EP14.26: Outcome of monochorionic twin pregnancies complicated with selective intrauterine growth restriction

Selective intrauterine growth restriction (sIUGR) affects 10-15% of monochorionic (MC) pregnancies. Early severe forms are associated with high risk for intrauterine demise or neurological adverse outcome for both twins. The objective of our study was to analyse the outcome of these pregnancies managed at our centre. A retrospective study was performed at our tertiary referral centre by collecting cases managed for sIUGR between 2018-2022. Classification of the cases was based on the characteristics of umbilical artery Doppler of the growth restricted twin. The follow up focused on the monitoring of the fetal status, gestational age at delivery, birthweight discordance, perinatal mortality, neonatal death, neonatal morbidity including postnatal brain imaging, intraventricular hemorrhage, respiratory distress syndrome. Long term follow-up data of the newborns were collected up to 2 years. During this period 138 MC pregnancies could be identified and 12 of them were associated with selective IUGR. The composite adverse outcome was found to be the worst in the type II group. Cord occlusion of the growth restricted fetus was counselled only in one case with type II sIUGR, but finally the parents opted for expectant management. Our outcome results were consistent with the literature data and showed a strong association between the subtypes of sIUGR monochorionic twins and the perinatal outcome.