TY - JOUR
T1 - Esophageal atresia in twins compared to singletons
T2 - In utero manifestation and characteristics
AU - Weissbach, Tal
AU - Kassif, Eran
AU - Kushnir, Anya
AU - Shust-Barequet, Shir
AU - Leibovitch, Leah
AU - Eliasi, Elior
AU - Elkan-Miller, Tal
AU - Zajicek, Michal
AU - Yinon, Yoav
AU - Weisz, Boaz
N1 - Publisher Copyright:
© 2020 John Wiley & Sons Ltd
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Objective: Esophageal atresia with/without tracheo-esophageal fistula (EA/TEF) is more common among twins. The detection of polyhydramnios might be altered in twins, leading to EA/TEF underdiagnosis, prenatally. The aim of the study was to compare the prenatal manifestation of EA/TEF between twins and singletons. Methods: A 12-year study of EA/TEF cases was performed at a tertiary center. Cases exhibiting (a) small/absent stomach or (b) polyhydramnios were considered “suspected”; cases with (c) esophageal pouch were considered “detected.” We compared the rate and timing of appearance of these signs between the groups. Results: There were 76 cases of EA/TEF, of which 17 were a co-twin. All twin pairs were EA/TEF discordant. The prevalence of EA/TEF at our center was 1:750 for twins (1:319 monochorionic and 1:1133 dichorionic) and 1:2399 for singletons. The rate of small/absent stomach, polyhydramnios and pouch in twins vs singletons was 23.5%, 47.1%, 29.4% and 39.7%, 72.4%,34.5%, respectively (P =.2, P =.09 and P =.7). Esophageal pouch was detected earlier in twins (P =.03). Twins were scanned more frequently (×1.8 times, P =.01). Conclusion: EA/TEF is more prevalent in twins. Despite lower rate of polyhydramnios, twins were similarly detected prenatally as singletons, and this was accomplished earlier in pregnancy; perhaps reflecting more frequent scans.
AB - Objective: Esophageal atresia with/without tracheo-esophageal fistula (EA/TEF) is more common among twins. The detection of polyhydramnios might be altered in twins, leading to EA/TEF underdiagnosis, prenatally. The aim of the study was to compare the prenatal manifestation of EA/TEF between twins and singletons. Methods: A 12-year study of EA/TEF cases was performed at a tertiary center. Cases exhibiting (a) small/absent stomach or (b) polyhydramnios were considered “suspected”; cases with (c) esophageal pouch were considered “detected.” We compared the rate and timing of appearance of these signs between the groups. Results: There were 76 cases of EA/TEF, of which 17 were a co-twin. All twin pairs were EA/TEF discordant. The prevalence of EA/TEF at our center was 1:750 for twins (1:319 monochorionic and 1:1133 dichorionic) and 1:2399 for singletons. The rate of small/absent stomach, polyhydramnios and pouch in twins vs singletons was 23.5%, 47.1%, 29.4% and 39.7%, 72.4%,34.5%, respectively (P =.2, P =.09 and P =.7). Esophageal pouch was detected earlier in twins (P =.03). Twins were scanned more frequently (×1.8 times, P =.01). Conclusion: EA/TEF is more prevalent in twins. Despite lower rate of polyhydramnios, twins were similarly detected prenatally as singletons, and this was accomplished earlier in pregnancy; perhaps reflecting more frequent scans.
UR - http://www.scopus.com/inward/record.url?scp=85088990495&partnerID=8YFLogxK
U2 - 10.1002/pd.5785
DO - 10.1002/pd.5785
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C2 - 32652641
AN - SCOPUS:85088990495
SN - 0197-3851
VL - 40
SP - 1418
EP - 1425
JO - Prenatal Diagnosis
JF - Prenatal Diagnosis
IS - 11
ER -