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VP37.20: A new approach in management of fetal growth‐restricted pregnancy using daily interval fetal weight gain gms/day in third trimester

with growth restriction (FGR) and previously identified abnormal UAD. Methods: Retrospective cohort study of fetuses from twin pregnancies with FGR and absent end-diastolic flow (AEDF) on UAD in which ACS were given from November 2014 to October 2018 at a single centre. Monochorionic twin pregnancies with Twin–twin transfusion syndrome were excluded. Two twin pregnancies in the cohort had growth restriction of both fetuses and each fetus was treated as a separate subject. The cohort was divided into groups based on whether UAD performed within 7 days of ACS improved (return of diastolic flow), stayed the same (remained absent), or worsened (reversed end diastolic flow). Perinatal outcomes following ACS were analysed with ANOVA and Fisher’s exact test when appropriate. Results: There were 37 fetuses with FGR from 35 twin pregnancies (19 dichorionic-diamniotic, 15 monochorionic-diamniotic and 1 monochorionic-monoamniotic) during the study period. Following ACS, 21( 57%) of UAD improved and 16 (43%) were unchanged. Worsening of the UAD was not noted. No differences were noted in baseline maternal demographics or incidence of pre-existing maternal disease between groups. No difference in gestational age FGR diagnosis, ACS administration or delivery was noted. No perinatal deaths occurred in this cohort. Those with improved UAD were likely to have a higher birthweight (p = 0.002) and shorter NICU stay (p = 0.002). No other differences in perinatal outcomes following ACS were observed. Conclusions: Fetuses from twin pregnancies with AEDF on UAD that receive ACS have improvement in UAD 57% of the time that is associated with improved outcomes including shorter NICU duration and increased birthweight. Doppler response to ACS can assist with optimal antepartum management.