Perinatal outcome of monochorionic twin pregnancy complicated by selective fetal growth restriction according to management: systematic review and meta‐analysis

What is it about?

Twins that share a placenta can be affected by selective growth restriction (sFGR) in the womb. Management of this condition is complex because of the need to balance risks to the affected twin with risks to the normally grown sibling. Current management options include close monitoring and delivery of both twins or invasive therapy (selective termination of the affected twin or using laser to close the blood vessels connecting the twins). We conducted a systematic review to identify studies comparing these different management strategies. We found that mild sFGR is usually associated with a good prognosis when managed expectantly. In more serious sFGR (Type 2 and 3), invasive treatment was associated with an increase in death but reduction in severe illness in surviving babies compared to expectant management. There were insufficient trials to make a recommendation for any one strategy.

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