Abstract
As methods for identifying small-for-date fetuses in twin pregnancies, serial ultrasonic cephalometry and a new 2-stage ultrasound examination schedule were evaluated and compared. Serial cephalometry is associated with technical problems, and only 24 (56%) of 43 small-for-date fetuses in 66 retrospectively studied twin pregnancies showed detectably abnormal biparietal diameter growth. The 2-stage schedule comprises an accurate assessment of gestational age in early pregnancy, and determination of the product of the crown-rump length and trunk area at 34-36 wk; this identified all 15 small-for-date fetuses in 21 prospectively studied twin pregnancies, and the method offers several other advantages over serial cephalometry.

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