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Mcda twins

Jing Wu, Zhiming He, Yu Gao, Guanglan Zhang, Xuan Huang, Qun Fang
INTRODUCTION: Nuclear factor, erythroid 2 like 2 (NFE2L2) is an important transcription factor that protects cells from oxidative stress (OS). NFE2L2 deficiency in placentas is associated with pregnancy complications. We have demonstrated that elevated OS existed in placental shares of the smaller fetus in selective intrauterine growth restriction (sIUGR); however, the role of NFE2L2 in the development of sIUGR remains unknown. In this study, we examined the levels of NFE2L2 and heme oxygenase 1 (HMOX1), a major antioxidant regulated by NFE2L2, in sIUGR placentas...
April 25, 2017: Free Radical Research
Christoph Wohlmuth, David Boudreaux, Kenneth J Moise, Anthony Johnson, Ramesha Papanna, Michael Bebbington, Helena M Gardiner
OBJECTIVES: In twin-twin transfusion syndrome (TTTS) unbalanced transfer of vasoactive mediators and fluid from the 'donor' to the 'recipient' alters cardiovascular function. We evaluated cardiac function in 145 monochorionic-diamniotic (MCDA) pregnancies with and without TTTS. METHODS: Echocardiography was performed in uncomplicated MCDA, n = 26; TTTS stage I+II, n = 61; TTTS stage III+IV, n = 58, before selective fetoscopic laser photocoagulation (SFLP) in TTTS, and afterwards in 41 (34%) at a mean of 1...
March 31, 2017: Ultrasound in Obstetrics & Gynecology
Luming Sun, Jia Zhou, Kai Wang, Jian Wang, Ling Shang, Jianguang Zhang, Junqing Wu, David S Cram
Fetal growth discordance is a relatively common complication of monochorionic diamniotic (MCDA) twin pregnancies and is caused by a combination of maternal and placental factors. The aim of the study was to survey placental gene expression patterns and identify genes associated with growth discordance. Clinical samples comprised eight growth-discordant MCDA twin placentas (31+3-34+4 weeks gestational age) and six growth-concordant twin placentas (31+2-37 weeks gestational age). Gene expression libraries were constructed from placental biopsy samples and analyzed by RNA-sequencing...
April 2017: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Eric Jauniaux, Yaakov Melcer, Ron Maymon
BACKGROUND: Twin pregnancies are at higher risks of velamentous cord insertion and vasa previa. In vitro fertilization is an additional risk factor of abnormal cord insertion and thus the incidence of vasa previa is likely to increase over the next decades. OBJECTIVE: We sought to evaluate the role of ultrasound imaging in optimizing the management of twins diagnosed with vasa previa antenatally. STUDY DESIGN: We searched our database for twin pregnancies diagnosed with vasa previa and managed antenatally using measurements of cervical length and performed a systematic review of articles that correlated prenatal diagnosis of vasa previa in twins and pregnancy outcome...
January 30, 2017: American Journal of Obstetrics and Gynecology
Yaniv Zipori, Karen Reidy, T Gilchrist, Lex W Doyle, Mark P Umstad
BACKGROUND: Monochorionic diamniotic (MCDA) twin pregnancies are associated with adverse perinatal outcome. Intertwin discordances at the time of nuchal translucency (NT) screening may have a value in the prediction of fetal loss or twin-to-twin transfusion syndrome. We aimed to determine the ability of intertwin NT and crown rump length (CRL) discordances among MCDA twins to predict adverse outcomes. MATERIAL AND METHODS: All MCDA twins with a documented routine ultrasound at 11 to 13+6 weeks' gestation, and known pregnancy outcome between August 2003 and August 2012 were included...
December 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Y Wang, Y Wei, P B Yuan, X J Wang, Y Y Zhao
Objective: To analyze the prognosis of surviving monochorionic co-twin after single intrauterine fetal demise (sIUFD). Methods: Retrospectively analyzed the twin pregnancy cases admitted in Peking University Third Hospital between Jan 2008 and Feb 2015. We recorded perinatal characteristics, neuroimage in co-twin, and followed up the neonatal outcome. Results: 47 cases were found, including 45 cases of monochorionic diamniotic (MCDA) and 2 cases of monochorionic monoamniotic (MCMA). Median gestational age at sIUFD was 27 weeks...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Liran Hiersch, Mayan Eitan, Eran Ashwal, Boaz Weisz, Benny Chayen, Shlomo Lipitz, Yoav Yinon
OBJECTIVE: To estimate the risk for twin anemia-polycythemia sequence (TAPS) and adverse perinatal outcome in monochorionic diamniotic (MCDA) twin pregnancies with amniotic fluid discordance (AFD). METHODS: Retrospective cohort study of 34 MCDA pregnancies with AFD (intertwin difference of ≥3 cm in maximal vertical pocket measurement) without meeting the criteria for twin to twin transfusion syndrome or selective intrauterine growth restriction. Perinatal outcome measures and the risk for TAPS were compared with a control group consisted of 101 MCDA twin pregnancies without AFD, twin to twin transfusion syndrome, or selective intrauterine growth restriction...
December 2016: Prenatal Diagnosis
Oliver T Stirrup, Asma Khalil, Francesco D'Antonio, Baskaran Thilaganathan
INTRODUCTION: This study investigates patterns of intertwin size discordance in dichorionic diamniotic (DCDA) and monochorionic diamniotic (MCDA) twin pregnancies. MATERIAL AND METHODS: Ultrasound measurements of twin pregnancies, from 14 weeks to term, were collected by 9 hospitals over a 10-year period. This analysis considers the modelled and observed levels of discordance in abdominal circumference (AC) and estimated fetal weight (EFW) in relation to gestational age...
2017: Fetal Diagnosis and Therapy
Rebecca McDonald, Ryan Hodges, Michelle Knight, Mark Teoh, Andrew Edwards, Peter Neil, Euan M Wallace, Philip DeKoninck
INTRODUCTION: Monochorionic-diamniotic (MCDA) twin pregnancies are high risk, due to twin-to-twin transfusion syndrome (TTTS), twin anaemia polycythaemia sequence (TAPS) and intrauterine growth restriction (IUGR). There is limited evidence to guide ultrasound surveillance protocols. Using a retrospective cohort, we aimed to provide insight into the optimal interval of ultrasound surveillance. METHODS: Retrospective cohort of women with MCDA pregnancies who received antenatal care at Monash Medical Centre (January 2011-October 2014)...
2017: Fetal Diagnosis and Therapy
Hiroshi Kawamura, Keisuke Ishii, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Nobuaki Mitsuda
AIM: To evaluate the incidence of twin-twin transfusion syndrome (TTTS) and the perinatal outcome at 28 days of age in monochorionic diamniotic (MCDA) pregnancies complicated with isolated polyhydramnios (I-Poly) and isolated oligohydramnios (I-Oligo) diagnosed < 26 weeks of gestation. METHODS: This was a retrospective study of women with MCDA pregnancies diagnosed with I-Poly or I-Oligo before 26 weeks of gestation over a period of six years. The incidence of subsequent TTTS and neonatal outcome in terms of intact survival (IS) at 28 days of age were evaluated...
December 2016: Journal of Obstetrics and Gynaecology Research
Rebecca Fischbein, James Meeker, Julia R Saling, Michelle Chyatte, Lauren Nicholas
BACKGROUND: Twin-to-twin transfusion syndrome (TTTS) affects 10-20 % of monochorionic diamniotic (MCDA) births and accounts for 50 % of fetal loss in MCDA pregnancies. This exploratory qualitative study identified shared experiences, including potential emotional and psychosocial impacts, of this serious disease. METHODS: Forty-five publicly accessible, online stories posted by families who experienced TTTS were analyzed using grounded theory. RESULTS: Shared TTTS experiences included a common trajectory: early pregnancy experiences, diagnostic experiences, making decisions, interventions and variable outcomes...
2016: BMC Pregnancy and Childbirth
Ruan Peng, Yi Zhou, Hong-Ning Xie, Ju Zheng, Ying-Jun Xie, Jian-Bo Yang
OBJECTIVE: To evaluate whether discrepant copy number variations (CNVs) contribute to the risk for discordant congenital anomalies in monochorionic diamniotic (MCDA) twins. METHODS: We conducted a parallel testing using both G-banding for standard karyotyping and chromosomal microarray analysis (CMA) with Affymetrix CytoScan HD array in MCDA twins with discordant malformations. RESULTS: During the study period, 193 MCDA twins with discordant malformations were detected and followed up...
August 2016: Prenatal Diagnosis
Luming Sun, Gang Zou, Xing Wei, Yan Chen, Jun Zhang, Nanette Okun, Tao Duan
The chorionicity-based evaluation of the perinatal risk in twin pregnancies after assisted reproductive technology (ART) is lacking. A retrospective review was performed of all twin pregnancies monitored prenatally and delivered at our hospital between 2010 and 2014. Chorionicity was diagnosed by ultrasound examination at first trimester and confirmed by postnatal pathology. Pregnancy and perinatal outcomes were prospectively recorded. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated in a logistic regression model...
2016: Scientific Reports
Matthew M Finneran, Ryan Pickens, Megan Templin, Courtney D Stephenson
OBJECTIVE: To validate the efficacy of laser therapy for twin-twin transfusion syndrome (TTTS) in the treatment of recipient twin cardiomyopathy and investigate whether severity of preoperative cardiomyopathy can predict fetal survival postoperatively. STUDY DESIGN: Retrospective study of monochorionic-diamniotic (MCDA) pregnancies complicated by TTTS treated by selective fetoscopic laser photocoagulation (SFLP) performed between March 2010 and October 2014 at a single center...
May 26, 2016: Journal of Maternal-fetal & Neonatal Medicine
Isabella Wilson, Amanda Henry, Ellen Hinch, Neama Meriki, Daniel Challis, John Smoleniec, Alec William Welsh
OBJECTIVE: To audit immediate pregnancy and neonatal outcomes of selective laser photocoagulation of communicating vessels (SLPCV) for twin-twin transfusion syndrome (TTTS) at the New South Wales Fetal Therapy Centre. METHODS: Retrospective cohort study of 151 TTTS cases undergoing SLPCV between July 2003 and May 2013, evaluating procedural details, delivery and perinatal outcomes. RESULTS: The majority of cases were Stage III at SLPCV (56...
June 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Ellen Hinch, Amanda Henry, Isabella Wilson, Alec W Welsh
OBJECTIVES: To investigate rates of progression, regression and stabilisation and outcomes for stage I twin-twin transfusion syndrome (TTTS) and significant liquor discordant (LD) monochorionic diamniotic (MCDA) twins referred to the New South Wales Fetal Therapy Centre between June 2007 and May 2013. METHODS: Retrospective cohort study of 329 monochorionic referrals, of whom 47 had LD and 28 had stage I TTTS at presentation; 43 were stage I or higher at any time during surveillance...
June 2016: Prenatal Diagnosis
C Wohlmuth, F A Osei, K J Moise, I Wieser, A Johnson, R Papanna, M Bebbington, H M Gardiner
OBJECTIVES: To evaluate changes in ductus venosus (DV) waveforms and the timing of these changes in twin-twin transfusion syndrome (TTTS), to relate these to disease severity and to assess the clinical applicability of the suggested measurements in the prediction of TTTS. METHODS: DV time intervals and velocity-time integrals (VTI) normalized to cardiac cycle and total VTI, respectively, as well as velocity ratios were analyzed in 149 monochorionic diamniotic (MCDA) twin pairs...
December 2016: Ultrasound in Obstetrics & Gynecology
Rika Sugibayashi, Katsusuke Ozawa, Masahiro Sumie, Seiji Wada, Yushi Ito, Haruhiko Sago
OBJECTIVE: To report the pregnancy outcomes of patients with twin reversed arterial perfusion (TRAP) sequence treated by radiofrequency ablation (RFA). METHODS: This was a retrospective study of TRAP sequences treated in a single center between March 2002 and February 2015. Forty patients underwent RFA with expandable tines through a multistep coagulation method between 15 and 26 gestational weeks. The primary outcome was neonatal survival to discharge. RESULTS: The overall survival of the pump twin was 85%...
May 2016: Prenatal Diagnosis
Christoph Wohlmuth, Helena M Gardiner, Werner Diehl, Kurt Hecher
Twin-twin transfusion syndrome (TTTS) complicates 10-15% of monochorionic-diamniotic (MCDA) pregnancies. It originates from unbalanced transfer of fluid and vasoactive mediators from one twin to its co-twin via placental anastomoses. This results in hypovolemia in the donor and hypervolemia and vasoconstriction in the recipient twin. Consequently, the recipient demonstrates cardiovascular alterations including atrioventricular valve regurgitation, diastolic dysfunction, and pulmonary stenosis/atresia that do not necessarily correlate with Quintero-stages...
June 2016: Acta Obstetricia et Gynecologica Scandinavica
M Fishel-Bartal, B Weisz, S Mazaki-Tovi, E Ashwal, B Chayen, S Lipitz, Y Yinon
OBJECTIVE: The antenatal diagnosis of twin anemia-polycythemia sequence (TAPS) in monochorionic-diamniotic (MCDA) twin pregnancies is based on elevated peak systolic velocity in the middle cerebral artery (MCA-PSV) in the donor twin and decreased MCA-PSV in the recipient twin. However, the association between these parameters and polycythemia has not yet been established. The aim of this study was to determine whether MCA-PSV can predict polycythemia in MCDA pregnancies. METHODS: This was a prospective cohort study of MCDA pregnancies recruited at 14-18 weeks' gestation from a single tertiary care center between January 2011 and June 2014...
October 2016: Ultrasound in Obstetrics & Gynecology
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