{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:08:52Z","timestamp":1649117332630},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to identify differences in sequential integrated screening and early ultrasound markers in monochorionic\/diamniotic (MC\/DA) pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) and unequal placental sharing (UPS).<\/jats:p><jats:p>\n            Study Design\u2003Retrospective cohort study of MC\/DA pregnancies evaluated between January 2012 and July 2017 at the University of California San Francisco. MC\/DA pregnancies with ultrasound surveillance up to 26 weeks who participated in the California Prenatal Screening Program (CPSP) were included. Pregnancies with structural or genetic anomalies were excluded. UPS was defined as an intertwin growth discordance \u226520%. Intertwin nuchal translucency (NT) discordance was calculated by the absolute value of the difference of the NT of cotwins. Kruskal\u2013Wallis or ANOVA testing was performed where appropriate, and negative binomial regression models were chosen to test for differences in mean biomarker levels by outcome group.<\/jats:p><jats:p>\n            Results\u2003A total of 191 MC\/DA pregnancies were included; 85 were affected by TTTS, 35 by UPS, and 71 controls. Significant differences in intertwin NT discordance in pregnancies complicated by TTTS and UPS compared with controls (p\u2009=\u20090.007) were found. TTTS cases had a mean NT discordance greater than two times that of controls (p\u2009=\u20090.04), while UPS cases had a value more than three times greater (p\u2009=\u20090.003). There was a statistically significant difference in mean second trimester human chorionic gonadotropin (hCG) between the cohorts (p\u2009=\u20090.0002) with TTTS cases having a mean second trimester hCG value 1.5 greater than both controls (p\u2009&lt;\u20090.001) and UPS cases (p\u2009=\u20090.001). Analysis showed a significant difference in mean second trimester inhibin between the three cohorts (p\u2009=\u20090.029). Pregnancies complicated by UPS had a mean second trimester inhibin 1.5 times greater than controls (p\u2009=\u20090.010).<\/jats:p><jats:p>\n            Conclusion\u2003Our study shows that there are unique differences in early ultrasound and sequential integrated serum markers between MC\/DA gestations complicated by TTTS and UPS versus those unaffected.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1718371","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T22:38:44Z","timestamp":1602196724000},"page":"421-427","source":"Crossref","is-referenced-by-count":0,"title":["The Use of Sequential Integrated Screening to Stratify Risk in Monochorionic-Diamniotic Twin Pregnancies"],"prefix":"10.1055","volume":"38","author":[{"given":"Edward","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cinthia","family":"Blat","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Gosnell","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neda","family":"Ghaffari","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,10,8]]},"reference":[{"key":"ref1","volume-title":"Twin Pregnancy: Prenatal Issues, in Up to Date","author":"T Chasen","year":"2018"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.bpobgyn.2013.12.002","article-title":"Diagnosis of twin-to-twin transfusion syndrome, selective fetal growth restriction, twin anaemia-polycythaemia sequence, and twin reversed arterial perfusion sequence","volume":"28","author":"M Sueters","year":"2014","journal-title":"Best Pract Res Clin Obstet 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