Cerebroplacental ratio discordance at 16–20 weeks to predict complications in monochorionic diamniotic twins
Official title: Role of Cerebroplacental Ratio Discordance at 16-20 Weeks in Predicting Monochorionic Twin Pregnancies' Specific Complications : a Prospective Cohort Study
Run by Ain Shams Maternity Hospital · NCT06935422 · Data updated 2026-11-12
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 |
|---|---|
| Sex | Women only |
| Enrollment | 55 (estimated) |
| Sponsor | Ain Shams Maternity Hospital Academic / other |
| Locations | 1 site (Cairo) |
| Status | Recruiting |
| Started | March 1, 2025 |
| Main results expected | August 1, 2026 |
| Study ends | September 15, 2026 |
| Registry record updated | September 5, 2025 |
| Trial ID | NCT06935422 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a 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.
✕Probably 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.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
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.
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 gone: 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.
Who can join: the full rules
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 it's running
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Ain shams maternity hospital
Cairo, Egypt Recruiting
Study contacts
- Study coordinator: Muhammed Ali Hassan, Assistant lecturer
- Email: muhammedali20191@yahoo.com
- Phone: +201020256117
Similar studies
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Placental characteristics in monochorionic twins
This project will see how placental anatomy relates to outcomes for families with monochorionic twins by analyzing placentas after birth at a Birmingham NHS site.
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.