Abstract
Placental insufficiency, twin-twin transfusion, or acute complications at birth can contribute to fetal hypoxia in twins. Our aim was to differentiate between acute and prolonged fetal hypoxia in these infants.
Patients: 50 sets of twins (24 - 38 weeks' gestation, 660 - 3200 g birth weight). 76 infants were appropriate (AGA; 10th - 90th centiles), 20 small (SGA; < 10th centile), and 4 large (> 90th centile) for gestational age. In 24 sets, the infants' birth weight differed > 10 %. 26 singleton AGA term newborns after uncomplicated pregnancy and delivery served as controls.
Methods: Umbilical arterial pH as marker for acute and umbilical venous erythropoietin concentration (EPO) at birth as marker for prolonged fetal hypoxia. Mann-Whitney-U test and Wilcoxon-Matched-Pairs-Signed-Ranks test.
Results: EPO did not significantly differ between the 1st and the 2nd twin, whereas pH was lower (p = 0.02) in the 2nd. In 17 weight-discordant sets, EPO was higher (p = 0.02) and in 18 sets pH was lower (p = 0.03) in the smaller twin. In SGA twins, EPO was higher (p < 0.05) than in AGA twins and in controls:
Conclusion: The 2nd twin is at risk for acute birth asphyxia. Growth retarded twins are at increased risk for prolonged fetal hypoxia.
Supported by Deutsche Forschungsgemeinschaft, SFB 174/A9
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Maier, R., Bialobrzeski, B., Günther, A. et al. 142 VARIOUS FORMS OF FETAL HYPOXIA IN TWIN PREGNANCIES. Pediatr Res 36, 26 (1994). https://doi.org/10.1203/00006450-199407000-00142
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DOI: https://doi.org/10.1203/00006450-199407000-00142