Randomized Clinical Trial: Expectant Management vs Laser Treatment of Monochorionic Twins With Severe Selective Intrauterine Growth Retardation and Absent or Reverse Diastolic Flow in the Umbilical Artery

Launched by UNIVERSITY OF SOUTH FLORIDA · Aug 6, 2010

Keywords

ClinConnect Summary

No description provided

Gender

FEMALE

Eligibility criteria

• Inclusion Criteria:
• • Gestational age 16--24 weeks
• • Sonographic evidence of monochorionicity: single placenta, same gender, absent twin-peak sign
• • Diagnosis of IUGR present in one twin (fetal weight at or below the 10th percentile for gestational age)
• • Persistent absent or reverse-end diastolic flow in the umbilical artery in the SIUGR twin
• • Able to provide written informed consent
• Exclusion Criteria:
• • Patients unwilling to participate in the study, provide consent, or to be followed up
• • Presence of twin-twin transfusion syndrome (TTTS) defined as a maximum vertical pocket (MVP) of ≤2 cm in one sac and MVP of ≥8 cm in the other sac.
• • Presence of major congenital anomalies (anencephaly, acardia, spina bifida) or intracranial findings in either twin: IVH, porencephalic cysts, ventriculomegaly or other findings suggestive of brain damage.
• • Both twins are \<10th percentile
• • Diastolic flow or intermittently absent end-diastolic flow in the umbilical artery in the SIUGR twin
• • Unbalanced chromosomal complement (if known).
• • Ruptured or detached membranes
• • Placental abruption
• • Chorioamnionitis
• • Triplets
• • Active labor
• • Jehovah's witness
• • Any other patient deemed inappropriate for the study by the principal investigator
• • Placenta previa

Trial Officials