{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:38:11Z","timestamp":1791437891746,"version":"4.3.3"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"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;amp; Gyne"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To report the outcome of selective fetal growth restriction (sFGR) diagnosed according to the new Delphi consensus definition, and determine potential predictors of survival, in a cohort of unselected monochorionic diamniotic twin pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective study of monochorionic diamniotic twin pregnancies followed from the first trimester onward, which were diagnosed with sFGR at 16, 20 or 30\u2009weeks' gestation. sFGR was defined according to the new Delphi consensus criteria as presence of either an estimated fetal weight (EFW) &lt;\u20093\n                      <jats:sup>rd<\/jats:sup>\n                      centile in one twin or at least two of the following: EFW of one twin &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      centile, abdominal circumference of one twin &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      centile, EFW discordance \u2265\u200925% or umbilical artery pulsatility index of the smaller twin &gt;\u200995\n                      <jats:sup>th<\/jats:sup>\n                      centile. The primary outcomes were the overall survival rate (up to day 28 after birth) and risk of loss of one or both twins. We further determined possible predictors of survival using uni\u2010 and multivariate generalized estimated equation modeling.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analyzed 675 pregnancies, of which 177 (26%) were diagnosed with sFGR at 16, 20 or 30\u2009weeks. The overall survival rate was 313\/354 (88%) with 146\/177 (82%) pregnancies resulting in survival of both twins, 21\/177 (12%) in survival of one twin and 10\/177 (6%) in loss of both twins. Subsequent twin anemia\u2013polycythemia sequence (TAPS) developed in 6\/177 (3%) and twin\u2013twin transfusion syndrome (TTTS) in 17\/177 (10%) pregnancies. All TAPS fetuses survived. The survival rate in sFGR pregnancies that subsequently developed TTTS was 65% (22\/34), compared with 91% (279\/308) in those with isolated sFGR (no subsequent TAPS or TTTS) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The majority of sFGR cases were Type I (110\/177 (62%)) and had a survival rate of 96% (212\/220), as compared with a survival of 55% (12\/22) in those with Type\u2010II (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 83% (55\/66) in those with Type\u2010III (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006) sFGR. The majority of sFGR pregnancies (130\/177 (73%)) were first diagnosed at 16 or 20\u2009weeks (early onset), with a survival rate of 85% (221\/260), as compared with a survival of 98% (92\/94) in sFGR first diagnosed at 30\u2009weeks (late onset) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04). A major anomaly in at least one twin was present in 28\/177 (16%) sFGR cases. In these pregnancies, survival was 39\/56 (70%), compared with 274\/298 (92%) in those without an anomaly (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Subsequent development of TTTS (odds ratio (OR), 0.18 (95%\u2009CI, 0.06\u20130.52)), Type\u2010II sFGR (OR, 0.06 (95%\u2009CI, 0.02\u20130.24)) and Type\u2010III sFGR (OR, 0.21 (95%\u2009CI, 0.07\u20130.60)) and presence of a major anomaly in at least one twin (OR, 0.12 (95%\u2009CI, 0.04\u20130.34)), but not gestational age at first diagnosis, were independently associated with decreased survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Isolated sFGR is associated with a 90% survival rate in monochorionic diamniotic twin pregnancies. The subsequent development of TTTS, absent or reversed end\u2010diastolic flow in the umbilical artery of the smaller twin and the presence of a major anomaly adversely affect survival in sFGR. Copyright \u00a9 2020 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.21975","type":"journal-article","created":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T13:23:52Z","timestamp":1579181032000},"page":"821-830","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Outcome of monochorionic twin pregnancy with selective fetal growth restriction at 16, 20 or 30\u2009weeks according to new Delphi consensus definition"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3002-7151","authenticated-orcid":false,"given":"I.","family":"Couck","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Hospitals Leuven  Leuven Belgium"},{"name":"Department of Development and Regeneration Biomedical Sciences, KU Leuven  Leuven 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