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Objective The purpose of this study was to evaluate the association between the crown-rump length (CRL) difference in twin gestations and adverse pregnancy outcome. Study Design Women with a first trimester ultrasound scan of a twin pregnancy who delivered between June 2000 and March 2006 at Northwestern Memorial Hospital were identified. The association between the difference in CRLs and pregnancy outcomes was explored. Results For the 178 twins who were eligible for the study, the median difference in CRLs was 4.2% and the median difference in birthweights was 9.3%. Twins with a CRL difference of >85th percentile (11.1%) were more likely to have discordant birthweights and to have at least 1 of the pair be small-for-gestational age, be admitted to the special care nursery, and have perinatal morbidity. Conclusion CRL differences of >85th percentile are associated with several measures of adverse perinatal outcome.

Objective: To investigate feasibility of identifying the number of vessels in umbilical cord during nuchal translucency screening. Methods: We performed a prospective study in patients undergoing nuchal translucency screening at 11.0-13.9 weeks’ from 2011-2012. An oblique transverse view of fetal abdomen utilizing Doppler flow and a cross section view of free loop of umbilical cord were obtained. Maternal characteristics, technical aspects of first trimester ultrasound, and number of umbilical cord vessels identified in the second trimester were collected. McNemar’s test and kappa analysis were used to compare quantification of umbilical cord vessels in the first vs. second trimesters. Results: Total of 123 women were included. The number of umbilical cord vessels was successfully visualized in 95.9% of patients utilizing the bladder view, and 65.0% of patients on cross sectional cord views. Three-vessel cord was correctly identified in 99.2% of patients; one case was incorrectly diagnosed with a two two-vessel cord. McNemar’s test indicated that overall, first and second trimester ultrasounds have the same propensity to detect umbilical cord vessels (p=0.414), with moderate agreement (kappa=0.226). Conclusions: Identification of umbilical cord vasculature is possible in the first trimester and can be used as an adjunct to early fetal anatomy evaluation.

by anomalies, no increased risk of stillbirth, IUGR, NICU admission, or delivery 34 weeks was noted in the discordant group. CONCLUSION: Dichorionic pregnancies where a CRL discordance 11% is noted at the first ultrasound are at increased risk for SAB and fetal anomalies. However, patients can be reassured that, in the absence of structural anomalies, CRL discordance does not appear to be associated with other adverse outcomes in continuing pregnancies.