{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T05:29:15Z","timestamp":1793338155412,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"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":["BJOG"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To review perinatal and neurodevelopmental outcome (NDO) following selective fetoscopic laser coagulation (SFLC), cord coagulation (CC) or expectant management of monochorionic diamniotic twin pregnancies complicated with selective intrauterine growth restriction (sIUGR) and absent or reverse end\u2010diastolic flow (AREDF) in the umbilical arteries (UA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Single\u2010centre retrospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>108 cases of sIUGR diagnosed before 26<jats:sup>+6<\/jats:sup>\u00a0weeks\u2019 gestation with AREDF in the UA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Survival rate and potential risk factors were analysed. NDO was assessed using parental questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcomes measures<\/jats:title><jats:p>Survival, gestational age at delivery and NDO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SFLC, CC and EM were performed in 13, 50 and 45 cases, respectively, with an overall survival of 23.1, 40 and 77.8% and intrauterine demise of the co\u2010twin of 30.8, 10 and 6.7% respectively. Intrauterine demise of the sIUGR twin occurred in 76.9 and 17.8% following SFLC and EM, respectively. The discordance in EFW at diagnosis was higher and absent\/negative a\u2010wave in the ductus venosus (DV) was more prevalent in the surgical groups. NDO in survivors at follow up was abnormal in 0 and 18% in the smaller twin following SFLC and EM, respectively, and in 25, 24 and 21% in the larger twin following SFLC, CC and EM, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SFLC yielded a poor result. EM seems a valid option when EFW discordance is &lt;30% and a\u2010wave in DV is positive. Otherwise, CC should be considered to protect the AGA co\u2010twin. The long\u2010term outcome of both small and large twins seems unaffected by the choice in primary prenatal management strategy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>In type II sIUGR in MC twins, long\u2010term neurodevelopment is normal in over 80% of the survivors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16318","type":"journal-article","created":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T21:55:35Z","timestamp":1589666135000},"page":"401-409","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Impact of different prenatal management strategies in short\u2010 and long\u2010term outcomes in monochorionic twin pregnancies with selective intrauterine growth restriction and abnormal flow velocity waveforms in the umbilical artery Doppler: a retrospective observational study of 108 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