{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:31:22Z","timestamp":1762918282721,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":2,"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":[[2022,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Little is known regarding fetal growth patterns in monochorionic twin pregnancy complicated by Type\u2010III selective fetal growth restriction (sFGR). We aimed to assess fetal growth and umbilical artery Doppler pattern in Type\u2010III sFGR across gestation and evaluate the effect of changing Doppler flow pattern on growth and intertwin growth discordance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of all Type\u2010III sFGR pregnancies managed at nine fetal centers over a 12\u2010year time period. Higher\u2010order multiple pregnancy and cases with major fetal anomaly or other monochorionicity\u2010related complications at presentation were excluded. Estimated fetal weight (EFW) was assessed on ultrasound for each twin pair at five timepoints (16\u201320, 21\u201324, 25\u201328, 29\u201332 and &gt;\u200932\u2009weeks' gestation) and compared with singleton and uncomplicated monochorionic twin EFW. EFW and intertwin EFW discordance were compared between pregnancies with normalization of umbilical artery Doppler of the smaller twin later in pregnancy and those with persistently abnormal Doppler.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 328 pregnancies (656 fetuses) met the study criteria. In Type\u2010III sFGR, the smaller twin had a lower EFW than an average singleton fetus (EFW <jats:italic>Z<\/jats:italic>\u2010score ranging from \u22121.52 at 16\u2009weeks to \u22122.69 at 36\u2009weeks) and an average monochorionic twin in uncomplicated pregnancy (<jats:italic>Z<\/jats:italic>\u2010score ranging from \u22121.73 at 16\u2009weeks to \u22121.49 at 36\u2009weeks) throughout the entire gestation, while the larger twin had a higher EFW than an average singleton fetus until 22\u2009weeks' gestation and was similar in EFW to an average uncomplicated monochorionic twin throughout gestation. As pregnancy advanced, growth velocity of both twins decreased, with the larger twin remaining appropriately grown and the smaller twin becoming more growth restricted. Intertwin EFW discordance remained stable throughout gestation. On multivariable longitudinal modeling, normalization of fetal umbilical artery Doppler was associated with better growth of the smaller twin (<jats:italic>P<\/jats:italic>\u2009=\u20090.002) but not the larger twin (<jats:italic>P<\/jats:italic>\u2009=\u20090.1), without affecting the intertwin growth discordance (<jats:italic>P<\/jats:italic>\u2009=\u20090.09).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Abnormal fetal growth of the smaller twin in Type\u2010III sFGR was evident early in pregnancy, while EFW of the larger twin remained normal throughout gestation. Normalization of umbilical artery Doppler was associated with improved fetal growth of the smaller twin. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23752","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T11:25:44Z","timestamp":1628508344000},"page":"371-376","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Growth patterns of monochorionic twin pregnancy complicated by <scp>Type\u2010III<\/scp> selective fetal growth restriction"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-4846","authenticated-orcid":false,"given":"S.","family":"Shinar","sequence":"first","affiliation":[{"name":"Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital University of Toronto  Toronto ON 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Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0702-370X","authenticated-orcid":false,"given":"Y.","family":"Yinon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3957-3810","authenticated-orcid":false,"given":"L.","family":"Raio","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Inselspital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9914-6496","authenticated-orcid":false,"given":"D.","family":"Baud","sequence":"additional","affiliation":[{"name":"Department of Woman\u2013Mother\u2013Child Lausanne University Hospital  Lausanne 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