Clinical Research Directory

Inclusion Criteria: * Aged 18 years or more and able to consent. * Monochorionic Diamniotic twin pregnancy. * Discordant inter-twin cerebroplacental ratio at 16-20 weeks of gestation. Exclusion Criteria: * Fetal structural malformations or chromosomal abnormalities in any of the twins as detected by anomaly scan antenatally or neonatal examination postnatally (chromosomal abnormalities and some congenital malformations can interfere with normal fetal growth). * Identified infectious etiologies detected during immediate postnatal examination or during pregnancy (fetal infections can cause FGR ,usually symmetric type particularly if they occur in early gestation). * Referral after development of Twin to twin transfusion syndrome, twin anemia polycythemia sequence or selective fetal growth restriction. * Single fetal demise at the time enrollment in the study. * Conjoint twins.