EP14.06: Natural conversion in selective fetal growth restriction at a tertiary hospital in Indonesia: a retrospective observational study

To evaluate the natural evolution for the adverse outcome of monochorionic twins with selective Fetal Growth Restriction (sFGR) under expectant management. A retrospective study was conducted in a Harapan Kita maternity and children hospital in Jakarta, Indonesia from January 2022 until December 2023. The clinical characteristics and neonatal outcomes of 11 patients with natural conversion subtype of sFGR under expectant management were evaluated. 239 twin pregnancies were referred to our hospital during 2 years period. Monochorionic twin accounted for 181 pregnancies and selective fetal growth restriction complicated 80 (44%) monochorionic pregnancies. Eleven patients (13.75%) showed a changed pattern in umbilical artery Doppler at the last examination. The rate of mortality of fetuses was higher in type 2 and the rate of severe neonatal complications in both fetuses was significantly higher in type 3. Different types of selective fetal growth restriction could convert to the other subtype. Therefore, the clinician should be aware of this phenomenon that would affect the outcomes.