 2014
Inklaar MJ et al: Cerebral injury in monochorionic twins with selective intrauterine growth restriction: a systematic review. Prenat Diagn. 34(3):205-13, 2014
Johansen ML et al: Crown-rump length discordance in the first trimester: a predictor of adverse outcome in twin pregnancies? Ultrasound Obstet Gynecol. 43(3):277-83, 2014
Lewi L et al: Growth discordance. Best Pract Res Clin Obstet Gynaecol. 28(2):295-303, 2014
Nakayama S et al: Perinatal complications of monochorionic diamniotic twin gestations with discordant crown-rump length determined at mid-first trimester. J Obstet Gynaecol Res. 40(2):418-23, 2014
Byers BD et al: Twin pregnancies discordant for single umbilical artery. J Reprod Med. 58(5-6):241-5, 2013
D'Antonio F et al: Crown-rump length discordance and adverse perinatal outcome in twins: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort. Ultrasound Obstet Gynecol. 41(6):621-6, 2013
Harper LM et al: Significance of growth discordance in appropriately grown twins. Am J Obstet Gynecol. 208(5):393.e1-5, 2013
Breathnach FM et al: Fetal growth disorders in twin gestations. Semin Perinatol. 36(3):175-81, 2012
Kent EM et al: Placental pathology, birthweight discordance, and growth restriction in twin pregnancy: results of the ESPRiT study. Am J Obstet Gynecol. 207(3):220, 2012
Breathnach FM et al: Definition of intertwin birth weight discordance. Obstet Gynecol. 118(1):94-103, 2011
Alam Machado Rde C et al: Early neonatal morbidity and mortality in growth-discordant twins. Acta Obstet Gynecol Scand. 88(2):167-71, 2009
Lewi L et al: Clinical outcome and placental characteristics of monochorionic diamniotic twin pairs with early- and late-onset discordant growth. Am J Obstet Gynecol. 199(5):511, 2008
Bagchi S et al: Birth weight discordance in multiple gestations: occurrence and outcomes. J Obstet Gynaecol. 26(4):291-6, 2006
Kingdom JC et al: Discordant growth in twins. Prenat Diagn. 25(9):759-65, 2005
Rustico MA et al: Managing twins discordant for fetal anomaly. Prenat Diagn. 25(9):766-71, 2005
Adegbite AL et al: Neuromorbidity in preterm twins in relation to chorionicity and discordant birth weight. Am J Obstet Gynecol. 190(1):156-63, 2004
Blickstein I et al: Neonatal mortality rates among growth-discordant twins, classified according to the birth weight of the smaller twin. Am J Obstet Gynecol. 190(1):170-4, 2004
Blickstein I et al: Birthweight discordance in multiple pregnancy. Twin Res. 6(6):526-31, 2003
Branum AM et al: The effect of birth weight discordance on twin neonatal mortality. Obstet Gynecol. 101(3):570-4, 2003
Kalish RB et al: First trimester prediction of growth discordance in twin gestations. Am J Obstet Gynecol. 189(3):706-9, 2003
Caravello JW et al: Sonographic examination does not predict twin growth discordance accurately. Obstet Gynecol. 89(4):529-33, 1997
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