Triplet ultrasound growth parameters

Fetal Growth and Antenatal Testing in Uncomplicated Multiple Gestations

Multiple gestations experience a slowing of fetal growth in the third trimester and have been described as having a higher risk of growth restriction. Whether this increased diagnosis of fetal growth restriction is physiological or pathologic is controversial. In an attempt to better identify those fetuses most at risk, twin-specific growth charts have been developed and tested. In addition, there are data to suggest that multiple gestations experience an increased risk of unexpected third-trimester stillbirth in apparently uncomplicated pregnancies. This chapter reviews the current data and recommendations for fetal growth assessment, antenatal surveillance, and delivery timing in uncomplicated multiple gestations.

Long-term follow-up of 2 newborns with a combined birth weight of 540 grams

Long-term growth and developmental data are presented for the smallest and third smallest surviving newborns in the world literature to 5 and 20 years of age, respectively. Both patients exhibited normal motor and language development. Although head circumference for both newborns demonstrated catchup growth, significant differences in height and weight growth velocities persisted.

Comparison between singleton- and triplet-specific "growth" curves to detect growth restricted triplet infants

OBJECTIVE

To evaluate whether triplet- or singleton-specific growth standards should be used to define the growth restricted triplet fetus/neonate.

STUDY DESIGN

We retrospectively compared the predictive values of singleton vs. triplet-specific "growth" standards using the neonatal ponderal index as reference for growth restriction.

RESULTS

A ponderal index <1 SD from the mean was found in 356 (14.4%) of 2477 triplet infants. A total of 686 (27.7%) infants were small for gestational age (SGA) by singleton standards, but only 168 (6.8%) by triplet standards. After 31 weeks' gestation, triplet standards are significantly better associated with a low ponderal index (OR 2.0, 95% CI 1.1, 3.4 at 32 weeks to OR 4.1, 95% CI 2.8, 6.3 at 36-37 weeks), resulting in better positive predictive value and higher specificity of triplet standards in predicting a low ponderal index.

CONCLUSION

Triplet birth weight standards are better than singleton standards at >31 but not at < or =31 weeks' gestation in predicting a low neonatal ponderal index.