CLINICS

Clinics (Sao Paulo). 2017 May; 72(5): 265-271.
doi:10.6061/clinics/2017(05)02

Copyright © 2017 CLINICS

Placental weight and birth weight to placental weight ratio in monochorionic and dichorionic growth-restricted and non-growth-restricted twins

Mariângela Alves Souza I , Maria de Lourdes Brizot I * , Sckarlet Ernandes Biancolin I , Regina Schultz II , Mário Henrique Burlacchini de Carvalho I , Rossana Pulcineli Vieira Francisco I , Marcelo Zugaib I

Departamento de Ginecologia e Obstetricia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR

Departamento de Patologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, BR

*Corresponding author. E-mail: mlbrizot@uol.com.br

received November 23, 2016; revised December 5, 2016; accepted December 20, 2016.

Abstract

OBJECTIVE:

The aim of the present study was to compare the placental weight and birth weight/placental weight ratio for intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins.

METHODS:

This was a retrospective analysis of placentas from twin pregnancies. Placental weight and the birth weight/placental weight ratio were compared in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. The association between cord insertion type and placental lesions in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins was also investigated.

RESULTS:

A total of 105 monochorionic (intrauterine growth restriction=40; non-intrauterine growth restriction=65) and 219 dichorionic (intrauterine growth restriction=57; non-intrauterine growth restriction=162) placentas were analyzed. A significantly lower placental weight was observed in intrauterine growth-restricted monochorionic (p=0.022) and dichorionic (p<0.001) twins compared to non-intrauterine growth-restricted twins. There was no difference in the birth weight/placental weight ratio between the intrauterine growth restriction and non-intrauterine growth restriction groups for either monochorionic (p=0.36) or dichorionic (p=0.68) twins. Placental weight and the birth weight/placental weight ratio were not associated with cord insertion type or with placental lesions.

CONCLUSION:

Low placental weight, and consequently reduced functional mass, appears to be involved in fetal growth restriction in monochorionic and dichorionic twins. The mechanism by which low placental weight influences the birth weight/placental weight ratio in intrauterine growth-restricted monochorionic and dichorionic twins needs to be determined in larger prospective studies.

Keywords: Twin Pregnancy, Placental Pathology, Placental Weight, Birth Weight/Placental Weight Ratio, Monochorionic Twin, Growth Restriction


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