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Multifetal gestation

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https://www.readbyqxmd.com/read/28899350/epidemiological-profile-and-obstetric-outcomes-of-patients-with-peripartum-congestive-heart-failure-in-taiwan-a-retrospective-nationwide-study
#1
Ying-Jen Chang, Chung-Han Ho, Jen-Yin Chen, Ming-Ping Wu, Chia-Hung Yu, Jhi-Joung Wang, Chia-Ming Chen, Chin-Chen Chu
BACKGROUND: During pregnancy, the hyperdynamic physiology of circulation can exacerbate many cardiovascular disorders. Congestive heart failure (CHF) usually occurs during late pregnancy, which is significantly associated with a high level of maternal and neonatal morbidities and mortalities. The profile of women who develop peripartum CHF (PCHF) is unknown. We investigated the epidemiological profiles of PCHF. METHODS: In this retrospective cohort study, PCHF patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in Taiwan's National Health Insurance Research Database...
September 12, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28889767/delayed-interval-delivery-in-twin-pregnancies-report-of-three-cases-and-literature-review
#2
Marta Benito Vielba, Carlos De Bonrostro Torralba, Victoria Pallarés Arnal, Rebeca Herrero Serrano, Eva Lucía Tejero Cabrejas, Jose Manuel Campillos Maza
INTRODUCTION: Delayed delivery is sometimes performed in selected multifetal pregnancies when the first twin birth occurs inevitably. The aim of this procedure is to improve the prognosis and decrease the morbidity and mortality of the second twin. We report three cases of delayed-interval delivery of dichorionic-diamniotic twin pregnancies assisted in our center between 2015 and 2017. After the first twin delivery, the second twin was left in utero and the patient received tocolytic therapy and antibiotics...
September 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28719908/ultrasound-guided-intrauterine-labeling-of-rat-fetuses
#3
Hatice Gulcin Gumus, Miriam Illa, Laura Pla, Anna Gonzalez, Elena Demicheva, David Ley, Fatima Crispi, Eduard Gratacos
AIM: To compare intra-amniotic versus fetal subcutaneous injections for selective fetal labeling in multifetal rat pregnancies. METHODS: A total of 14 pregnant rats were randomized to receive intra-amniotic injections of dyes (including Fluorescein, Indigo Carmine, or Evans Blue) or fetal subcutaneous injections (of commercial tattoo ink) both guided by ultrasound at 15-17 days of gestation. Survival, injection, and labeling success rates of both techniques were compared...
July 18, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28715920/genital-tract-gbs-and-rate-of-histologic-chorioamnionitis-in-patients-with-preterm-premature-rupture-of-membrane
#4
Krunal Patel, Shauna Williams, George Guirguis, Lisa Gittens-Williams, Joseph Apuzzio
INTRODUCTION: Histologic chorioamnionitis (HC) is a common finding in the placenta from patients with preterm premature rupture of membranes (PPROM). The purpose of this study is to determine if HC differs based on the Group B streptococcus (GBS) status in patients managed expectantly with PPROM <34 weeks gestation. METHODS: A retrospective study was performed of patients admitted with PPROM between 23 0/7 and 33 6/7 weeks from 2003 to 2014 at one institution...
July 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28637061/multifetal-pregnancy-reduction-of-trichorionic-triplet-gestations-what-is-the-benefit
#5
Nola Herlihy, Mariam Naqvi, Julie Romero, Simi Gupta, Ana Monteagudo, Andrei Rebarber, Nathan S Fox
No abstract text is available yet for this article.
June 21, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28625760/multifetal-pregnancy-reduction-of-triplets-to-twins-compared-with-non-reduced-triplets-a-meta-analysis
#6
REVIEW
Yaniv Zipori, Jigal Haas, Howard Berger, Eran Barzilay
The current systematic review and meta-analysis evaluate the perinatal outcomes in twin pregnancies following multifetal pregnancy reduction (MPR) compared with non-reduced triplet pregnancies. All studies comparing perinatal outcome of twin pregnancies following MPR to non-reduced triplet pregnancies were considered. MEDLINE, non-indexed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science were searched for relevant published articles up to August 2016. The search yielded 653 publications of which 92 were assessed for eligibility...
September 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28486367/intra-amniotic-dye-alternatives-for-the-diagnosis-of-preterm-prelabor-rupture-of-membranes
#7
Kayla E Ireland, Emma I Rodriguez, Ometeotl M Acosta, Patrick S Ramsey
Intra-amniotic dye instillation is a useful tool for evaluation of equivocal cases of preterm prelabor rupture of membranes and for genetic amniocentesis in multifetal gestation. Indigo carmine, the most used and studied dye, is no longer available. We sought to provide a resource of potential dyes for clinical use that summarizes dosing along with maternal, fetal, and neonatal outcomes. We reviewed the literature evaluating the use of alternative agents. Sodium fluorescein has proven clinical usefulness but has side effects when used intravenously...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28486365/nonpresenting-dichorionic-twins-and-placental-vascular-malperfusion
#8
Eran Weiner, Michael Kahn, Kristine Giltvedt, Mia Kibel, Christopher Sherman, John Kingdom, Jon Barrett, Nir Melamed
OBJECTIVE: To explore the hypothesis that selective placental pathology affecting the nonpresenting twin is a significant contributory factor mediating the smaller size at birth of nonpresenting dichorionic twins. METHODS: We conducted a retrospective cohort study of all dichorionic twin deliveries in a single tertiary center between 2002 and 2015 where by departmental policy, all placentas from multifetal gestations are routinely sent for pathologic examination...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28483844/perinatal-outcomes-in-multifetal-pregnancy-following-fetal-reduction
#9
Neda Razaz, Tehila Avitan, Joseph Ting, Tracy Pressey, K S Joseph
BACKGROUND: There is currently insufficient evidence regarding the prognosis of multifetal pregnancy following elective fetal reduction to twin or singleton pregnancy. We compared perinatal outcomes in pregnancies with and without fetal reduction. METHODS: We used data on all stillbirths and live births in British Columbia, Canada, from 2009 to 2013. We compared outcomes of multifetal pregnancies with fetal reduction (to twin or singleton pregnancy) with outcomes of pregnancies without fetal reduction...
May 8, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28434652/multifetal-reduction-of-triplets-to-twins-compared-with-non-reduced-twins-a-meta-analysis
#10
Yaniv Zipori, Jigal Haas, Howard Berger, Eran Barzilay
The current systematic review and meta-analysis evaluates the perinatal outcomes in twin pregnancies following multifetal pregnancy reduction (MPR) compared with non-reduced twins. We considered all studies comparing perinatal outcomes of twin pregnancies following MPR to non-reduced twin pregnancies. Our search yielded 639 publications, of which 91 were assessed for eligibility. A total of 22 studies met our inclusion criteria. Overall, fetal reduction of triplets to twins resulted in comparable perinatal outcomes to non-reduced twins with regards to gestational age and birthweight at delivery, pregnancy loss prior to 24 weeks, as well as the development of gestational diabetes and hypertensive disorders of pregnancy...
April 10, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28272225/a-new-method-for-selective-reduction-in-trap-sequence-with-a-contraindication-to-fetoscopic-surgery-a-case-report
#11
Qi Li, Xin-Hua Wu, Wei-She Zhang
RATIONALE: The preferred method for multifetal pregnancy reduction (MFPR) is a transabdominal intrathoracic or intracranial injection of potassium chloride (KCl). However, in monochorionic multiple pregnancies (MMPs), especially in monoamnionic multifetal pregnancies, selective feticide by this method is often associated with miscarriage of the remaining fetuses. Selective fetal reduction in MMPs by blood flow ablation using radiofrequency ablation or fetoscopic laser surgery may improve survival of the remaining fetus...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068852/maternal-outcomes-following-the-initiation-of-an-institutional-delayed-cord-clamping-protocol-an-observational-case-control-study
#12
Kelly Kuo, Priyanka Gokhale, David N Hackney, Chayatat Ruangkit, Monika Bhola, Melissa March
OBJECTIVE: The objective of this study is to evaluate maternal outcomes before and after implementation of an institutional delayed cord clamping (DCC) protocol. STUDY DESIGN: We performed a secondary analysis of a retrospective cohort study of deliveries occurring at <34 weeks at a tertiary care center in 2013-2014. About 139 women who underwent early cord clamping were compared with 130 women delivered after DCC protocol implementation. Maternal estimated blood loss (EBL) was the primary outcome of interest...
February 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27825408/preterm-births-in-peking-union-medical-college-hospital-in-the-past-25-years
#13
Fang Jiang, Jin-Song Gao, Yi-Feng Zhong, Jing Hu, Jian-Qiu Yang, Liang-Kun Ma, Jun-Tao Liu
Objective To investigate the changes in preterm birth rate,its gestational age distribution,and possible contributors in Peking Union Medical College Hospital (PUMCH) over the last 25-year period. Methods The clinical data of premature deliveries,both singleton and twins,in PUMCH from January 1,1990 to December 31,2014 were retrospectively analyzed. We counted the number of premature fetuses and assessed the changes of preterm birth rate and its gestational age distribution (including extremely preterm birth,early preterm birth,and late preterm birth) over time...
October 10, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/27803585/comparative-analysis-of-perinatal-outcome-of-spontaneous-pregnancy-reduction-and-multifetal-pregnancy-reduction-in-triplet-pregnancies-conceived-after-assisted-reproductive-technique
#14
Shilpa Bhandari, Ishita Ganguly, Pallavi Agrawal, Shweta Bhandari, Aparna Singh, Nitika Gupta
INTRODUCTION: With the advent of assisted reproductive treatment options, the incidence of multiple pregnancies has increased. Although the need for elective single embryo transfer is emphasized time and again, its uniform applicability in practice is yet a distant goal. In view of the fact that triplet and higher order pregnancies are associated with significant fetomaternal complications, the fetal reduction is a commonly used option in such cases. This retrospective study aims to compare the perinatal outcome in patients with triplet gestation who have undergone spontaneous fetal reduction (SFR) as against those in whom multifetal pregnancy reduction (MFPR) was done...
July 2016: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/27770131/incarceration-of-the-gravid-uterus
#15
REVIEW
Kelsey L Shnaekel, Michael P Wendel, Nader Z Rabie, Everett F Magann
Objective: The aim of this review was to describe the risk factors, clinical and radiographic criteria, and management of this rare complication of pregnancy. Methods: A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched. Results: There were 60 articles identified, with 53 articles being the basis of this review. Multiple risk factors have been suggested in the literature including retroverted uterus in the first trimester, deep sacral concavity with an overlying sacral promontory, endometriosis, previous abdominal or pelvic surgery, pelvic or uterine adhesions, ovarian cysts, leiomyomas, multifetal gestation, uterine anomalies, uterine prolapse, and uterine incarceration in a prior pregnancy...
October 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27661652/practice-bulletin-no-169-multifetal-gestations-twin-triplet-and-higher-order-multifetal-pregnancies
#16
(no author information available yet)
The incidence of multifetal gestations in the United States has increased dramatically over the past several decades. The rate of twin births increased 76% between 1980 and 2009, from 18.9 to 33.3 per 1,000 births (). The rate of triplet and higher-order multifetal gestations increased more than 400% during the 1980s and 1990s, peaking at 193.5 per 100,000 births in 1998, followed by a modest decrease to 153.4 per 100,000 births by 2009 (). The increased incidence in multifetal gestations has been attributed to two main factors: 1) a shift toward an older maternal age at conception, when multifetal gestations are more likely to occur naturally, and 2) an increased use of assisted reproductive technology (ART), which is more likely to result in a multifetal gestation ()...
October 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27661644/practice-bulletin-no-169-summary-multifetal-gestations-twin-triplet-and-higher-order-multifetal-pregnancies
#17
(no author information available yet)
The incidence of multifetal gestations in the United States has increased dramatically over the past several decades. The rate of twin births increased 76% between 1980 and 2009, from 18.9 to 33.3 per 1,000 births (1). The rate of triplet and higher-order multifetal gestations increased more than 400% during the 1980s and 1990s, peaking at 193.5 per 100,000 births in 1998, followed by a modest decrease to 153.4 per 100,000 births by 2009 (2). The increased incidence in multifetal gestations has been attributed to two main factors: 1) a shift toward an older maternal age at conception, when multifetal gestations are more likely to occur naturally, and 2) an increased use of assisted reproductive technology (ART), which is more likely to result in a multifetal gestation (3)...
October 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27639267/glucose-tolerance-in-singleton-twin-and-triplet-pregnancies
#18
Amir Weissman, Arie Drugan
BACKGROUND: Data regarding the effects of multifetal pregnancy on the incidence of gestational diabetes mellitus (GDM) are inconsistent and even conflicting. Twin pregnancies have been associated with no increase, a marginal increase or a higher incidence of gestational diabetes. In triplet pregnancies, these effects have not been investigated yet. OBJECTIVES: To analyze the results of the glucose challenge and tolerance tests in singleton, twin and triplet pregnancies...
October 1, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27593480/outcome-of-early-versus-late-multifetal-pregnancy-reduction
#19
COMPARATIVE STUDY
Jigal Haas, Eran Barzilay, Ariel Hourvitz, Jehoshua Dor, Shlomo Lipitz, Yoav Yinon, Mor Shlomi, Adrian Shulman
Multifetal pregnancy reduction (MPR) is an accepted method of reducing complications of triplet pregnancies and higher-order multifetal pregnancies. Eighty-three pregnancies that underwent early (68 weeks) transvaginal MPR were compared with 125 pregnancies that underwent late (11-14 weeks) transabdominal MPR. Rates of pregnancy loss, preterm delivery, gestational diabetes and hypertensive disorders were similar among both groups. Early MPR was associated with a lower risk for small for gestational age newborns (6...
November 2016: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/27577884/umbilical-cord-occlusion-via-laser-coagulation-in-monochorionic-multifetal-gestations-before-and-after-20-weeks-of-gestation
#20
Jennifer R King, Charlotte L Conturie, Joseph G Ouzounian, Lisa M Korst, Arlyn Llanes, Ramen H Chmait
INTRODUCTION: Umbilical cord occlusion (UCO) utilizing laser photocoagulation is often not considered an option for selective termination after 20 weeks of gestation due to reported limitations of the procedure because of umbilical cord size. We compared outcomes after laser umbilical cord occlusion (L-UCO) before and after 20 weeks of gestation. MATERIALS AND METHODS: We examined all patients with monochorionic- diamniotic twins and higher-order multiples (monoamniotic excluded) that underwent L-UCO at our facility between 2006 and 2014...
2017: Fetal Diagnosis and Therapy
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