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Twin separate placenta

M M McCarthy, M W Overton
The objective of this research was to determine the effect of disease misclassification on the estimated effect of metritis on milk production. Misclassification introduces bias that usually results in an underestimation of the association between exposure (disease) and the outcome of interest (milk production). This distorted measure of association results from the comparison of an affected population (some of which may not truly be affected) to a nonaffected population (which often includes affected subjects that are unidentified)...
March 14, 2018: Journal of Dairy Science
Jing Lu, Yvonne Kwun Yue Cheng, Yuen Ha Ting, Kwok Ming Law, Tak Yeung Leung
Accurate diagnosis of chorioamnionicity in multiple pregnancies is the key to appropriate clinical management of multiple gestation. Although prenatal ultrasound assessment of chorioamnionicity is well established and highly accurate if performed in early pregnancy, exceptions and artifacts arise from anatomic variations in multiple pregnancies and unusual sonographic features do exist. We have summarized our own experiences and reports from the literature on these pitfalls as follows: (1) discordant fetal sex in monochorionic pregnancies due to sex chromosome abnormalities, genital malformation in 1 fetus, or dizygotic twins forming a monochorionic placenta; (2) separate placental masses in monochorionic pregnancies due to bipartite placenta; (3) false-negative and false-positive λ sign can arise for various reasons, and in partial monochorionic/dichorionic placentas both T and λ sign may co-exist; (4) intrauterine synechia appearing as a thick and echogenic intrauterine septum may lead to erroneous diagnosis of dichorionic twins; and (5) errors in ascertaining amnionicity by the visualization of thin intertwin amniotic membranes and the number of yolk sacs...
February 17, 2018: American Journal of Obstetrics and Gynecology
Johanna Savage, Emily Adams, Emanuela Veras, Kathleen M Murphy, Brigitte M Ronnett
Choriocarcinoma is an uncommon malignant neoplasm, which can be either gestational or nongestational in origin. Distinction of these subtypes has prognostic and therapeutic implications. Twenty-two tumors were genotyped using polymerase chain reaction amplification of 15 short tandem repeat loci and the amelogenin locus (XY determination). DNA patterns from tumor and maternal tissue, as well as villous tissue from any available prior or concurrent gestation, were compared, to determine gestational versus nongestational nature (containing vs...
December 2017: American Journal of Surgical Pathology
C Anthoulakis, T Dagklis, A Mamopoulos, A Athanasiadis
STUDY QUESTION: Is pregnancy outcome in triplet pregnancies improved with embryo reduction (ER) to twins compared to expectant management? SUMMARY ANSWER: In trichorionic triplet pregnancies, ER to twins reduces the risk of preterm birth (<34 weeks) without significantly increasing the risk of miscarriage (<24 weeks), whereas in dichorionic triplet pregnancies, the results are inconclusive. WHAT IS KNOWN ALREADY: Triplet pregnancies are associated with a high risk of miscarriage and preterm birth...
June 1, 2017: Human Reproduction
Sunita Dubey, Meesha Verma, Poonam Goel, Rps Punia
Acardiac twinning or Twin Reverse Arterial Perfusion (TRAP)-sequence is a rare complication of monochorionic twin pregnancy. Whether to start elective or therapeutic treatment in TRAP-sequence is still controversial. In the present case, acardiac twin was not diagnosed till her delivery at 39 weeks. A healthy baby weighing 2.45 kg was delivered along with another amorphous mass (acardiac twin) of about 150 g which was attached to the placenta with a short and separate cord. As outcome of normal twin vary according to the growth of acardiac twin, frequent follow-up of the normal twin is required to look for the features of heart failure...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
Wassihun Nega, Meku Damte, Yonas Girma, Getachew Desta, Mengistu Hailemariam
BACKGROUND: Craniopagus parasiticus is rare with an incidence of approximately four to six cases in 10,000,000 births. In our case, the head of the parasitic twin protruded from the temporal area of the normal twin's cranium. The parasitic twin had two deformed lower limbs, of which one was rudimentary, and long bones of the bilateral lower limbs and some pelvic bone. Dissection of the mass of the parasitic twin's body revealed the intestine but no chest organs or abdominal organs. There was a rudimentary labium but no vaginal opening...
December 1, 2016: Journal of Medical Case Reports
C Urhausen, K Wolf, A Beineke, C Dierks, M Schmicke, A Einspanier, A R Günzel-Apel
A 6.5-year-old clinically healthy German Shepherd Dog with regular oestrous cycles of 6 months was presented for pregnancy diagnosis on day 38 after ovulation (p.ov.). Ultrasonography revealed three individual placental sites in progressed resorption and two vital adequately developed foetuses sharing a joint placenta. On days 41 and 48 p.ov., sonographic signs indicated normal development of both foetuses, but on day 52 p.ov., both foetuses were found to be dead. A caesarean section was performed the same day...
February 2017: Reproduction in Domestic Animals, Zuchthygiene
Shiri Shinar, Michael Shenhav, Sharon Maslovitz, Ariel Many
Introduction The aim of our study was to demonstrate the distribution of an uncomplicated third stage and to determine the optimal time for manual intervention. Risk factors for a prolonged third stage were studied. Materials and Methods Computerized data of all vaginal deliveries at our L&D unit from 2010 to 2014 were obtained. Cases of complete and spontaneous placental separation were extracted for further analysis. Cases necessitating manual removal of the placenta due to immediate postpartum hemorrhage (PPH) were also excluded...
August 2016: American Journal of Perinatology
Stephen P Emery, Lananh Nguyen, W Tony Parks
Background Placental laser equatorialization or "solomonization" during treatment for twin-twin transfusion syndrome (TTTS) is associated with improved pregnancy outcomes. Concern exists, however, about the extent of placental injury caused by the technique, and of its ability to create "dichorionization," or complete separation of the fetal vascular circuits. Case Study A "solomonized" placenta was histologically examined for depth of cell damage. Solomonization produces complete devascularization of the chorionic plate, but has minimal effect on the underlying villi...
April 2016: American Journal of Perinatology Reports
Sureyya Burcu Gorkem, Mehmet Serdar Kutuk, Selim Doganay, Tamer Gunes, Karamehmet Yildiz, Mustafa Kucukaydin
The aim of this study is to evaluate perfusional changes in brain and placenta of omphalopagus conjoined twins and to compare them with singleton fetuses by using diffusion weighted imaging and apparent diffusion coefficient. Fetal MRIs of 28-week-old omphalopagus conjoined twins with a shared liver with two separate gallbladders and portal and hepatic venous systems and three singleton fetuses with unilateral borderline ventriculomegaly at the same gestational week as control group were enrolled retrospectively...
2016: Radiology Research and Practice
Kristine Marceau, Minni T B McMaster, Taylor F Smith, Joost G Daams, Catharina E M van Beijsterveldt, Dorret I Boomsma, Valerie S Knopik
A literature search was conducted to identify articles examining the association of chorionicity (e.g., whether twins share a single chorion and thus placenta or have separate chorions/placentas) and genetics, psychiatry/behavior, and neurological manifestations in humans twins and higher-order multiples. The main aim was to assess how frequently chorionicity has been examined in relation to heritability estimates, and to assess which phenotypes may be most sensitive to, or affected by, bias in heritability estimates because of chorionicity...
May 2016: Behavior Genetics
Zhiming He, Hanlin Lu, Huijuan Luo, Fei Gao, Tong Wang, Yu Gao, Qun Fang, Junwen Wang
Intrauterine growth restriction (IUGR) affects the foetus and has a number of pathological consequences throughout life. Recent work has indicated that variations in DNA methylation might cause placental dysfunction, which may be associated with adverse pregnancy complications. Here, we investigated the promoter methylomes of placental shares from seven monochorionic (MC) twins with selective intrauterine growth restriction (sIUGR) using the healthy twin as an ideal control. Our work demonstrated that the IUGR placental shares harboured a distinct DNA hypomethylation pattern and that the methylation variations preferentially occurred in CpG island shores or non-CpG island promoters...
February 2, 2016: Scientific Reports
C M Salafia, N Kiryankova, H Inany, P Charlagorla, M Park, N Khawar, S VanHorn, B Dygulska, P Narula, S Lederman
OBJECTIVE: Do monochorionic (MC) and/or dichorionic (DC) twins show allometric scaling between placental and birth weight (PW, BW)? METHODS: We extracted BW, PW, gestational age (GA) and cord insertion type from 52 MC to 310 DC twins to calculate β. DC twins were analyzed as summed and as individuals if placentas were separate. RESULTS: Mean β for MC (0.78 ± 0.02), DC summed (0.78 ± 0.02), and DC with separate placentas (0.77 ± 0...
January 2016: Placenta
Martin J C van Gemert, Lourens R Pistorius, Kurt Benirschke, Gouke J Bonsel, Frank P H A Vandenbussche, K Marieke Paarlberg, Jeroen P H M van den Wijngaard, Peter G J Nikkels
BACKGROUND: A total of 75% of monozygotic twins share 1 monochorionic placenta where placental anastomoses cause several serious complications, for example, acardiac twinning. Acardiac twins lack cardiac function but grow by perfusion of arterial blood from the pump twin. This rare pregnancy has 50% natural pump twin mortality but accurate risk prediction is currently impossible. Recent guidelines suggest prophylactic surgery before 18 weeks, suggesting 50% unnecessary interventions. We hypothesize that (1) adverse pump twin outcome relates to easy-to-measure pump/acardiac umbilical venous diameter (UVD) ratios, representing acardiac perfusion by the pump's excess cardiac output...
February 2016: Birth Defects Research. Part A, Clinical and Molecular Teratology
Masato Bui, Beben Benyamin, Sonia Shah, Anjali K Henders, Nicholas G Martin, Grant W Montgomery, Allan F McRae
Monozygotic (MZ) twins provide a natural system for investigating developmental plasticity and the potential epigenetic origins of disease. A major difference in the intrauterine environment between MZ pairs is whether they share a common placenta or have separate placentas. Using DNA methylation measured at >400,000 points in the genome on the Illumina HumanMethylation450 array, we demonstrate that the co-twins of MZ pairs (average age of 14) that shared a common placenta (n = 18 pairs) have more similar DNA methylation levels in blood throughout the genome relative to those with separate placentas (n = 16 pairs)...
December 2015: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Heejin Bang, Go Eun Bae, Ha Young Park, Yeon Mee Kim, Suk-Joo Choi, Soo-Young Oh, Cheong-Rae Roh, Jung-Sun Kim
BACKGROUND: Chronic placental inflammation, such as villitis of unknown etiology (VUE) and chronic chorioamnionitis (CCA), is considered a placental manifestation of maternal anti-fetal rejection. The aim of this study is to investigate its frequency in twin pregnancies compared to singleton pregnancies. METHODS: Three hundred twin placentas and 1,270 singleton placentas were consecutively collected at a tertiary medical center in Seoul, Republic of Korea from 2009 to 2012...
October 2015: Journal of Pathology and Translational Medicine
A Mahnani, A Sadeghi-Sefidmazgi, V E Cabrera
The objectives of this study were (1) to describe the risk factors, incidence, and productive and reproductive consequences of metritis in dairy cows, and (2) to estimate the financial losses associated with metritis using data gathered from 4 Holstein dairy farms in Isfahan, Iran. Calving records from March 2008 to December 2013, comprising 43,488 calvings, were included in the data set. The effects of metritis on productive and reproductive performance were analyzed using a mixed linear model for primiparous and multiparous cows separately and in an overall data set (all cows combined), whereas risk factors on metritis incidence were examined using a multivariable logistical regression model for the overall data set...
September 2015: Journal of Dairy Science
Tessa L Cutler, Kate Murphy, John L Hopper, Louise A Keogh, Yun Dai, Jeffrey M Craig
All same-sex dizygotic (DZ) twins and approximately one-third of monozygotic (MZ) twin pairs have separate placentas, making it impossible to use the number of placentas to determine zygosity. Zygosity determination is further complicated because incorrect assumptions are often made, such as that only DZ pairs have two placentas and that all MZ pairs are phenotypically identical. These assumptions, by twins, their families and health professionals, along with the lack of universal zygosity testing for same-sex twins, has led to confusion within the twin community, yet little research has been conducted with twins about their understanding and assumptions about zygosity...
June 2015: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Wiebke Garrels, Stephanie Holler, Ulrike Taylor, Doris Herrmann, Heiner Niemann, Zoltan Ivics, Wilfried A Kues
Human cells migrate between mother and fetus during pregnancy and persist in the respective host for long-term after birth. Fetal microchimerism occurs also in twins sharing a common placenta or chorion. Whether microchimerism occurs in multiparous mammals such as the domestic pig, where fetuses have separate placentas and chorions, is not well understood. Here, we assessed cell chimerism in litters of wild-type sows inseminated with semen of transposon transgenic boars. Segregation of three independent monomeric transposons ensured an excess of transgenic over non-transgenic offspring in every litter...
2014: PloS One
Ana Beatriz Godinho, Diana Martins, Cláudia Araújo, Maria Antonieta Melo, Luís Mendes Graça
A complete hydatiform mole coexisting with a live, viable twin is a rare event. The diagnosis is challenging, and is normally achieved only at second trimester. It may be associated with thyrotoxicosis, vaginal bleeding, preeclampsia, fetal death or persistent throphoblastic disease. The authors describe the case of a pregnant woman presenting with first trimester bleeding. Ultrasound revealed a twin pregnancy with a viable twin and another placenta apparently detached. At 16 gestational weeks ultrasound revealed a live fetus with a normal placenta and a separate vacuolated and vascularized mass...
January 2014: Acta Médica Portuguesa
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