Evidence map›Paper›PMID 41808584›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2026

Risk of Placental Pathology Across Ultrasound-Defined Phenotypes of Impaired Fetal Growth in Dichorionic Twins: A Retrospective Cohort Study.

Ala Essalah, John Kingdom, Liran Hiersch, Jon Barrett, Megan Watson, Nir Melamed

Abstract read
In one paragraph

Article in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ala EssalahDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Center, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
John KingdomDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Liran HierschLis Maternity Hospital, Sourasky Medical Center, and Gray Faculty of Medical and Health Science, Tel Aviv University, Tel Aviv, Israel.ORCID https://orcid.org/0000-0003-4443-388X
Jon BarrettDepartment of Obstetrics and Gynaecology, McMaster University, Hamilton, Ontario, Canada.
Megan WatsonDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Center, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Nir MelamedDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Center, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-2704-1385

Funding

University of Toronto
6 · The paper itself

Abstract

objectiveTo determine the risk of placental dysfunction associated with different ultrasound-based phenotypes of impaired fetal growth in dichorionic twin pregnancies.

designRetrospective cohort study.

settingSingle tertiary centre. POPULATION: Patients with dichorionic twin pregnancies delivered at ≥ 32

methodsEach twin fetus was classified into a distinct exposure group based on combinations of fetal weight percentile (categorised as AGA, mild SGA, or severe SGA) based on singleton- or twin-specific growth chart, weight discordance and Doppler.

main outcome measuresAbnormal placental histopathology known to be associated with FGR.

resultsThe rate of the primary outcome in the reference group (AGA, concordant growth, normal Doppler) was 12.8%. When using a singleton chart, isolated discordance and mild SGA were not associated with the primary outcome. Only isolated severe SGA (28.8%, aRR 2.47[1.52-4.03]), followed by severe SGA with discordant growth (41.9%, aRR 3.53[2.15-5.79]) and abnormal Doppler (54.7%, aRR 4.33[2.90-6.48]) showed significant associations with the primary outcome. In contrast, when using a twin-specific chart, both isolated discordance (32.4%, aRR 2.63[1.46-4.73]) and mild SGA (28.2%, aRR 2.43[1.30-4.51]) were associated with the primary outcome. We propose three risk categories for late-onset placenta-mediated FGR based on the likelihood of the primary outcome: (1) possible small increase (< 2-fold); (2) moderate increase (2-3 fold); and (3) highest risk (> 4-fold).

conclusionThe risk categories proposed in the current study can serve as a framework to inform the design of future trials and contribute to the development of guidelines for managing twin pregnancies affected by late-onset FGR.

Indexed as

Fetal Growth RetardationPlacentaPlacenta DiseasesPregnancy, TwinUltrasonography, PrenatalAdultFemaleHumansInfant, NewbornInfant, Small for Gestational AgePhenotypePregnancyRetrospective StudiesTwins, DizygoticUltrasonography, DopplerdiscordancediscordantdopplerFGRgrowth chartsgrowth restrictionhistopathologyIUGRSGAtwin

Identifiers

PMID41808584
PMCPMC13254041

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.