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Twin pregnancies complications

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https://www.readbyqxmd.com/read/29340788/the-impact-of-advanced-maternal-age-on-the-outcome-of-twin-pregnancies
#1
Ohad Gluck, Yossi Mizrachi, Jacob Bar, Giulia Barda
PURPOSE: To assess the effect of advanced maternal age on the obstetrics and neonatal outcome of twin pregnancies. METHODS: A retrospective study of 716 dichorionic-diamniotic twin pregnancies delivered at our institute. The study population was divided into two groups: women aged 35-39 years (group A, n = 142) and women aged ≥ 40 years (Group B, n = 48). The control group consisted of women younger than 35 years (group C, n = 516). RESULTS: The rate of cesarean section (CS) was significantly higher among women older than 35 years compared to the control group (A 76...
January 16, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29338992/subsequent-fertility-pregnancy-and-gynecologic-outcomes-after-fetoscopic-laser-therapy-for-twin-twin-transfusion-syndrome-compared-to-normal-monochorionic-twin-gestations
#2
Simen Vergote, Liesbeth Lewi, Willem Gheysen, Luc de Catte, Roland Devlieger, Jan Deprest
BACKGROUND: An improved survival and quality of life for neonatal survivors after fetoscopic laser therapy (FLC) for twin-twin transfusion syndrome (TTTS) has been reported. However, little is known about the medium-term maternal effects after FLC with respect to reproductive and gynecologic outcomes. OBJECTIVE: To document reproductive, obstetric, gynecologic and psychological outcomes in women who underwent FLC for TTTS. STUDY DESIGN: Monocentric controlled study on consecutive women who underwent FLC for TTTS between 2007 and 2013 at the University Hospitals Leuven (cases; n=198)...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29338857/obstetric-complications-after-frozen-versus-fresh-embryo-transfer-in-women-with-polycystic-ovary-syndrome-results-from-a-randomized-trial
#3
Bo Zhang, Daimin Wei, Richard S Legro, Yuhua Shi, Jing Li, Lin Zhang, Yan Hong, Gang Sun, Ting Zhang, Weiping Li, Zi-Jiang Chen
OBJECTIVE: To evaluate the effect of frozen embryo transfer on maternal and neonatal complications of singleton and twin pregnancies compared with fresh embryo transfer in women with polycystic ovary syndrome (PCOS). DESIGN: A secondary analysis of a multicenter, randomized, controlled trial comparing live birth after frozen vs. fresh embryo transfer (FreFro-PCOS). SETTING: Reproductive medicine centers. PATIENT(S): A total of 1,508 patients with a diagnosis of PCOS who were undergoing IVF were enrolled...
January 12, 2018: Fertility and Sterility
https://www.readbyqxmd.com/read/29325265/-clinical-analysis-of-105-intrauterine-fetal-deaths-in-17-years
#4
S Wang, H X Yang
Objective: To study the cause of intrauterine fetal death (IUFD) in 17 years. Methods: From June 1(st), 2000 to May 31(st), 2017, 65 621 women delivered in Peking University First Hospital. Clinical data of 105 cases of IUFD (including 82 singleton pregnancies and 23 twin pregnancies) during the 17 years were analyzed retrospectively. Results: (1) In singleton pregnancies, the leading cause of IUFD was maternal complications, including severe pre-eclampsia (36/82, 43.9%) and diabetes mellitus (6/82, 7.3%). The second reason was umbilical cord factors (13/82, 15...
December 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29324601/potentially-preventable-stillbirth-in-a-diverse-u-s-cohort
#5
Jessica M Page, Vanessa Thorsten, Uma M Reddy, Donald J Dudley, Carol J Rowland Hogue, George R Saade, Halit Pinar, Corette B Parker, Deborah Conway, Barbara J Stoll, Donald Coustan, Radek Bukowski, Michael W Varner, Robert L Goldenberg, Karen Gibbins, Robert M Silver
OBJECTIVE: To estimate the proportion of potentially preventable stillbirths in the United States. METHODS: We conducted a secondary analysis of 512 stillbirths with complete evaluation enrolled in the Stillbirth Collaborative Research Network from 2006 to 2008. The Stillbirth Collaborative Research Network was a multisite, geographically, racially, and ethnically diverse, population-based case-control study of stillbirth in the United States. Cases of stillbirth underwent standard evaluation that included maternal interview, medical record abstraction, biospecimen collection, postmortem examination, placental pathology, and clinically recommended evaluation...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29302809/preeclampsia-acts-differently-in-in-vitro-fertilization-versus-spontaneous-twins
#6
Rania Okby, Avi Harlev, Kira Nahum Sacks, Ruslan Sergienko, Eyal Sheiner
OBJECTIVE: To investigate risk factors and pregnancy outcome of spontaneous vs in-vitro fertilization (IVF) twins complicated with preeclampsia. STUDY DESIGN: A retrospective population-based cohort study comparing maternal and neonatal outcome in IVF vs spontaneously conceived twins was conducted. Deliveries occurred in a tertiary medical center between the years 1988 and 2010. Women who conceived after ovulation induction and those with chronic hypertension were excluded from the study...
January 4, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29301441/use-of-the-fetal-myocardial-performance-index-in-monochorionic-diamniotic-twin-pregnancy-a-prospective-cohort-and-nested-case-control-study
#7
Amanda Henry, Saranya Gopikrishna, Aditi Mahajan, Jennifer Alphonse, Neama Meriki, Alec W Welsh
AIMS: Assess clinical utility of the fetal Myocardial Performance Index (MPI) in evaluation and management of monochorionic, diamniotic twin (MCDA) pregnancies. METHODS: Prospective cohort of a) initially uncomplicated MCDA b) Complicated MCDA, including twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and liquor and/or growth discordance (L/GD) not meeting TTTS or sIUGR criteria. TTTS and sIUGR were case-control matched...
January 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29298686/a-single-center-experience-with-12-consecutive-cases-of-pregnancy-among-patients-with-membranous-ventricular-septal-aneurysm
#8
Kana Wang, Xiaodong Wang, Haiyan Yu, Xinghui Liu, Aiyun Xing, Yong You
BACKGROUND: Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. This study was to assess the clinical implications of this condition from our center's experience...
January 3, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29275238/simultaneous-pregnancy-in-each-uterine-cavity-of-a-double-uterus-in-a-young-nigerian-multipara-who-presented-with-a-retained-second-twin-following-an-unsupervised-preterm-labor-at-home-case-report
#9
Emmanuel Oluchikwu Ani, Emmanuel Ajuluchukwu Ugwa, Aminu Bashir Taiye, Iwasam Elemi Agbor, Ibrahim Shaaibu Suleiman
INTRODUCTION: Simultaneous pregnancy in each uterine cavity of a double uterus is unusual but is a recognized risk factor for preterm labour and other poor obstetrics outcomes. The work has been reported in line with the SCARE criteria. PRESENTATION OF CASE: We report an unusual case of simultaneous pregnancy in each uterine cavity of a double uterus in a young African grand multipara who presented with a retained second twin following a preterm labour at home. DISCUSSION: A double or didelphys uterus as reported in the literatures is still uncommon even in Africa...
December 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29241912/radiofrequency-ablation-for-selective-reduction-in-complex-monochorionic-multiple-pregnancies-a-case-series
#10
Hong-Mei Wang, Hong-Yan Li, Xie-Tong Wang, Yan-Yun Wang, Lei Li, Bo Liang, Jing Wang, Jia Song
OBJECTIVE: To determine the safety and efficacy of radiofrequency ablation (RFA) for selective fetal reduction in complex monochorionic multiple pregnancies. MATERIALS AND METHODS: From July 2011 to January 2015, data on all cases treated with RFA were collected prospectively in our hospital. Indications, procedure details, cause of fetal demise and pregnancy outcomes were analyzed. Sonography and magnetic resonance imaging were performed to detect fetal brain damage...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29238231/adverse-maternal-outcomes-and-birth-weight-discordance-in-twin-gestation-british-columbia-canadian-data
#11
Shayesteh Jahanfar, Kenneth Lim
Objective: The aim of this study was to determine whether twin pregnancies with birth weight discordance were associated with higher rates of maternal morbidities. Study design: A large retrospective population-based cohort study of twins born in British Columbia, Canada, from 2000 to 2010 was performed. Maternal morbidities and growth discordant were evaluated. Results: There were 6,328 twin deliveries during the study period. Pregnancies carrying growth-discordant twins had higher frequencies of hypertension disorders, preterm labor, and cesarean delivery compared with growth-concordant twins...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29237662/advanced-abdominal-pregnancy-in-a-spontaneous-heterotopic-pregnancy
#12
Nuno Maciel, Ana Furtado Lima, Rosa Cruz, Carlos Ponte
Spontaneous heterotopic pregnancy is a potentially life-threatening condition rarely considered when a patient with an intrauterine pregnancy is asymptomatic or presents with complaints such as abdominal pain. An advanced abdominal pregnancy as the form of the ectopic component, outside the context of assisted reproduction, is an even more unusual and perilous diagnosis with very few cases reported in the literature. We report such a case in a 34-year-old multipara, with no known risk factors for ectopic pregnancy...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29216770/maternal-age-over-40-years-and-pregnancy-outcome-a-hospital-based-survey
#13
Luca Marozio, Elisa Picardo, Claudia Filippini, Erika Mainolfi, Paola Berchialla, Franco Cavallo, Annalisa Tancredi, Chiara Benedetto
OBJECTIVE: Increased risk for adverse pregnancy outcomes with advancing maternal age has been described but the strength of association remains debated, particularly in presence of confounding factors such as parity, twin pregnancy and pregnancy from assisted reproductive technologies. The aim of this study was to evaluate pregnancy outcomes in a large cohort of women aged over 40 years. The hypothesis was that advanced maternal age may be an independent risk factor for adverse pregnancy outcome...
December 7, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29202976/perinatal-outcomes-after-natural-conception-versus-in%C3%A2-vitro-fertilization-ivf-in-gestational-surrogates-a-model-to-evaluate-ivf-treatment-versus-maternal-effects
#14
COMPARATIVE STUDY
Irene Woo, Rita Hindoyan, Melanie Landay, Jacqueline Ho, Sue Ann Ingles, Lynda K McGinnis, Richard J Paulson, Karine Chung
OBJECTIVE: To study the perinatal outcomes between singleton live births achieved with the use of commissioned versus spontaneously conceived embryos carried by the same gestational surrogate. DESIGN: Retrospective cohort study. SETTING: Academic in vitro fertilization center. PATIENT(S): Gestational surrogate. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Pregnancy outcome, gestational age at birth, birth weight, perinatal complications...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29189893/maternal-hemodynamics-in-late-gestation-and-immediate-postpartum-in-singletons-vs-twin-pregnancies
#15
Anat Lavie, Maya Ram, Shaul Lev, Yair Blecher, Uri Amikam, Yael Shulman, Tomer Avnon, Eran Weiner, Ariel Many
PURPOSE: Differences in hemodynamic changes during a cesarean section (CS) between twin and singleton pregnancies are poorly defined. The Non-Invasive Cardiac System (NICaS) is an impedance device that measures cardiac output (CO) and its derivatives. We compared maternal cardiac parameters using NICaS™ in singleton and twins before and during delivery, as well at the early puerperium in healthy women undergoing CS at term. METHODS: This prospective longitudinal study included women with twin (n = 27) or singleton pregnancies (n = 62) whose hemodynamic parameters were assessed by NICaS before an elective CS, after spinal anesthesia, immediately after delivery, after fascia closure, and within 24-36 and 48-72 h postpartum...
November 30, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29178652/mutations-in-fetal-genes-involved-in-innate-immunity-and-host-defense-against-microbes-increase-risk-of-preterm-premature-rupture-of-membranes-pprom
#16
Bhavi P Modi, Maria E Teves, Laurel N Pearson, Hardik I Parikh, Hannah Haymond-Thornburg, John L Tucker, Piya Chaemsaithong, Nardhy Gomez-Lopez, Timothy P York, Roberto Romero, Jerome F Strauss
BACKGROUND: Twin studies have revealed a significant contribution of the fetal genome to risk of preterm birth. Preterm premature rupture of membranes (PPROM) is the leading identifiable cause of preterm delivery. Infection and inflammation of the fetal membranes is commonly found associated with PPROM. METHODS: We carried out whole exome sequencing (WES) of genomic DNA from neonates born of African-American mothers whose pregnancies were complicated by PPROM (76) or were normal term pregnancies (N = 43) to identify mutations in 35 candidate genes involved in innate immunity and host defenses against microbes...
November 2017: Molecular Genetics & Genomic Medicine
https://www.readbyqxmd.com/read/29175171/early-warning-system-hypertension-thresholds-to-predict-adverse-outcomes-in-pre-eclampsia-a-prospective-cohort-study
#17
Hannah L Nathan, Paul T Seed, Natasha L Hezelgrave, Annemarie De Greeff, Elodie Lawley, John Anthony, David R Hall, Wilhelm Steyn, Lucy C Chappell, Andrew H Shennan
OBJECTIVES: To evaluate the association between blood pressure (BP) measurements and adverse outcomes in women with pre-eclampsia. STUDY DESIGN: A prospective cohort study of women with pre-eclampsia admitted to three South African tertiary facilities. BP was measured using the CRADLE Vital Signs Alert (VSA), incorporated with a traffic light early warning system; green: systolic BP <140 mmHg and diastolic BP <90 mmHg, yellow: systolic BP 140-159 and/or diastolic BP 90-109 mmHg (but neither is above the upper threshold), red: systolic BP ≥160 mmHg and/or diastolic BP ≥110 mmHg...
November 21, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29169712/-about-twins-epidemiological-genetic-and-obstetrical-aspects-specific-risks-and-outcome
#18
M Tauzin, A Felix, C Michot, C Dedieu, L Aoust, F Fortas, C Guillier, J Ngo, P-Y Wachter, L Petermann, E Kermorvant-Duchemin
The incidence of twin pregnancies has increased steadily for the last 40 years due to assisted reproductive technology and increased maternal childbearing age. Multiple pregnancies, especially monochorionic twin pregnancies, carry a high risk for the mother and the fetuses and require close follow-up. Twins are exposed to a higher risk of perinatal anoxia, in utero fetal demise, preterm birth, congenital malformations, fetal growth restriction, and vascular complications. Compared to singletons, twins are at higher risk of perinatal mortality and impaired neurodevelopmental outcome, justifying a thorough follow-up by pediatricians, including assessment and management of familial and psychosocial impact...
November 20, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29153312/discordant-intrauterine-transfusion-in-dichorionic-twin-pregnancy-with-rh-isoimmunization
#19
Jing Wu, Lin-Huan Huang, Yan-Min Luo, Qun Fang
Discordant intrauterine transfusion (IUT) in twin pregnancy with Rh isoimmunization is uncommon and complicated. We report a gravida 3, para 2 woman with a dichorionic diamniotic (DCDA) twin pregnancy and two fetuses received discordant transfusions. Middle cerebral artery peak systolic velocity (MCA-PSV) was used to evaluate the anemic degree in each foetus. IUT was performed 3 times in twin A and 4 times in twin B to reverse foetal anaemia. Transfusions were distinct due to the different tolerance to IUT, and the procedure could be continued in one foetus even if the other one underwent complications...
November 7, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29122542/twin-twin-transfusion-syndrome-what-we-have-learned-from-clinical-trials
#20
REVIEW
Fatiha Djaafri, Julien Stirnemann, Imen Mediouni, Claire Colmant, Yves Ville
Monochorionic twin pregnancies are at increased risk for adverse outcome compared to dichorionic twin pregnancies and singletons. Monochorionic-specific complications include twin-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence, single intrauterine fetal demise and its consequences on the co-twin, and selective intrauterine growth restriction. Whereas the natural history of monochorionic-specific complications carries a high risk of fetal death or severe neurologic disability, a framework now exists, based on well-designed clinical trials, for optimal treatment of these entities...
November 6, 2017: Seminars in Fetal & Neonatal Medicine
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