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Twin pregnancies

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https://www.readbyqxmd.com/read/28351027/re-thinking-elective-single-embryo-transfer-increased-risk-of-monochorionic-twinning-a-systematic-review
#1
Margaret Dziadosz, Mark I Evans
BACKGROUND/OBJECTIVES: Multiple pregnancies have tripled in the United States over the past 3 decades. Attributed to increasing maternal age at delivery but more so assisted reproductive technological advances, an effort has been made to decrease twinning through elective single embryo transfer. We sought to review and evaluate risks of monochorionic twinning as a predictable consequence of increasing utilization of elective single embryo transfer on perinatal outcomes. Primary outcomes included twinning rates, fetal anomalies, growth, preterm birth, and mortality...
March 29, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28346766/maternal-thyroid-parameters-in-pregnant-women-with-different-ethnic-backgrounds-do-ethnicity-specific-reference-ranges-improve-the-diagnosis-of-subclinical-hypothyroidism
#2
Flora Veltri, Julie Belhomme, Pierre Kleynen, Lidia Grabczan, Serge Rozenberg, Thierry Pepersack, Kris Poppe
OBJECTIVE: Guidelines on the management of thyroid dysfunction during pregnancy have recently been updated and, for the diagnosis of subclinical hypothyroidism (SCH), a TSH upper reference limit (cutoff) of 4.0 mIU/L has been proposed when no institutional values are available. It is also suggested that serum TSH and thyroid autoimmunity (TAI) may be different according to the ethnic background of the women. We therefore determined the prevalence of TAI and SCH in pregnant women with different ethnic backgrounds and, to define SCH, we used different first trimester TSH upper reference cutoffs (institutional, ethnicity-specific, 2...
March 27, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28345302/outcome-of-subsequent-pregnancies-in-patients-with-a-history-of-peripartum-cardiomyopathy
#3
Denise Hilfiker-Kleiner, Arash Haghikia, David Masuko, Justus Nonhoff, Dominik Held, Elena Libhaber, Mark C Petrie, Niki L Walker, Edith Podewski, Dominik Berliner, Johann Bauersachs, Karen Sliwa
AIMS: Subsequent pregnancies (SSPs) in patients with peripartum cardiomyopathy (PPCM) have a high risk of heart failure relapse. We report on outcome of SSPs in PPCM patients in Germany, Scotland, and South Africa. METHODS AND RESULTS: Among 34 PPCM patients with a SSP, pregnancy ended prematurely in four patients while it was full-term in 30. Overall relapse rate [left ventricular ejection fraction, LVEF <50% or death after at least 6-month follow-up] was 56% with 12% (4/34) mortality...
March 27, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28344956/maternal-serum-placental-growth-factor-and-pregnancy-associated-plasma-protein-a-measured-in-the-first-trimester-as-parameters-of-subsequent-pre-eclampsia-and-small-for-gestational-age-infants-a-prospective-observational-study
#4
Kyung Uk Sung, Jeong A Roh, Kyung Jin Eoh, Eui Hyeok Kim
OBJECTIVE: To examine the first-trimester maternal serum placental growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) levels in pregnancies associated with pre-eclampsia (PE) or small-for-gestational-age (SGA) infants, and determine the predictive accuracy of PlGF and of PAPP-A for either PE or SGA infants. METHODS: This prospective, observational study included 175 pregnant women, and of these women, due to participant withdrawal or loss to follow-up, delivery data were collected from the medical records of 155 women, including 4 who had twin pregnancies...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28341515/computerised-interpretation-of-fetal-heart-rate-during-labour-infant-a-randomised-controlled-trial
#5
(no author information available yet)
BACKGROUND: Continuous electronic fetal heart-rate monitoring is widely used during labour, and computerised interpretation could increase its usefulness. We aimed to establish whether the addition of decision-support software to assist in the interpretation of cardiotocographs affected the number of poor neonatal outcomes. METHODS: In this unmasked randomised controlled trial, we recruited women in labour aged 16 years or older having continuous electronic fetal monitoring, with a singleton or twin pregnancy, and at 35 weeks' gestation or more at 24 maternity units in the UK and Ireland...
March 21, 2017: Lancet
https://www.readbyqxmd.com/read/28335669/the-experience-of-modified-sequential-selective-laser-photocoagulation-of-communicating-vessels-technique-for-twin-twin-transfusion-syndrome
#6
Susumu Murata, Mayumi Takano, Yukiko Kagawa, Masahiro Sumie, Masahiko Nakata
OBJECTIVE: Fetoscopic laser photocoagulation of vascular anastomoses is the essential choice in twin-twin transfusion syndrome (TTTS). We proposed that the modified sequential selective laser photocoagulation of communicating vessels (modified SQLPCV) to clarify the perinatal outcomes in TTTS. METHODS: The modified SQLPCV was designed with the following order: 1, artery-to-artery anastomoses; 2, venous-to-venous anastomoses; 3, artery-to-venous anastomoses from donor to recipient; and 4, artery-to-venous anastomoses from recipient to donor...
March 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28332220/perspectives-on-risk-assessment-of-risk-profiles-and-outcomes-among-women-planning-community-birth-in-the-united-states
#7
Marit L Bovbjerg, Melissa Cheyney, Jennifer Brown, Kim J Cox, Lawrence Leeman
BACKGROUND: There is little agreement on who is a good candidate for community (home or birth center) birth in the United States. METHODS: Data on n=47 394 midwife-attended, planned community births come from the Midwives Alliance of North America Statistics Project. Logistic regression quantified the independent contribution of 10 risk factors to maternal and neonatal outcomes. Risk factors included: primiparity, advanced maternal age, obesity, gestational diabetes, preeclampsia, postterm pregnancy, twins, breech presentation, history of cesarean and vaginal birth, and history of cesarean without history of vaginal birth...
March 22, 2017: Birth
https://www.readbyqxmd.com/read/28329721/how-many-embryos-should-be-transferred-a-validated-score-to-predict-ongoing-implantation-rate
#8
Nicolas Gatimel, Melissa Ladj, Carole Teston, Florence Lesourd, Carole Fajau, Clémentine Cohade, Jean Parinaud, Roger D Léandri
OBJECTIVE: To developed a prognostic score to predict ongoing implantation rate according to clinical and biological parameters and to choose the number of embryos to be transferred in patients undergoing IVF/ICSI. STUDY DESIGN: The transfer score was established using multivariate analysis of biological and clinical parameters in 3211 fresh embryo transfers in a retrospective study. Then we validated the score in 694 fresh embryo transfers in a prospective study...
March 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28325122/the-predicting-factors-and-outcomes-of-caesarean-section-of-the-second-twin
#9
Choi Wah Kong, William Wing Kee To
The aim of this study was to review the indications for caesarean delivery of second twins after vaginal delivery of a first twin (combined delivery) and the associated foetal outcomes of the second twin. Possible factors that could be employed to predict combined delivery were explored. This was a retrospective review of all twin pregnancies delivered in a tertiary maternity unit between 2000 and 2013. All twins (> =24 week gestation) with vaginal delivery of the first twin were reviewed. Of a total of 1039 pairs of twins, 441 pairs had vaginal delivery of the first twin, of which 47 (10...
March 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28323984/trimester-specific-urinary-bisphenol-a-concentrations-and-blood-glucose-levels-among-pregnant-women-from-a-fertility-clinic
#10
Yu-Han Chiu, Lidia Mínguez-Alarcón, Jennifer B Ford, Myra Keller, Ellen W Seely, Carmen Messerlian, John Petrozza, Paige L Williams, Xiaoyun Ye, Antonia M Calafat, Russ Hauser, Tamarra James-Todd
Context: Women with a history of infertility are at increased risk of impaired glucose tolerance during pregnancy. Studies suggest higher urinary bisphenol A (BPA) concentrations are associated with diabetes in non-pregnant populations, but the association between BPA and glucose levels among pregnant women is unclear. Objective: To assess trimester-specific urinary BPA concentrations in relation to blood glucose levels among subfertile women. Design: Environment and Reproductive Health Study, an ongoing prospective cohort study...
January 12, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#11
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28322775/pregnancy-and-birth-outcomes-in-couples-with-infertility-with-and-without-assisted-reproductive-technology-with-an-emphasis-on-us-population-based-studies
#12
REVIEW
Barbara Luke
Infertility, defined as the inability to conceive within one year of unprotected intercourse, affects an estimated 80 million individuals worldwide, or 10-15 percent of couples of reproductive age. Assisted reproductive technology (ART) includes all infertility treatments to achieve conception; in vitro fertilization (IVF) is the process by which an oocyte is fertilized by semen outside the body; non-IVF ART treatments include ovulation induction, artificial insemination, and intrauterine insemination. Use of ART has risen steadily in the United States during the past two decades due to several reasons, including childbearing at older maternal ages and increasing insurance coverage...
March 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28321530/pregnancy-in-patients-with-thalassemia-major-a-cohort-study-and-conclusions-for-an-adequate-care-management-approach
#13
E Cassinerio, I M Baldini, R S Alameddine, A Marcon, R Borroni, W Ossola, A Taher, M D Cappellini
An improvement in quality of life and survival occurred among thalassemia major (TM) patients: pregnancy in such patients has become a reality. Safe pregnancy and delivery require efforts to ensure the best outcomes. Between 2007 and 2016, 30 TM patients had 37 pregnancies. We analyzed the hematological parameters before, during, and after pregnancies and in 19 patients a cardiovascular magnetic resonance (CMR) T2* was performed. The mean age at first pregnancy was 30 ± 4 years; the current mean age is 35 ± 5 years...
March 20, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28320252/the-impact-of-laser-surgery-on-angiogenic-and-anti-angiogenic-factors-in-twin-twin-transfusion-syndrome-a-prospective-study
#14
Andrew H Chon, Emiliano R Chavira, Melissa L Wilson, Sue A Ingles, Arlyn Llanes, Ramen H Chmait
OBJECTIVE: To examine the effect of laser surgery on angiogenic and anti-angiogenic factors in patients with twin-twin transfusion syndrome (TTTS). METHODS: Cases of TTTS and uncomplicated monochorionic diamniotic twin pregnancies between 16-26 weeks' gestation were prospectively enrolled into the study. Maternal blood samples were obtained to measure angiogenic factors (vascular endothelial growth factor-A (VEGF), placental-derived growth factor (PlGF), endothelin) and anti-angiogenic factors (soluble fms-like tyrosine kinase (sFlt-1), soluble endoglin (sEng), sFlt-1/PlGF ratio)...
March 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28320233/does-cervical-cerclage-decrease-preterm-birth-in-twin-pregnancies-with-a-short-cervix
#15
Tracy M Adams, Timothy J Rafael, Nadia B Kunzier, Supriya Mishra, Rose Calixte, Anthony M Vintzileos
PURPOSE: To determine if use of cerclage in twin gestations with mid-trimester short cervix is associated with decreased preterm birth rate. STUDY DESIGN: This is a retrospective cohort of twin gestations identified with cervical length of ≤2.5cm before 24 weeks gestation through the perinatal ultrasound database of two institutions from 2008-2014. Patients with and without cerclage were compared for a primary outcome of preterm birth at <35 weeks. A pre-planned sub-group analysis of patients with cervical length ≤1...
March 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28320230/placental-characteristics-in-monochorionic-twins-with-selective-intrauterine-growth-restriction-assessed-by-gradient-angiography-and-three-dimensional-reconstruction
#16
Chenyu Gou, Meizhi Li, Xiaoling Zhang, Xiangzhen Liu, Xuan Huang, Yi Zhou, Qun Fang
OBJECTIVE: To investigate the placental characteristics in selective intrauterine growth restriction (sIUGR) using gradient angiography and three-dimensional (3D) reconstruction from computed tomography (CT) scan data. METHODS: This study included 23 sIUGR cases and 16 monochorionic twin-pregnancies without sIUGR. We injected nonionic iodinated contrast agents into the umbilical arteries and veins. Placental characteristics were analyzed after CT scanning and 3D reconstruction...
March 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28317207/hidden-high-rate-of-preeclampsia-in-twin-compared-to-singleton-pregnancies
#17
Carla Francisco, David Wright, Zsófia Benkő, Argyro Syngelaki, Kypros H Nicolaides
OBJECTIVE: To examine the gestational age at delivery with and without preeclampsia (PE) in dichorionic (DC) and monochorionic (MC) twin pregnancies and determine the relative risk for total and preterm-PE compared to singleton pregnancies. METHODS: This was a screening study for PE in twin pregnancies undergoing first-trimester combined screening for aneuploidy and subsequently delivering two phenotypically normal live or stillborn babies at ≥24 weeks' gestation...
March 19, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28314387/twin-pregnancy-complicated-by-esophageal-atresia-duodenal-atresia-gastric-perforation-and-hypoplastic-left-heart-structures-in-one-twin-a-case-report-and-review-of-the-literature
#18
Mohamad K Abou Chaar, Mariana L Meyers, Bethany D Tucker, Henry L Galan, Kenneth W Liechty, Timothy M Crombleholme, Ahmed I Marwan
BACKGROUND: The antenatal diagnosis of a combined esophageal atresia without tracheoesophageal fistula and duodenal atresia with or without gastric perforation is a rare occurrence. These diagnoses are difficult and can be suspected on ultrasound by nonspecific findings including a small stomach and polyhydramnios. Fetal magnetic resonance imaging adds significant anatomical detail and can aid in the diagnosis of these complicated cases. Upon an extensive literature review, there are no reports documenting these combined findings in a twin pregnancy...
March 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28306541/clinical-characteristics-and-outcome-of-twin-pregnancies-complicated-by-single-intrauterine-death
#19
Qiong Luo, Xiujun Han
AIM: To investigate the clinical characteristics and outcome of twin pregnancies complicated by single intrauterine death and how to improve the outcomes of surviving twins. Three thousand three hundred and eighty-four women who delivered twin pregnancies at Women's Hospital, Zhejiang University, School of Medicine were included. Clinical and demographic data on gestational age, etiology, morbidity and mortality for mothers and fetuses were collected. RESULTS: The median gestational age for detecting a single intrauterine death in twin pregnancy was 29 weeks and the average gestational age of pregnancy termination was 32 weeks...
March 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28303982/twin-chorionicity-and-prospective-stillbirth-risk-experience-at-a-tertiary-care-hospital
#20
Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim
OBJECTIVE: To determine the prospective risk of stillbirth, perinatal death and neonatal morbidities in twins. METHODS: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised cases of twin pregnancies from January 2001 to December 2012. . Cases of both monochorionic diamniotic and dichorionic diamniotic twin pregnancies were included. SPSS 19 was used for data analysis.. RESULTS: Of the 394 cases, 84(21...
March 2017: JPMA. the Journal of the Pakistan Medical Association
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