
The present retrospective cohort study aimed to assess the accuracy of sonographic fetal weight estimation in twin pregnancies and its ability to predict actual birthweight and birthweight discordance. The study analyzed data from 2154 twin pregnancies at a single medical center from 2010 to 2021. Results showed a strong correlation between sonographic estimated fetal weights and actual birthweights for both presenting and non-presenting twins, as well as larger and smaller co-twins. However, there was a mean absolute error of 7.41% in sonographic estimated fetal weight, which was higher for non-presenting and smaller twins. Earlier gestational age at scanning, being the non-presenting or smaller co-twin, were independent risk factors for inaccuracies. Moreover, when the presenting twin was estimated to be the smaller co-twin, the rate of false positive birthweight discordance was higher. Overall, sonographic estimation of fetal weight accurately predicts birthweight in twin pregnancies, but accuracy is influenced by various factors.
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