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Correlation between cord insertion type and chorionic villus vascularization of the co-twin in diamniotic-monochorionic twin pregnancies.

Abstract：

BACKGROUND:Recent evidence suggests that cord insertion type of one twin correlates with chorionic plate vascularization of the monochorionic co-twin. Specifically, for twins with paracentral cords, chorionic plate vascularization is significantly greater when the co-twin has a velamentous, rather than paracentral cord insertion. AIMS:To determine whether this correlation between cord insertion type and vascularization of the co-twin also extends to the deeper chorionic villus tree. STUDY DESIGN:Morphometric analysis of chorionic villus vascularization in CD31-immunostained sections of a retrospective cohort of gestational age-matched third trimester monochorionic placentas with discordant paracentral/velamentous (PC/V) or concordant paracentral/paracentral (PC/PC) cord insertions. OUTCOME MEASURES:Vascular numerical density (number of vascular profiles per unit villus stromal area) of intermediate villi (>80 μm diameter) and terminal villi (<80 μm). RESULTS:For twins with paracentral cord insertion, the vascular numerical density of intermediate villi was significantly higher for twins in a discordant PC/V relationship than for those in a concordant PC/PC relationship (P<0.05), thus replicating previous findings in superficial chorionic vessels. For terminal villi, in contrast, the vascular numerical density of twins with paracentral cords in a PC/V combination was significantly lower than of those in a PC/PC combination, and similar to that of their co-twins with velamentous cord insertion. CONCLUSIONS:Early placental angiogenesis in monochorionic twin gestations may be influenced by implantation and cord localization of the co-twin. The regulation of terminal villus angiogenesis appears to be dissociated from more proximal villus angiogenesis and independent of cord insertion of the co-twin.

journal_name

Early Hum Dev

journal_title

Early human development

authors

Chu S,Mao Q,Shapiro S,Luks SL,De Paepe ME

doi

10.1016/j.earlhumdev.2013.01.009

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

243-7

issue

4

eissn

0378-3782

issn

1872-6232

pii

S0378-3782(13)00018-2

journal_volume

89

pub_type

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