RESUMO
The increased risks of various obstetric, maternal and fetal comorbidities of monochorionic twin pregnancies are widely known. However, despite its high prevalence and significance, the assessment of neurological morbidity as more commonly in selective fetal growth restriction (sFGR) is concerned with more health care. This literature review aims to provide more information about such an assessment. To this end, retrospective cases of sFGR were studied in monochorionic twins, already diagnosed, classified and who had the recommended management, published between 2001 and 2018 in 17 scientific articles. In the assessment of fetal mortality, the highest risk of death of the restricted fetus was found in type 3 of sFGR, while type 2 sFGR was responsible for the highest death rates of both fetuses and also the lowest mean gestational age at delivery, 30.9 weeks. Regarding neurological morbidity, however, studies have shown a higher risk of brain damage in the habitually growing twin compared to the restricted one in the case of sFGR. This may be due to prematurity or intermittent diastolic flow on Doppler in type 2 and 3 of sFGR, however, statements about its pathophysiology still lack further studies.
Assuntos
Retardo do Crescimento Fetal , Gravidez de Gêmeos , Feminino , Humanos , Gravidez , Retardo do Crescimento Fetal/epidemiologia , Retardo do Crescimento Fetal/diagnóstico , Morbidade , Estudos RetrospectivosRESUMO
Maternal age has increased significantly over the years and assisted reproduction techniques are becoming more available in less developed countries, contributing to the rising number of multiple gestations. Multiple pregnancy is associated with greater risk for both the mother and the fetus than a singleton pregnancy and needs well-trained professionals to assist and surveil its progression. This review aimed to describe the available evidence and summarize the current recommendations for fetal surveillance and delivery timing for monochorionic gestations. The information contained in this review aimed to improve prenatal care and management of monochorionic twin pregnancies, reducing complications and adverse perinatal outcomes.