{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T07:01:52Z","timestamp":1781247712034,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2025,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To investigate the role of intertwin discordance in crown\u2013rump length (\u0394CRL) and nuchal translucency thickness (\u0394NT) in predicting twin\u2010to\u2010twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR) and composite adverse outcome in unselected monochorionic diamniotic (MCDA) twin pregnancy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n MCDA pregnancies that underwent first\u2010trimester screening ultrasound between January 2014 and January 2023 at the twin clinic in the Department of Obstetrics and Gynecology, ASST Spedali Civili of Brescia, Italy, were identified retrospectively from our fetal ultrasound database. From medical records, we extracted information on adverse outcome, defined as the development of TTTS, sIUGR or composite adverse outcome (one or more of: fetal loss, need for fetoscopic laser surgery, preterm delivery before 32\u2009weeks of gestation, low birth weight (<\u20093\n rd<\/jats:sup>\n percentile) and neonatal death). We compared the incidence of adverse outcomes between the group with and that without intertwin \u0394CRL\u2009\u2265\u200910% and between the group with and that without intertwin \u0394NT\u2009\u2265\u200920%. The ability of \u0394CRL and \u0394NT to predict pregnancy complications was examined using the area under the receiver\u2010operating\u2010characteristics curve (AUC).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study included 177 unselected MCDA twin pregnancies. Of these, 20.9% developed sIUGR, 15.8% developed TTTS and 36.2% had the composite adverse outcome. Furthermore, 36.7% had \u0394NT\u2009\u2265\u200920% and 11.3% had \u0394CRL\u2009\u2265\u200910%. Compared to pregnancies with \u0394NT\u2009<\u200920%, those with \u0394NT\u2009\u2265\u200920% had a significantly higher incidence of TTTS (9.8%\n vs<\/jats:italic>\n 26.2%;\n P<\/jats:italic>\n \u2009=\u20090.004) and composite adverse outcome (30.4%\n vs<\/jats:italic>\n 46.2%;\n P<\/jats:italic>\n \u2009=\u20090.035), but there was no difference in their incidence of sIUGR (17.9%\n vs<\/jats:italic>\n 26.2%;\n P<\/jats:italic>\n \u2009=\u20090.191). The AUC for the performance of \u0394NT in the prediction of TTTS was 0.647 (95%\u2009CI, 0.530\u20130.763) and that for composite adverse outcome was 0.595 (95%\u2009CI, 0.510\u20130.681). Compared to MCDA pregnancies with \u0394CRL\u2009<\u200910%, those with \u0394CRL\u2009\u2265\u200910% demonstrated a significantly higher incidence of sIUGR (17.2%\n vs<\/jats:italic>\n 50.0%;\n P<\/jats:italic>\n \u2009=\u20090.001), but there was no difference in their incidence of TTTS (15.9%\n vs<\/jats:italic>\n 15.0%;\n P<\/jats:italic>\n \u2009=\u20090.915) or composite adverse outcome (35.0%\n vs<\/jats:italic>\n 45.0%;\n P<\/jats:italic>\n \u2009=\u20090.382). The AUC for the performance of \u0394CRL in the prediction of sIUGR was 0.595 (95%\u2009CI, 0.479\u20130.710).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In MCDA pregnancies, \u0394NT\u2009\u2265\u200920% is associated with increased risk of TTTS and composite adverse outcome, and \u0394CRL\u2009\u2265\u200910% is associated with increased risk of sIUGR. However, their predictive value is too low to warrant changes in clinical practice. \u00a9 2025 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.29229","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T14:13:51Z","timestamp":1745676831000},"page":"723-728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["First\u2010trimester ultrasound markers for prediction of adverse outcome in monochorionic diamniotic twin pregnancy"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6829-2849","authenticated-orcid":false,"given":"C.","family":"Pedretti","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology ASST Spedali Civili of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0417-1793","authenticated-orcid":false,"given":"N.","family":"Fratelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology ASST Spedali Civili of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0174-9756","authenticated-orcid":false,"given":"R.","family":"Orabona","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology ASST Spedali Civili of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Monaci","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. Di","family":"Stasio","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-714X","authenticated-orcid":false,"given":"F.","family":"Prefumo","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, IRCCS Istituto Giannina Gaslini Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8870-4739","authenticated-orcid":false,"given":"F. E.","family":"Odicino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7368-0823","authenticated-orcid":false,"given":"A.","family":"Fichera","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000313300"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01556.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.09.025"},{"issue":"2","key":"e_1_2_6_5_1","first-page":"107","article-title":"Twin\u2010to\u2010twin transfusion syndrome (TTTS)","volume":"39","author":"Baschat A","year":"2011","journal-title":"J Perinat Med"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000326"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20114"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822f129d"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.29166"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2010.09.375"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4006"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.005"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.12.6.605"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03250.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15989"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.05.008"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.2314"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19013"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4046"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61490-2"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13335"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2023.2184223"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2023-0132"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12430"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.29229","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.29229","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.29229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:29:22Z","timestamp":1781245762000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.29229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,26]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/uog.29229"],"URL":"https:\/\/doi.org\/10.1002\/uog.29229","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,26]]},"assertion":[{"value":"2024-08-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}