PERINATOLOGIYA I PEDIATRIYA.2015.3(63):23-28; doi 10.15574/PP.2015.63.23 
 

Data analysis of ultrasound examination dichorionic diamniotic twins in high risk pregnant women 
 

Grebinichenko A. A.

SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS of Ukraine», Kyiv, Ukraine 
 

Objective: to analyze the frequency and structure of the disease diagnosed during the ultrasound examination dichorionic diamniotic twins in high risk pregnant women. 
 

Patients and methods. Complex prenatal examination during the multiple pregnancy was carried out on the basis of protocols ultrasound examination at different stages of pregnancy and data analysis of biochemical screening. In the I trimester was determined the number and location of fetal bladder, embryos, bile bags, evaluated concordant/discordant embryos dimensions, collar space. During the II and III trimester were found the number and arrangement of embryos, concordant/discordant of their size (by the expected mass, size of abdominal circumference) and gender, the number and location of the placenta, the place of location of umbilical cord the output structure of the amniotic membrane and amniotic fluid. According to the obtained data were determined chorionic, amniotic, the presence of non-specific and specific complications of multiple pregnancy. Also prenatal care plan was developed. According to the testimony were carried out invasive studies for the determination of the karyotype of one or both fetuses. Ultrasound examination was performed with the use of scanners «HDI 4000», ACCUVIX V20EX-EXP, ACCUVIX V10. 
 

Results. The percent part of dichorionic diamniotic twins among the women with specific and nonspecific fetal abnormalities were 44.6%. It is significantly lower (p<0.01) than in the group with normal development (63.3%). The frequency of congenital malformations of the fetus, diagnosed in such twins in high risk pregnant women with a spontaneous pregnancy rate was significantly higher than after in vitro fertilization in 1.8 times. A frequent complication in the examined dichorionic diamniotic twins was embryonic losses in the I trimester; under natural pregnancies present pathology is diagnosed significantly more often (28.7%) than after in vitro fertilization (12%), (j=2.618, p<0.01). Idiopathic delay in the growth of one of the fetus during the dichorionic diamniotic twins have been determined in the second trimester, its frequency in spontaneous pregnancy is 4.87%, after in vitro fertilization — 16% (j= 2.327, p<0.01). 
 

Conclusions. Ultrasound examination during the pregnancy with twins is an important part of prenatal monitoring, which allows to determine the type of placentation, to find pathology, to develop a plan of prenatal patient's conduction. 
 

Key words: congenital malformations, ultrasound examination, prenatal diagnosis, dichorionic diamniotic twins. 
 

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