Placental plasticity in monochorionic twins: Impact on birth weight and placental weight

被引:9
作者
Baumann, Marc U. [1 ]
Marti, Michelle [1 ]
Durrer, Lukas [1 ]
Koumoutsakos, Petros [2 ]
Angelikopoulos, Panagiotis [2 ]
Bolla, Daniele [1 ]
Acharya, Ganesh [3 ]
Bichsel, Ursina [1 ]
Surbek, Daniel V. [1 ]
Raio, Luigi [1 ]
机构
[1] Univ Bern, Univ Hosp Bern, Dept Obstet & Gynecol, Inselspital, CH-3012 Bern, Switzerland
[2] ETH, Dept Mech & Proc Engn, Computat Sci & Engn Lab, CH-8092 Zurich, Switzerland
[3] Arctic Univ Norway, Univ Tromso, Fac Hlth Sci, Womens Hlth & Perinatol Res Grp,Dept Clin Med, N-9037 Tromso, Norway
关键词
Twin pregnancy; Monochorionic; Dichorionic; Birth weight; Placental weight; Fetal:placental ratio; Allometric metabolic scaling; GESTATIONAL-AGE; PREGNANCIES; RATIO; FETAL; MODEL;
D O I
10.1016/j.placenta.2015.07.120
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Introduction: The knowledge about adaptive mechanisms of monochorionic placentas to fulfill the demands of two instead of one fetus is largely speculative. The aim of our study was to investigate the impact of chorionicity on birth weight and placental weight in twin pregnancies. Methods: Forty Monochorionic (MC) and 43 dichorionic (DC) twin pregnancies were included in this retrospective study. Individual and total (sum of both twins) birth weights, placental weights ratios between placental and birth weights and observed-to-expected (O/E)-ratios were calculated and analyzed. Additionally, we investigated whether in twin pregnancies placental and birth weights follow the law of allometric metabolic scaling. Results: MC pregnancies showed higher placental O/E-ratios than DC ones (2.25 +/- 0.85 versus 1.66 +/- 0.61; p < 0.05), whereas the total neonatal birth weight O/E-ratios were not different. In DC twins total placental weights correlated significantly with gestational age (r = 0.74, p < 0.001), but not in MC twins. Analysis of deliveries <= 32 weeks revealed that the placenta to birth weight ratio in MC twins was higher than in matched DC twins (0.49 +/- 0.3 versus 024 +/- 0.03; p = 0.03). Allometric metabolic scaling revealed that dichorionic twin placentas scale with birth weight, while the monochorionic ones do not. Discussion: The weight of MC placentas compared to that of DC is not gestational age dependent in the third trimester. Therefore an early accelerated placental growth pattern has to be postulated which leads to an excess placental mass particularly below 32 weeks of gestation. The monochorionic twins do not follow allometric metabolic scaling principle making them more vulnerable to placental compromise. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1018 / 1023
页数:6
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