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Monochorionic twins

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https://www.readbyqxmd.com/read/28926832/persistent-pulmonary-hypertension-of-the-newborn-in-twin-twin-transfusion-syndrome-a-case-control-study
#1
Manon Gijtenbeek, M C Haak, Derk Jan Ten Harkel, Arjan B Te Pas, Johanna M Middeldorp, Frans J C M Klumper, Nan van Geloven, Dick Oepkes, Enrico Lopriore
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is associated with severe morbidity and mortality. Twin-twin transfusion syndrome (TTTS) is suggested to increase the risk of PPHN. OBJECTIVES: To describe the incidence of PPHN in TTTS twins and to identify risk factors in TTTS twins for the development of severe PPHN. METHODS: Cases with severe PPHN were extracted from our monochorionic twin database (2002-2016). Severe PPHN was defined as severe hypoxaemia requiring mechanical ventilation and inhaled nitric oxide (iNO) treatment, confirmed by strict echocardiographic criteria...
September 20, 2017: Neonatology
https://www.readbyqxmd.com/read/28918426/aortic-isthmus-flow-recording-predicts-the-outcome-of-the-recipient-twin-after-laser-coagulation-in-twin-twin-transfusion-syndrome
#2
France Leduc, Amélie Delabaere, Roxanne Gendron, Florent Fuchs, Sandrine Wavrant, Marie-Josée Raboisson, Jean-Claude Fouron, François Audibert
INTRODUCTION: The objective was to assess the prognostic value of the systolic flow through the aortic isthmus in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS) treated by placental laser ablation. MATERIAL AND METHODS: Fetal echocardiography and outcome data of 105 cases of TTTS treated by laser photocoagulation of placental anastomoses were reviewed. Hemodynamic parameters were collected before and after treatment. The isthmic systolic index (ISI) was calculated as the peak systolic velocity/systolic nadir ratio...
September 16, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28906394/growth-discordance-of-monoamniotic-twin-because-of-difference-of-cords-diameter-in-forked-umbilical-cord-case-report
#3
Yongbing Guo, Yu Sun, Huixia Yang
A case of monochorionic-monoamniotic (MCMA) twin pregnancy with growth discordance because of difference of cord diameter in forked umbilical cord is reported.MCMA twins were diagnosed at 12 weeks of gestation and twin growth discordance was considered during the follow-up twice-weekly visits to the ultrasound and prenatal care units. The pregnancy was terminated at 34 weeks. Two live female babies weighing 2510 g and 1940 g were delivered. Examination of placenta and umbilical cords after birth showed that the 2 cords merged into a conjoint cord 1 cm from insertion to the placenta (forked umbilical cord)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28901463/microrna-expression-profiles-and-networks-in-placentas-complicated-with-selective-intrauterine-growth-restriction
#4
Hong Wen, Lu Chen, Jing He, Jun Lin
The microRNA (miRNA) profiles of placentas complicated with selective intrauterine growth restriction (sIUGR) are unknown. In the present study, the sIUGR‑associated placental miRNA expression was investigated using microarray and confirmatory reverse transcriptase‑quantitative polymerase chain reaction studies. Placenta samples around the individual insertion region for each umbilical cord were collected from monochorionic twins complicated with (n=17) or without sIUGR (control, n=16). miRNA profile analysis was performed on two sIUGR cases and one control using an Affymetrix microRNA 4...
September 11, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28884893/chimerism-for-20q11-2-microdeletion-of-gdf5-explains-discordant-phenotypes-in-monochorionic-diamniotic-twins
#5
Matthew M Meredith, Beau Crabb, Marcelo Vargas, Betsy A Hirsch
Microdeletions of 20q11.2 are rare but have been associated with characteristic clinical findings. A 1.6 Mb minimal critical region has been identified that includes three OMIM genes: GDF5, EPB41L1, and SAMHD. Here we describe a male monozygotic, monochorionic-diamniotic twin pair with discordant phenotypes, one with multiple findings that overlap with those reported in 20q11.2 deletions, and the other unaffected. Microarray analysis revealed mosaicism for a 363 Kb deletion encompassing GDF5 in the peripheral blood of both twins, which was confirmed by FISH...
September 8, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28880696/sex-discordant-monochorionic-dizygotic-twins-a-case-report
#6
Sheila Vázquez Rodríguez, Loida Pamplona Bueno, Farida Akhoundova Sanoyan, Ramiro Quiroga de la Cruz, Vicente Diago Almela, Alfredo Perales Marín
No abstract text is available yet for this article.
September 7, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28873067/association-of-histological-chorioamnionitis-and-magnesium-sulfate-treatment-in-singleton-and-dichorionic-twin-pregnancies-with-preterm-premature-rupture-of-membranes-preliminary-observations
#7
James M O'Brien, Jacobo L Santolaya, Kristy Palomares, David Blitzer, Joaquin Santolaya-Forgas
OBJECTIVE: To evaluate the possible association between antenatal magnesium sulfate treatment with histological chorioamnionitis in patients with singleton or dichorionic twins that had preterm premature rupture of the membranes. METHODS: This was an observational study performed in patients admitted to the hospital with rupture of membranes before 34 weeks' gestation. The primary outcome was histological chorioamnionitis and the primary predictor was antenatal magnesium sulfate treatment...
September 5, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28869935/fetal-aneuploidy-a-comparison-of-dichorionic-twins-and-monochorionic-twins
#8
Xiaomei Shi, Lin Li, Xuan Huang, Baojiang Chen, Yi Zhou, Qun Fang
OBJECTIVE: To assess the clinical characteristics of fetal aneuploidy between dichorionic twins (DCT) and monochorionic twins (MCT) undergoing invasive prenatal diagnosis. METHODS: Twin fetuses undergoing invasive prenatal diagnosis were enrolled in this study. All twin fetuses were classified into 2 groups according to chorionicity. The rates of fetal aneuploidy in different groups were compared. RESULT: This study included 1,714 fetuses (857 sets of twin pairs); among them, 1,190 were DCT and 524 were MCT...
September 5, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28864011/can-color-difference-on-the-maternal-side-of-the-placenta-distinguish-between-acute-peripartum-twin-twin-transfusion-syndrome-and-twin-anemia-polycythemia-sequence
#9
Lisanne S A Tollenaar, Danny P Zhao, Johanna M Middeldorp, Dick Oepkes, Femke Slaghekke, Enrico Lopriore
OBJECTIVE: To investigate the color difference between two placental shares in monochorionic placentas with acute peripartum twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). METHODS: We evaluated all digital pictures of TAPS, acute peripartum TTTS and a control group of uncomplicated monochorionic placentas examined at our center. We determined the color intensity of the individual placental share on the maternal side of each monochorionic placenta using an image-processing program and calculated the color difference ratio (CDR)...
September 2017: Placenta
https://www.readbyqxmd.com/read/28822629/acute-intrapartum-rupture-of-the-pubic-symphysis-requiring-resuscitation-and-surgical-intervention-a-case-report
#10
Marie Buitendyk, Barbara Brennan, Parag Vora, Patricia Smith, Stephanie Winsor
BACKGROUND: Pubic symphysis rupture significant enough to cause serious complications or require surgical intervention is exceedingly rare. Here we review the literature and examine the details of a unique presentation. CASE: A 27-year-old woman presented in labour at 34+6 weeks gestation after an uncomplicated monochorionic-diamniotic twin pregnancy. After vaginal delivery, she developed a substantial labial hematoma. Hours later, she became hemodynamically unstable...
August 16, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28792107/intrafetal-laser-for-embryo-reduction-from-dichorionic-triplets-to-dichorionic-twins
#11
Petya Chaveeva, Gergana Peeva, Savino Gil Pugliese, Atanas Shterev, Kypros H Nicolaides
OBJECTIVE: To report the outcome of dichorionic (DC) triplet pregnancies reduced to DC twins by laser ablation of the pelvic vessels of one of the monochorionic twins. METHODS: Intrafetal laser embryo reduction (ER) from DC triplet to DC twins was carried out in 61 pregnancies at 11(+0) - 14(+3) weeks' gestation. Pregnancy outcome was examined and compared to previous studies in DC triplets managed expectantly or by ER to twins or singleton with fetal intracardiac injection of potassium chloride (KCl)...
August 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28736902/pseudoamniotic-band-syndrome-after-fetoscopic-laser-ablation-of-placental-anastomoses-for-twin-twin-transfusion-syndrome-two-case-reports-and-systematic-review
#12
Anne Sophie Lafitte, Eric Verspyck, Corinne Jeanne Pasquier, Patricia Dolley, Michel Dreyfus, Guillaume Benoist
Pseudoamniotic band syndrome is a rare complication that occurs after invasive procedures for complicated monochorionic twins. We report 2 cases of intrauterine recipient fetal death after laser therapy for twin-twin transfusion syndrome due to umbilical cord constriction by the amniotic band.
July 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28728213/performance-of-non-invasive-prenatal-screening-for-fetal-aneuploidy-in-twin-pregnancies-a-meta-analysis
#13
Hong Liao, Shanling Liu, He Wang
OBJECTIVE: The objectives of this study were to review the published studies of non-invasive prenatal screening (NIPS) in twin pregnancies and to evaluate the performance for screening fetal trisomies 21, 18, and 13 in twin pregnancies. METHOD: Ten eligible studies were included in this meta-analysis. Data analysis, heterogeneity exploring, meta-regression, and subgroup analysis were all conducted with Meta-DiSc 1.4. Quality assessments were carried out with the Quality Assessment Tool for Diagnostic Accuracy Studies...
July 20, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28727977/the-vanishing-twin-syndrome-two-cases-of-extreme-malformations-associated-with-vanished-twins
#14
Julia K Shinnick, Nasim Khoshnam, Sydney R Archer, Philip C Quigley, Haynes Robinson, Sarah Keene, Matthew T Santore, Sarah Hill, Binita Patel, Bahig M Shehata
Two cases of devastating fetal malformations associated with vanished monochorionic twins were identified upon review of pathology files. A 35-year-old G1P0 woman and 36-year-old G3P1 woman were both diagnosed with an intrauterine twin gestation via transvaginal ultrasound at 10 weeks. The spectrum of fetal anomalies ranged from omphalocele, bilateral upper extremity, and unilateral lower extremity hypoplasia, to craniofacial malformation with diaphragmatic hernia. On histopathologic examination, the placentas demonstrated vascular anastomoses between the surviving co-twin and the "vanished" fetal sac...
July 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28719330/case-report-microcephaly-in-twins-due-to-the-zika-virus
#15
Victor S Santos, Sheila J G Oliveira, Ricardo Q Gurgel, Dorothy R R Lima, Cliomar A Dos Santos, Paulo R S Martins-Filho
Recent studies have demonstrated an association between congenital Zika virus (ZIKV) infection and microcephaly; however, to date, there have been no reports on the consequences of ZIKV infection on fetuses in twin pregnancies. Herein, we reported on the first case of a monochorionic diamniotic (MCDA) twin pregnancy having ZIKV-related microcephaly. Our findings suggested that, in an MCDA twin pregnancy, the ZIKV may cause infection in both fetuses, resulting in severe abnormalities in the central nervous system due to neural cell destruction and the disruption of the normal development processes of the brain...
July 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28695721/aortic-isthmus-shunt-dynamics-in-normal-and-complicated-monochorionic-pregnancies
#16
Viola Seravalli, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat, Jena Miller
OBJECTIVE: To study fetal aortic isthmus (AoI) shunt dynamics in monochorionic (MC) twins. METHODS: Normal and complicated MC pregnancies were prospectively enrolled. The relationship of isthmus flow index (IFI) with Doppler parameters of umbilical artery (UA), descending aorta, middle cerebral artery, and ductus venosus and with left and right ventricular cardiac output and stroke volume was studied. RESULTS: The IFI was obtained in 180 examinations from 48 pregnancies (24 twin-twin transfusion syndrome, TTTS; 4 selective intrauterine growth restriction, sIUGR; 12 TTTS + sIUGR; and 8 uncomplicated)...
July 11, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28679510/neonatal-alloimmune-thrombocytopaenia-associated-with-maternal-hla-antibodies
#17
Kristina Wendel, Çiğdem Akalin Akkök, Stefan Kutzsche
Neonatal alloimmune thrombocytopaenia (NAIT) generally results from platelet opsonisation by maternal antibodies against fetal platelet antigens inherited from the infant's father. Newborn monochorionic twins presented with petechial haemorrhages at 10 hours of life, along with severe thrombocytopaenia. Despite the initial treatment with platelet transfusions and intravenous immunoglobulin, they both had persistent thrombocytopaenia during their first 45 days of life. Class I human leucocyte antigen (HLA) antibodies with broad specificity against several HLA-B antigens were detected in the maternal serum...
July 5, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28661110/-single-fetal-demise-in-monochorionic-twins
#18
REVIEW
Isaac Blickstein
Single fetal death in a monochorionic twin pregnancy is more frequent than in a dichorionic twin gestation. Due to inter-twin vascular anastomosis in the monochorionic common placenta, the death of one twin causes a drop in blood pressure due to a shift of blood from the survivor to the dead fetus. If the drop of blood pressure is abrupt and serious, the survivor will die soon after (as occurs in 15% of cases). If the drop is less serious, the survivor may sustain ischemic injury (in about 26% of the cases) and if the drop in blood pressure is subtle, the survivor will be intact...
June 2017: Harefuah
https://www.readbyqxmd.com/read/28618747/first-trimester-ultrasonographic-parameters-in-prediction-of-the-course-and-outcome-of-monochorionic-twin-pregnancies
#19
Slavica Aksam, Snezana Plesinac, Jelena Dotlic, Jasmina Tadic, Svetlana Vrzic-Petronijevic, Milos Petronijevic, Dusica Kocijancic-Belovic, Snezana Buzadzic
BACKGROUND/AIM: The aim of the study was to evaluate the association and the potential predictive value of first trimester ultrasonographic parameters on the course and outcome of monochorionic diamniotic twin pregnancies. MATERIALS AND METHODS: A prospective cohort study was undertaken of 39 healthy women with consecutive monochorionic diamniotic twin pregnancies. During first-trimester screening, crown-rump length (CRL) and nuchal translucency (NT) were measured...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28617177/discordant-anomalies-with-combined-features-of-pentalogy-of-cantrell-and-oeis-complex-a-case-report-in-monochorionic-twins
#20
Nique Kunapinun, Jitsupa Treetipsatit
INTRODUCTION: Ventral body wall defects have various manifestations. Among others, pentalogy of Cantrell (PC) and omphalocele exstrophy imperforate anus spinal abnormalities (OEIS) complex are defects that involve upper and lower anterior midline of body wall, respectively. Although both entities are in a spectrum of ventral body wall defects, the combination of PC and OEIS complex has not been described. CASE REPORT: In this report, we describe an unusual case of congenital ventral body wall defect with combined features of PC and OEIS complex, which discordantly occurred in monochorionic monoamniotic twins...
June 15, 2017: Fetal and Pediatric Pathology
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