{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:38:26Z","timestamp":1791437906296,"version":"4.3.3"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T00:00:00Z","timestamp":1585872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the natural history and outcome of selective fetal growth restriction (sFGR) in monochorionic diamniotic (MCDA) twin pregnancy, according to gestational age at onset and various reported diagnostic criteria, and to quantify the risk of superimposed twin\u2010to\u2010twin transfusion syndrome (TTTS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a cohort study of MCDA twin pregnancies that had their routine antenatal care from the first trimester at St George's Hospital, London, UK. Pregnancies had ultrasound examinations every 2\u2009weeks at 16\u201324\u2009weeks and then every 2\u20133\u2009weeks until delivery. The diagnostic criteria for sFGR were estimated fetal weight (EFW) of one twin &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      centile and intertwin EFW discordance \u2265\u200925%. We also applied other diagnostic criteria reported in a recent Delphi consensus. Pregnancies in which the diagnosis of TTTS was made before that of sFGR were not included in the analysis. Pregnancies that underwent fetal intervention for sFGR were excluded. The incidence of sFGR was compared between the different diagnostic criteria, overall and according to gestational age at onset. In all subsequent analyses, cases of sFGR included those diagnosed according to any of the criteria. The Gratac\u00f3s classification of sFGR was applied (Type\u2009I, II or III). Pregnancy outcomes included miscarriage, intrauterine death, neonatal death and admission to the neonatal unit. Comparisons between groups were carried out using the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      \u2010test for continuous variables and the chi\u2010square or Fisher's exact test for categorical variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis included 287 MCDA twin pregnancies. According to the International Society of Ultrasound in Obstetrics and Gynecology diagnostic criteria, the incidence of early (&lt;\u200924\u2009weeks) sFGR was 4.9%, while that of late sFGR was 3.8%. When applying the various diagnostic criteria, the incidence of early sFGR varied from 1.7% to 9.1% and that of late sFGR varied from 1.1% to 5.9%. In early\u2010onset cases, the incidence of Type\u2009I sFGR was 80.8%, that of Type\u2009II was 15.4% and that of Type\u2009III was 3.8%. The corresponding figures in late\u2010onset cases were 94.4%, 5.6% and 0%. The incidence of superimposed TTTS was 26.9% in cases affected by early\u2010onset sFGR and 5.6% in those affected by late\u2010onset sFGR. The incidence of perinatal death was 8.0% in early\u2010onset sFGR and 5.6% in late\u2010onset sFGR (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.661). Admission to the neonatal unit occurred in 61.0% and 52.9% of cases, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.484).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In MCDA twin pregnancies, early\u2010onset sFGR is slightly more common than is late\u2010onset sFGR, although this difference was not significant, and is associated with worse perinatal outcome. The incidence of Types\u2009II and III sFGR is higher in early\u2010onset sFGR. The incidence also varies according to the diagnostic criteria used, which supports the use of standardized international diagnostic criteria. Superimposed TTTS is more common in early\u2010 than in late\u2010onset \nsFGR. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.20849","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T01:29:41Z","timestamp":1566350981000},"page":"661-666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Early\u2010 and late\u2010onset selective fetal growth restriction in monochorionic diamniotic twin pregnancy: natural history and diagnostic criteria"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2477-5479","authenticated-orcid":false,"given":"J.","family":"Curado","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7380-0576","authenticated-orcid":false,"given":"F.","family":"Sileo","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2393-7501","authenticated-orcid":false,"given":"A.","family":"Bhide","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-4301","authenticated-orcid":false,"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20093"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20114"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15821"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318292766b"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4353"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318160d65d"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.03.003"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000313300"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2010.07.002"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4298"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4046"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000326"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17362"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2536"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.022"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19013"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(77)90058-8"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14640"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2017.05.001"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.09.025"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19078"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.77.3.F235"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.116724"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19192"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20107"}],"container-title":["Ultrasound in Obstetrics &amp; 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