{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:25:34Z","timestamp":1789244734348,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"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":[[2023,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the outcome of monochorionic diamniotic (MCDA) twins complicated by Type\u2010II selective fetal growth restriction (sFGR) who underwent fetoscopic laser photocoagulation and to validate a previously proposed subclassification system for Type\u2010II sFGR in a large multicenter cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective multicenter cohort study included all MCDA twins complicated by Type\u2010II sFGR who underwent laser photocoagulation of placental anastomoses at four large tertiary fetal\u2010care centers between 2006 and 2020. Cases were subclassified according to a recently proposed system based on Doppler evaluation of the ductus venosus (DV) and middle cerebral artery (MCA) into Type\u2010IIA (normal DV flow and MCA peak systolic velocity (PSV) of the growth\u2010restricted fetus) or Type\u2010IIB (absent or reversed flow in the DV during atrial contraction and\/or MCA\u2010PSV \u2265\u20091.5\u2009multiples of the median of the growth\u2010restricted fetus). Demographic characteristics and pregnancy outcomes were compared between the groups. Data are presented as mean\u2009\u00b1\u2009SD or <jats:italic>n<\/jats:italic> (%) as appropriate. <jats:italic>P<\/jats:italic>\u2010values &lt;\u20090.05 were considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 98 patients with MCDA twins met our inclusion criteria, with 56 subclassified as Type IIA and 42 as Type IIB. Demographic characteristics were similar between the groups; however, Type\u2010IIB cases had a significantly earlier gestational age at diagnosis and at laser surgery, as well as larger intertwin estimated fetal weight discordance, which may be a reflection of disease severity. Postnatal survival of the growth\u2010restricted fetus to 30\u2009days of age was significantly lower in Type\u2010IIB compared to Type\u2010IIA cases (23.8% <jats:italic>vs<\/jats:italic> 46.4%; <jats:italic>P<\/jats:italic>\u2009=\u20090.034).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In MCDA twins complicated by Type\u2010II sFGR and treated with laser photocoagulation of placental anastomoses, preoperative Doppler assessment of the DV and MCA helped identify a subset of patients at increased risk of demise of the growth\u2010restricted fetus following intervention. This study provides valuable information for guiding surgical management and patient counseling. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26165","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T08:53:34Z","timestamp":1674809614000},"page":"369-373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Outcome of laser photocoagulation in monochorionic diamniotic twin pregnancy complicated by <scp>Type\u2010II<\/scp> selective fetal growth restriction"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-7965","authenticated-orcid":false,"given":"A. A.","family":"Nassr","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Hessami","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8583-2054","authenticated-orcid":false,"given":"R.","family":"Corroenne","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Paris Descartes, Hopital Necker\u2013Enfants Malades  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0265-9859","authenticated-orcid":false,"given":"M.","family":"Sanz Cortes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Donepudi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9830-2212","authenticated-orcid":false,"given":"J.","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2013Fetal Medicine Osaka Medical Center and Research Institute for Maternal and Child Health  Izumi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Stirnemann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Paris Descartes, Hopital Necker\u2013Enfants Malades  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2013Fetal Medicine Osaka Medical Center and Research Institute for Maternal and Child Health  Izumi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7887-5737","authenticated-orcid":false,"given":"M. A.","family":"Belfort","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. H.","family":"Chmait","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Los Angeles Fetal Surgery, Keck School of Medicine University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. A.","family":"Shamshirsaz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"issue":"514","key":"e_1_2_7_2_1","first-page":"e1","article-title":"The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort study","volume":"199","author":"Lewi L","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4046"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21975"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822f129d"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2012-0133"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000253880"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000374109"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.116724"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4031"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12827"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2020.1745177"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15821"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21882"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1638902"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26165","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26165","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T20:25:23Z","timestamp":1693945523000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.26165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,30]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/uog.26165"],"URL":"https:\/\/doi.org\/10.1002\/uog.26165","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,30]]},"assertion":[{"value":"2022-10-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}