Role of Cerebroplacental Ratio Discordance at 16-20 Weeks in Predicting Monochorionic Twin Pregnancies' Specific Complications

Active, not recruiting

• Conditions: Monochorionic Twins; Cerebroplacental Ratio

• Registration Number: NCT06935422
• Lead Sponsor: Ain Shams Maternity Hospital

Brief Summary

The purpose of this study is to evaluate the predictive value of CPR discordance at 16-20 weeks in MCDA twin pregnancies in predicting monochorionic-specific complications such as TTTS, TAPS, sFGR and IUFD of one or both fetuses

Detailed Description

Monochorionic (MC) twin pregnancies are at a higher risk of perinatal morbidity and mortality because of the risk of developing unique complications. These include twin to twin transfusion syndrome (TTTS), selective fetal growth restriction (sFGR) , twin anemia polycythemia sequence (TAPS) and intrauterine fetal death (IUFD) of one or both fetuses. Therefore, early identification of these conditions is warranted to plan proper perinatal surveillance and management to improve outcome.

Sparse studies have found that inter-twin differences in Doppler ultrasound may occur prior to meeting diagnostic criteria for TTTS, TAPS, sFGR or adverse perinatal outcomes.

This study will try to reveal the potential clinical predictive value of inter-twin cerebroplacental ratio (CPR) discordance in the surveillance of MC twin pregnancies.

Study Timeline

• Study Start: 2025-03-01
• Study First Submitted: 2025-03-12
• Status Verified: 2025-04
• Study First Submitted QC: 2025-04-11
• Last Update Submitted: 2025-04-11
• Study First Posted: 2025-04-20
• Last Update Posted: 2025-04-20
• Primary Completion: 2026-08-01
• Study Completion: 2026-09-15

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: Female
• Target Recruitment: 55

Inclusion Criteria

• Aged 18 years or more and able to consent.
• Monochorionic Diamniotic twin pregnancy.
• Discordant inter-twin cerebroplacental ratio at 16-20 weeks of gestation.

Exclusion Criteria

• Fetal structural malformations or chromosomal abnormalities in any of the twins as detected by anomaly scan antenatally or neonatal examination postnatally (chromosomal abnormalities and some congenital malformations can interfere with normal fetal growth).
• Identified infectious etiologies detected during immediate postnatal examination or during pregnancy (fetal infections can cause FGR ,usually symmetric type particularly if they occur in early gestation).
• Referral after development of twin to twin transfusion syndrome, twin anemia polycythemia sequence or selective fetal growth restriction.
• Single fetal demise at the time enrollment in the study.
• Conjoint twins.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Development of monochorionic specific complications	From 16-20 weeks of gestation till delivery.	Monochorionic specific complications include twin to twin transfusion syndrome, twin anemia polycythemia sequence and selective fetal growth restriction

Secondary Outcome Measures

Name	Time	Method
Occurrence of intrauterine fetal death or perinatal mortality of one or both fetuses	From 16-20 weeks of gestation till 7th day of life	Gestational age upon occurrence of IUFD with clarifying if complications occur in the surviving twin in case of single fetal demise. Time and reason of perinatal mortality for any of the fetuses Wil be recorded.

Trial Locations

Locations (1)

Ain shams maternity hospital; 🇪🇬 Cairo, Egypt