Is computerized cardiotocography useful in monochorionic twins with selective intrauterine growth restriction?

Bertrang Warncke, Anouk; Zbären, Sibylle; Bolla, Daniele; Baumann, Marc; Mosimann, Beatrice; Surbek, Daniel; Baud, David; Raio, Luigi (2022). Is computerized cardiotocography useful in monochorionic twins with selective intrauterine growth restriction? The journal of maternal-fetal & neonatal medicine, 35(1), pp. 116-121. 10.1080/14767058.2020.1712708

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Objective: To assess the value of using computerized cardiotocography (cCTG) short-term variation (STV) for intrapartum monitoring in monochorionic twins (MC) complicated by selective intrauterine growth restriction (sIUGR).Material and methods: All available cCTGs retrieved from computerized medical records of MC with sIUGR were retrospectively studied regarding the behavior of the STV. sIUGR was defined as intertwin estimated fetal weight (EFW) discordance of ≥20% with the abdominal circumference (AC) below the fifth percentile and/or the EFW of the smaller twin below the 10th percentile. The sIUGR classification system proposed by Gratacos et al. was used using types I-III on the basis of umbilical artery Doppler characteristics of the IUGR twin. The admission (entry) STV and final pre-delivery (last) STV values were analyzed. Cases with intrauterine demise, with structural or chromosomal abnormalities, with twin anemia polycythemia sequence (TAPS) and/or twin-to-twin transfusion syndrome (TTTS) were excluded.Results: During the study period, 64 consecutive cases were managed within our department. Thirty-two cases fulfilled the inclusion criteria for analysis. Mean gestational age at assessment and at delivery was 28.4 ± 2.7 and 31.5 ± 2.2 weeks, respectively. The entry STV and last STV before delivery were not statistically different (mean IUGR STV entry: 9.3 ± 3.4 ms versus last 8 ± 2.2 ms; p = .051; mean co-twin STV entry: 9.1 ± 2.8 ms versus last 9.2 ± 3 ms; p = .87). Neither was the sIUGR-type adjusted STV.Conclusions: In MC pregnancies complicated by sIUGR, the cCTG STV does not distinguish between fetuses, nor does it show differences in cases of fetal deterioration monitored by conventional CTG.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
UniBE Contributor:	Bertrang Warncke, Anouk Marie, Zbären, Sibylle, Bolla, Daniele Maik, Baumann, Marc, Mosimann, Beatrice, Surbek, Daniel, Raio, Luigi
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1476-4954
Language:	English
Submitter:	Monika Zehr
Date Deposited:	13 Jan 2021 08:40
Last Modified:	05 Dec 2022 15:43
Publisher DOI:	10.1080/14767058.2020.1712708
PubMed ID:	31928265
Uncontrolled Keywords:	Computerized cardiotocography Doppler ultrasound monochorionic twins selective IUGR short-term variability
URI:	https://boris.unibe.ch/id/eprint/150134