Selective fetal growth restriction in identical twins: from womb to adolescence

Groene, S.G. (2023)

Doctoral Thesis

In 70% of identical twin pregnancies, the twins share a single placenta in the womb that provides them with nutrients. This shared placenta can be unequaly shared. This means that one of the twins has a much smaller share of ​​the placenta compared to the other twin, resulting in a large growth discrepancy during pregnancy, also known as 'selective fetal growth restriction'. At birth, a large difference in birth weight ensues. Sometimes one twin can be almost twice the size of the other twin.
These twins are considered a vulnerable patient group in which perinatal complications are prevalent. Nevertheless, a large gap in knowledge persists, impeding proper parent counseling and risk assessment by health care providers. Simultaneously, these twins can also be considered a unique natural 'experiment' to uncover the early origins of health and disease following an adverse environment in the womb. The growth-restricted twin can be compared to a genetically identical, normally-grown twin who has been in the same womb of the same mother at the same time.
In this thesis, Sophie Groene has investigated the placental mechanisms and the short- and long-term outcomes of this special group of twins.

• Monochorionic twins
• Selective fetal growth restriction
• Identical twins
• Fetal growth restriction
• Early origins of disease

• All authors: Groene, S.G.
• Supervisor: Lopriore, E.; Heijmans, B.T.
• Co-supervisor: Klink, J.M.M. van
• Committee: Rings, E.H.H.M.; Lewi, L.; Counsell, S.; Roseboom, T.J.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2023-01-11
• ISBN (print): 9789464585858