You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is To say twin discordance the differences in the two twins should be : and explain in detail?
Ans. is c i.e. 25% with the larger twin as index Unequal sizes of twin fetuses with a difference of 25% (larger twin being used as the index), is called as Discordant growth. It is a sign of pathological growth restriction in the smaller fetus. As the weight difference within a twin pair increases and the earlier the growth discordance is evident, perinatal moality increases. Most common cause of discordance : In dichorionic twins - unequal placental mass. mr,nochnrinnic ftviriS - Twin - twin transfusion syndrome/Genetic syndrome Hazards of discordant growth. The smaller fetus is at increased risk of perinatal moality due to : Respiratory distress Intra ventricular hemorrhage - Seizure Sepsis - Periventricular leukomalacia Necrotising enterocolitis At a difference of more than 30% - Risk of fetal death increases. Extra Edge : Besides weight - other ultrasonographic parameters indicating discordance. Difference in Bipanetal diameter is 6 mm or more. - Difference in Head circumference is 5% or more. - Difference in Abdominal circumference is 20 mm or more. On colour doppler ultrasound in umbilical aeries systolic to diastolic (S/D) ratio difference -is 15% or more. but amongst all cnterias best is Fetal weight difference i.e. more than equal to 25deg Route of delivery : In case of discordant growth vaginal delivery is indicated if - Cervix is ripe - Presentation is veex / veex - Weight of smaller twin is > 1500gms