Diagnostic accuracy, main causes and neonatal morbidity of the birth weight discordant monochorionic twins

Objectives: To analyze the ultrasonographic accuracy in predicting twin growth discordance, also to evaluate the anomalies of a placenta and umbilical cord and its possible effects on neonatal morbidity in discordant monochorionic twins. Methods: Retrospective study of 136 twins, that was conducted at the Hospital of Lithuanian University of Health Sciences, Kaunas Clinics, Department of Obstetrics and Gynecology. The clinical data was assessed during the period of January 2010 to December 2014. Twins were divided into 2 groups: discordant (intertwin birth weight difference >20%) and concordant (<20%) twins. Statistical analysis of the data was performed by SPSS 23.0 statistical package. Results: 27.9% twin pairs were identified as discordant. Birth weight discordance was associated with the lower gestational age (median–35 weeks, p<0,001), lower birth weight (median – 1990 g, p=0,01) and higher rates of Caesarean delivery (73.7%). The mean error of estimated fetal weight and actual birth weight discordance was 6.1%. Matching of the estimated fetal weight and actual birth weight discordance expressed as κ coefficient – 0,404 (40.4%, p-value <0.001). Matching of the crown – rump length and the actual birth weight discordance-67.4% (κ=0.674, p