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Discordance in Nuchal Translucency Measurements in Monochorionic Diamniotic Twins as Predictor of Twin-to-Twin Transfusion Syndrome

Published online by Cambridge University Press:  21 February 2012

Ingeborg H. Linskens ,
Yolanda M. de Mooij ,
Jos W. Twisk ,
Willem J. Kist ,
Dick Oepkes  and
John M. van Vugt
Ingeborg H. Linskens*
Affiliation:
Department of Obstetrics and Gynaecology, VU University Medical Center, The Netherlands. I.Linskens@vumc.nl
Yolanda M. de Mooij
Affiliation:
Department of Obstetrics and Gynaecology, VU University Medical Center, The Netherlands.
Jos W. Twisk
Affiliation:
Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, The Netherlands.
Willem J. Kist
Affiliation:
Department of Obstetrics, Leiden University Medical Center, The Netherlands.
Dick Oepkes
Affiliation:
Department of Obstetrics, Leiden University Medical Center, The Netherlands.
John M. van Vugt
Affiliation:
Department of Obstetrics and Gynaecology, VU University Medical Center, The Netherlands.
*
*Address for correspondence: Ingeborg H. Linskens, VU University Medical Center, Department OBS/GYN, Suite PK 6 Z 170, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.

Abstract

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Objective: Discordance in nuchal translucency measurements in monochorionic diamniotic twin pregnancies was assessed as predictor of Twin-to-Twin Transfusion Syndrome. Study Design: A total of 61 monochorionic diamniotic twins were enrolled. Nuchal translucency (NT) and crown-rump-length (CRL) discordance was calculated as the percentage of delta NT and CRL (absolute difference NT/CRL fetus 1 and fetus 2) of the largest measurement, and correlated with subsequent development of Twin-to-Twin Transfusion Syndrome. Results: Twin-to-Twin Transfusion Syndrome developed in 14/61 (23%) of cases. A NT discordance of 20% or more best predicted Twin-to-Twin Transfusion Syndrome development, with a sensitivity of 64% and a specificity of 78%. We found a positive predictive value of 50% and negative predicted value of 86% for Twin-to-Twin Transfusion Syndrome development if NT discordance was 20% or more. Conclusion: NT discordance of more than 20% in monochorionic diamniotic twins is associated with an increased risk for subsequent development of Twin-to-Twin Transfusion Syndrome, and with earlier presentation of symptoms.

Keywords

monochorionic diamniotic twin pregnaciesnuchal translucencyTwin-to-Twin Transfusion Syndrome
Type
Articles
Information
Twin Research and Human Genetics , Volume 12 , Issue 6 , 01 December 2009 , pp. 605 - 610
Copyright
Copyright © Cambridge University Press 2009