{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:51:21Z","timestamp":1783072281972,"version":"3.54.6"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,8,4]],"date-time":"2014-08-04T00:00:00Z","timestamp":1407110400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2014,8]]},"abstract":"ABSTRACT<\/jats:title>Objective<\/jats:title>The aim of this systematic review was to explore the relationship between crown\u2013rump length (CRL<\/jats:styled-content>) discordance detected at 11\u201314\u2009weeks of gestation and adverse outcome in twin pregnancy and to assess its predictive accuracy.<\/jats:p><\/jats:sec>Methods<\/jats:title>A protocol designed a priori<\/jats:italic> following MOOSE<\/jats:styled-content> guidelines and recommended for systematic review and meta\u2010analysis was used. The outcomes observed were: total fetal and perinatal loss, fetal loss at <\u200924 weeks, fetal loss at \u2265\u200924\u2009weeks, birth\u2010weight (BW<\/jats:styled-content>) discordance, preterm delivery (PTD<\/jats:styled-content>) at <\u200934 weeks and fetal anomalies. The analysis was performed for all twins and for dichorionic (DC<\/jats:styled-content>) and monochorionic (MC<\/jats:styled-content>) twins separately.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 2008 articles were identified and 17 studies were included in the systematic review. Twin pregnancies with CRL<\/jats:styled-content> discordance \u2265\u200910% were at significantly higher risk of perinatal loss (RR<\/jats:styled-content>, 2.80; 95% CI<\/jats:styled-content>, 1.25\u22126.27; P<\/jats:italic>\u2009=\u20090.012), fetal loss at \u2265\u200924 weeks (RR<\/jats:styled-content>, 4.07; 95% CI<\/jats:styled-content>, 1.47\u221211.23; P<\/jats:italic>\u2009=\u20090.006), BW<\/jats:styled-content> discordance (RR<\/jats:styled-content>, 2.24; 95% CI<\/jats:styled-content>, 1.89\u20132.64; P<\/jats:italic>\u2009<\u20090.001) and PTD<\/jats:styled-content> at <\u200934 weeks (RR<\/jats:styled-content>, 1.49; 95% CI<\/jats:styled-content>, 1.23\u22121.80; P<\/jats:italic>\u2009<\u20090.001) but not of fetal loss at <\u200924\u2009weeks (P<\/jats:italic>\u2009= 0.130). A meta\u2010analysis of fetal anomalies was not possible because fewer than two studies explored this outcome. However, when used alone to screen for adverse pregnancy outcome, the predictive accuracy of CRL<\/jats:styled-content> discordance was low for each of the outcomes explored.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>CRL<\/jats:styled-content> discordance is associated with an increased risk of adverse pregnancy outcome. However, the accuracy of CRL<\/jats:styled-content> discordance in predicting adverse outcome is poor and thus limits its routine use in clinical practice. Copyright \u00a9 2014 ISUOG. Published by John Wiley & Sons Ltd<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13335","type":"journal-article","created":{"date-parts":[[2014,2,17]],"date-time":"2014-02-17T11:15:39Z","timestamp":1392635739000},"page":"138-146","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Crown\u2013rump length discordance and adverse perinatal outcome in twin pregnancies: systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"44","author":[{"given":"F.","family":"D'Antonio","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Division of Developmental Sciences St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Division of Developmental Sciences St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Pagani","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Division of Developmental Sciences St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. T.","family":"Papageorghiou","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Division of Developmental Sciences St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bhide","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Division of Developmental Sciences St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Division of Developmental Sciences St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,8,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5714"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.06.075"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12412"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12363"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.04.031"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.10.880"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.06.101"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/S0002-9378(03)00714-2"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2004.06.023"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2007.08.004"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1966"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.06.024"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6396"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2010.29.10.1439"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.13.4.389"},{"key":"e_1_2_5_17_1","first-page":"1224","article-title":"Crown\u2010rump length discordance in twins in the first trimester and its correlation with perinatal complications","volume":"16","author":"Shahshahan Z","year":"2011","journal-title":"J Res Med Sci"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12534"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11225"},{"key":"e_1_2_5_20_1","first-page":"110","article-title":"The first\u2010trimester growth\u2010discordant twin: an ominous prenatal finding","volume":"84","author":"Weissman A","year":"1994","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-12-200812160-00008"},{"key":"e_1_2_5_24_1","unstructured":"NHS Centre for Reviews and Dissemination.Systematic reviews: CRD's guidance for undertaking reviews in health care.York (UK):University of York;2009."},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det277"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(03)00177-X"},{"key":"e_1_2_5_29_1","unstructured":"HigginsJPT GreenS(editors).\u2009Cochrane Handbook for Systematic Reviews of Interventions\u2009Version 5.0.2 [updated September2009]. The Cochrane Collaboration 2009. Available from\u2009www.cochrane\u2010handbook.org."},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12430"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.766701"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2011-0250"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2010.09.375"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm.2011.047"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2739"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.4038\/cmj.v55i3.2291"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.005"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4006"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1802"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(92)91732-P"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00552-8"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12511"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.13335","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.13335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T15:12:56Z","timestamp":1696518776000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.13335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,8]]}},"alternative-id":["10.1002\/uog.13335"],"URL":"https:\/\/doi.org\/10.1002\/uog.13335","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8]]},"assertion":[{"value":"2013-11-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-01-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}