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Twin pregnancies complications

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https://www.readbyqxmd.com/read/28444780/fetal-brain-injury-in-complicated-monochorionic-pregnancies-diagnostic-yield-of-prenatal-mri-following-surveillance-ultrasound-and-influence-on-prognostic-counselling
#1
Alice Robinson, Mark Teoh, Andrew Edwards, Michael Fahey, Stacy Goergen
OBJECTIVE: To determine the additional diagnostic information provided by prenatal (fetal) magnetic resonance imaging (pMRI) following tertiary ultrasound (US) for fetal cranial abnormalities in complicated monochorionic gestations (cMCGs) METHODS: Women with cMCGs complicated by twin - twin transfusion syndrome (TTTS), co-twin demise (CD), selective intrauterine growth restriction (sIUGR), and / or twin anemia - polycythemia sequence (TAPS) who were referred for pMRI after tertiary US were included...
April 26, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28441900/placental-nfe2l2-is-discordantly-activated-in-monochorionic-twins-with-selective-intrauterine-growth-restriction-and-possibly-regulated-by-hypoxia
#2
Jing Wu, Zhiming He, Yu Gao, Guanglan Zhang, Xuan Huang, Qun Fang
INTRODUCTION: Nuclear factor, erythroid 2 like 2 (NFE2L2) is an important transcription factor that protects cells from oxidative stress (OS). NFE2L2 deficiency in placentas is associated with pregnancy complications. We have demonstrated that elevated OS existed in placental shares of the smaller fetus in selective intrauterine growth restriction (sIUGR); however, the role of NFE2L2 in the development of sIUGR remains unknown. In this study, we examined the levels of NFE2L2 and heme oxygenase 1 (HMOX1), a major antioxidant regulated by NFE2L2, in sIUGR placentas...
April 25, 2017: Free Radical Research
https://www.readbyqxmd.com/read/28403975/-fetoscopic-laser-coagulation-in-200%C3%A2-consecutive-monochorionic-pregnancies-with-twin-twin-transfusion-syndrome
#3
L Lecointre, N Sananès, A S Weingertner, A Gaudineau, C Akladios, V Cavillon, B Langer, R Favre
OBJECTIVES: To report preoperative data, surgical characteristics, complications and perinatal outcome of twin-twin transfusion syndrome (TTTS) managed with laser ablation surgery, to analyze predictors of neonatal survival and to compare the 100 most recent cases with the older 100. MATERIALS AND METHODS: Observational cohort moncentric study of 200 cases of TTTS consecutively treated with fetoscopic laser coagulation between January 2004 and December 2014...
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28403927/relevance-of-routine-doppler-sampling-at-the-two-umbilical-arteries-in-the-follow-up-of-dichorionic-twin-pregnancies-with-intrauterine-growth-restricted-fetuses
#4
A J Vivanti, E Lecarpentier, A-G Cordier, F Proulx, V Tsatsaris, A Benachi
OBJECTIVE: The aim of this study is to assess if the presence of bilateral absent or reverse end-diastolic velocity (AREDV) indicates a poorer prognosis than unilateral AREDV in dichorionic-diamniotic twin pregnancies complicated by intrauterine growth restriction. METHODS: A prospective observational study of 36 dichorionic-diamniotic twin pregnancies complicated by intrauterine growth restriction. One hundred and fifty seven ultrasound (US) examinations were performed...
March 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28371633/ovarian-torsion-and-spontaneous-ovarian-hyperstimulation-syndrome-in-a-twin-pregnancy-a-case-report
#5
Núria Gil Navarro, Emma Garcia Grau, Sílvia Pina Pérez, Laia Ribot Luna
INTRODUCTION: Ovarian hyperstimulation syndrome (OHSS) is extremely rare in spontaneous pregnancies. Spontaneous OHSS can result from glycoprotein hormones stimulating follicle-stimulating hormone receptors (FSHR). PRESENTATION OF CASE: We report a twin pregnancy in which ovarian torsion and hemoperitoneum complicating OHSS were treated with left adnexectomy and aspiration. The only trigger for spontaneous OHSS in this case was high levels of chorionic gonadotropin hormone...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28369714/obstetrical-and-perinatal-complications-of-twin-pregnancies-is-there-a-link-with-the-type-of-infertility-treatment
#6
Sophie Deltombe-Bodart, Philippe Deruelle, Elodie Drumez, Sophie Cordiez, Sophie Catteau-Jonard, Charles Garabedian
The aim of this study was to compare the maternal and perinatal data from spontaneous twin pregnancies with twin pregnancies conceived via assisted reproductive technology, and to evaluate the outcomes depending on the type of treatment MATERIAL AND METHODS: A historical cohort of all twin live births between 1997 and 2014 was used to create two groups: spontaneous pregnancies and pregnancies after infertility treatment (ovulation induction, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection)...
March 28, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28357558/effects-and-safety-of-gnrh-a-as-a-luteal-support-in-women-undertaking-assisted-reproductive-technology-procedures-follow-up-results-for-pregnancy-delivery-and-neonates
#7
Weiqin Zhou, Yanyan Zhuang, Yanping Pan, Fei Xia
PURPOSE: To investigate the effects and safety of gonadotropin releasing hormone analogue (GnRH-a) as an addition to progesterone luteal support in women who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) and achieved a clinical pregnancy. METHODS: A retrospective analysis was conducted on 214 patients who underwent IVF/ICSI-ET procedures with standard long mid-luteal protocol, of which 123 received GnRH-a-free protocol and 91 received GnRH-a-added protocol...
March 29, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28355686/-retrospective-analysis-of-outcomes-of-selectively-or-spontaneously-reduced-multiple-pregnancies-out-of-6-917-in-vitro-fertilization-embryo-transfer-pregnancy-cycles
#8
Q L Chen, H Ye, X Y Ding, X L Shen, G N Huang
Objective: To analyze the effects of fetal reduction in early pregnancy on obstetric and neonatal outcomes of spontaneously or selectively reduced multiple pregnancies produced by in vitro fertilization-embryo transfer (IVF-ET). Methods: Retrospective study of 6 917 clinical pregnancies from IVF-ET cycles, including 754 multiple pregnancies divided into two groups according to the remaining fetus number: reduced singleton group (n=599) and reduced twin group (n=155); and maternal and neonatal outcomes of two groups were compared to primary singleton group (n=3 589) and primary twin group (n=2 574)...
March 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28355685/-clinical-outcome-and-placenta-characteristics-of-spontaneous-twin-anemia-polycythemia-sequence
#9
X J Wang, L Y Li, Y Wei, Y Y Zhao, P B Yuan
Objective: To investigate the clinical outcome and placental characteristics of spontaneous twin anemia-polycythemia sequence (sTAPS). Methods: Twelve cases with sTAPS delivered in Peking University Third Hospital from May 2013 to August 2016. The data of ultrasound characteristics, gestational age at delivery, and 1 minute Apgar score were analyzed, retrospectively. Placental superficial vascular anastomoses, placental territory discordance and the ratio of umbilical cords insertion distance to the longest placental diameter were also analyzed...
March 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28335669/the-experience-of-modified-sequential-selective-laser-photocoagulation-of-communicating-vessels-technique-for-twin-twin-transfusion-syndrome
#10
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/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/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
#12
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
#13
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/28303777/placental-up-regulation-of-leptin-and-arms2-is-associated-with-growth-discordance-in-monochorionic-diamniotic-twin-pregnancies
#14
Luming Sun, Jia Zhou, Kai Wang, Jian Wang, Ling Shang, Jianguang Zhang, Junqing Wu, David S Cram
Fetal growth discordance is a relatively common complication of monochorionic diamniotic (MCDA) twin pregnancies and is caused by a combination of maternal and placental factors. The aim of the study was to survey placental gene expression patterns and identify genes associated with growth discordance. Clinical samples comprised eight growth-discordant MCDA twin placentas (31+3-34+4 weeks gestational age) and six growth-concordant twin placentas (31+2-37 weeks gestational age). Gene expression libraries were constructed from placental biopsy samples and analyzed by RNA-sequencing...
April 2017: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/28296372/-adolescent-pregnancy-its-causes-and-repercussions-in-the-dyad
#15
Arturo Loredo-Abdalá, Edgar Vargas-Campuzano, Abigail Casas-Muñoz, Jessica González-Corona, César Jesús Gutiérrez-Leyva
Teen pregnancy (TP) is a global public health problem that affects the physical and emotional health, educational and economic status of prospective parents and often also affects the product of gestation. In most cases, the TP is an unplanned event, and often difficult to accept by the couple. But it is more complicated for the future mother who suddenly finds herself without the protection of the couple, her family and her school companions. The risks to which the young mothers are exposed are diverse, but include: submitting to a clandestine abortion, falling into drug addiction, prostitution and crime; Also, it should be noted that with so many adversities, she can develop child maltreatment and frequently, she may be attacked at home, at school or in society giving rise to the twin phenomena of child abuse...
March 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28285310/incidence-and-causes-of-intentional-fetal-or-neonatal-demise-in-twin-twin-transfusion-syndrome
#16
Marjolijn S Spruijt, Ellen Tameeris, De-Peng Zhao, Johanna M Middeldorp, Monique C Haak, Dick Oepkes, Enrico Lopriore
INTRODUCTION: The aim of this study is to evaluate the incidence and causes of intentional fetal and neonatal demise in twin-twin transfusion syndrome (TTTS). MATERIAL AND METHODS: All TTTS pregnancies managed at our centre between 2000 and 2014 were included. We evaluated incidence and causes of intentional fetal/neonatal demise, defined as termination of pregnancy, selective fetal reduction, or withdrawal of neonatal intensive care. RESULTS: Intentional fetal/neonatal demise occurred in 9...
March 11, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28283263/impact-of-oocyte-donation-on%C3%A2-perinatal-outcome-in-twin-pregnancies
#17
Lucie Guilbaud, Pietro Santulli, Eva Studer, Vanessa Gayet, François Goffinet, Camille Le Ray
OBJECTIVE: To compare perinatal outcomes of twin pregnancies after oocyte donation (OD), in vitro fertilization (IVF) with autologous oocyte (AO), and non-IVF conception. DESIGN: Five-year retrospective cohort study. SETTING: Tertiary university medical center. PATIENT(S): All patients with twin pregnancies who gave birth after 24 weeks of gestation. The outcomes of 102 OD twin pregnancies were compared with those of 201 AO and 369 non-IVF twin pregnancies...
April 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28274006/twin-reversed-arterial-perfusion-to-treat-or-not
#18
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
https://www.readbyqxmd.com/read/28272225/a-new-method-for-selective-reduction-in-trap-sequence-with-a-contraindication-to-fetoscopic-surgery-a-case-report
#19
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/28256411/-newborn-outcomes-after-radiofrequency-ablation-for-selective-reduction-in-the-complicated-monochorionic-pregnancies
#20
M Panciatici, B Tosello, J Blanc, J-B Haumonté, C D'Ercole, C Gire
OBJECTIVE: To describe perinatal data and to evaluate the neonatal neurological outcome of monochorionic twin pregnancies with selective termination by radiofrequency ablation. METHODS: Retrospective data of perinatal data for nine consecutive monochorionic pregnancies eligible for radiofrequency ablation from January 2013 to August 2015 were collected. A prospective observational study of the neurological outcome of nine children was conducted using the Ages & Stages Questionnaire (ASQ), 2nd edition, French version, adapted to the age...
April 2017: Gynecologie, Obstetrique, Fertilite & Senologie
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