Cerebroplacental ratio discordance at 16–20 weeks to predict complications in monochorionic diamniotic twins
Role of Cerebroplacental Ratio Discordance at 16-20 Weeks in Predicting Monochorionic Twin Pregnancies' Specific Complications : a Prospective Cohort Study
This study tests whether differences in cerebroplacental ratio between twins at 16–20 weeks can help predict TTTS, TAPS, selective fetal growth restriction, or fetal death in monochorionic diamniotic pregnancies.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 55 (estimated) |
| Sex | Female |
| Sponsor | Ain Shams Maternity Hospital Academic / other |
| Locations | 1 site (Cairo) |
| Trial ID | NCT06935422 on ClinicalTrials.gov |
What this trial studies
This is an observational cohort study that measures inter-twin cerebroplacental ratio (CPR) discordance by ultrasound at 16–20 weeks gestation in monochorionic diamniotic twin pregnancies. Participants with CPR discordance are followed through pregnancy for development of monochorionic-specific complications including twin-to-twin transfusion syndrome (TTTS), twin anemia polycythemia sequence (TAPS), selective fetal growth restriction (sFGR), and intrauterine fetal death (IUFD). Outcome rates in pregnancies with early CPR discordance will be compared to expectations to estimate predictive value. No experimental treatments are given and clinical care follows standard practice at the recruiting center.
Who should consider this trial
Good fit: Adults (age ≥18) with confirmed monochorionic diamniotic twin pregnancies and inter-twin CPR discordance at 16–20 weeks who can consent to follow-up at the site.
Not a fit: Patients with fetal structural or chromosomal abnormalities, infectious causes of growth restriction, single fetal demise at enrollment, conjoint twins, or who are referred after development of TTTS/TAPS/sFGR are unlikely to benefit from this predictive approach.
Why it matters
Potential benefit: If successful, early identification of CPR discordance could enable targeted surveillance and earlier interventions for high-risk monochorionic twin pregnancies, potentially reducing adverse outcomes.
How similar studies have performed: Sparse prior studies have suggested that early inter-twin Doppler differences can precede clinical TTTS, TAPS, or sFGR, but evidence is limited and larger confirmatory studies are lacking.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Aged 18 years or more and able to consent. * Monochorionic Diamniotic twin pregnancy. * Discordant inter-twin cerebroplacental ratio at 16-20 weeks of gestation. Exclusion Criteria: * Fetal structural malformations or chromosomal abnormalities in any of the twins as detected by anomaly scan antenatally or neonatal examination postnatally (chromosomal abnormalities and some congenital malformations can interfere with normal fetal growth). * Identified infectious etiologies detected during immediate postnatal examination or during pregnancy (fetal infections can cause FGR ,usually symmetric type particularly if they occur in early gestation). * Referral after development of Twin to twin transfusion syndrome, twin anemia polycythemia sequence or selective fetal growth restriction. * Single fetal demise at the time enrollment in the study. * Conjoint twins.
Where this trial is running
Cairo
- Ain shams maternity hospital — Cairo, Egypt (Recruiting)
Study contacts
- Study coordinator: Muhammed Ali Hassan, Assistant lecturer
- Email: muhammedali20191@yahoo.com
- Phone: +201020256117
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.