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Twin pregnancies complications

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https://www.readbyqxmd.com/read/28929000/successful-vaginal-delivery-of-naturally-conceived-dicavitary-twin-in-didelphys-uterus-a-rare-reported-case
#1
Houda Nasser Al Yaqoubi, Nishat Fatema
Didelphys uterus, or double uterus, is an embryological developmental malformation of the müllerian ducts with the incidence of approximately 8.3% of all müllerian duct abnormalities (MDAs). Didelphys uterus accompanying dicavitary twin gestation is encountered as a very rare entity with overall incidence of about 1 in 1,000,000. We report a rare case of didelphys uterus, diagnosed since her first pregnancy, and during her fourth pregnancy she conceived dicavitary twin naturally without any infertility treatment...
2017: Case Reports in Obstetrics and Gynecology
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/28899594/delayed-detection-of-spontaneous-bilateral-tubal-ectopic-pregnancies-after-methotrexate-treatment
#3
Nicole E Brown, Shereen A Singer, Joe Suyama
BACKGROUND: Bilateral tubal ectopic pregnancies are a rare subset of ectopic pregnancy that can pose a diagnostic dilemma for clinicians. There is no distinct clinical presentation for bilateral tubal ectopic pregnancies, although they are typically associated with assistive reproductive techniques. In addition, there is no single diagnostic feature to help clinicians delineate bilateral tubal ectopic pregnancies from other types of ectopic pregnancy prior to passing the discriminatory zone (such as heterotopic pregnancy or twin ectopic [two gestational sacs in one tube])...
September 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28898871/placental-component-and-pregnancy-outcome-in-singleton-versus-twin-pregnancies-complicated-by-preeclampsia
#4
Eran Weiner, Ohad Feldstein, Letizia Schreiber, Ehud Grinstein, Elad Barber, Ann Dekalo, Jacob Bar, Michal Kovo
OBJECTIVE: To compare placental histopathological lesions and pregnancy outcomes in singleton and twin pregnancies complicated by preeclampsia (PE). METHODS: Maternal characteristics, neonatal outcomes, and placental histopathology reports of pregnancies complicated by PE between January 2008 and October 2016 were reviewed. Results were compared between singletons (singleton group) and dichorionic-diamniotic twins (twin group). Placental lesions were classified into maternal and fetal vascular supply lesions...
September 13, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28840194/rectus-muscle-reapproximation-at-cesarean-delivery-and-postoperative-pain-a-randomized-controlled-trial
#5
Deirdre J Lyell, Mariam Naqvi, Amy Wong, Renata Urban, Brendan Carvalho
Objective  Rectus muscle reapproximation at cesarean delivery (CD) is performed frequently by some obstetricians; however, the effect on postoperative pain is unclear. To this end, we investigated whether rectus muscle reapproximation increases postoperative pain. Materials and Methods  This is a prospective, double-blind, randomized controlled trial of women undergoing primary CD with singleton or twin pregnancy at >35 weeks' gestation. Women were randomized to rectus muscle reapproximation with three interrupted sutures or no reapproximation...
July 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28829001/iron-supplementation-in-twin-pregnancy-the-benefit-of-doubling-the-iron-dose-in-iron-deficient-pregnant-women-a-randomized-controlled-trial
#6
Shiri Shinar, Avital Skornick-Rapaport, Sharon Maslovitz
OBJECTIVE: To assess the efficacy of doubling the daily dose of iron supplement in iron-deficient women with twin pregnancies. STUDY DESIGN: Using a prospective randomized controlled trial, iron-deficient women with twin gestations were randomized to receive a single or a double dose of daily iron from 16 weeks of gestation until 6 weeks postpartum. The primary outcome was hemoglobin at 32 weeks. Secondary outcomes included ferritin at 32 weeks, hemoglobin during pregnancy and postpartum, birth weights, preterm birth rate, gastrointestinal side effects, intravenous iron administration, and compliance with treatment...
August 22, 2017: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/28822629/acute-intrapartum-rupture-of-the-pubic-symphysis-requiring-resuscitation-and-surgical-intervention-a-case-report
#7
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/28822628/retrospective-cohort-study-of-cervical-pessary-use-in-women-with-short-cervix-at-risk-of-preterm-delivery
#8
Laura Karis Allen, Jane Schulz, Catherine Flood, Sue Ross, Kentia Naud
OBJECTIVE: A paucity of effective interventions exists for the prevention of preterm birth (PTB). Renewed interest has focused on cervical pessaries, which have the benefits of being inexpensive, nonsurgical, and easily inserted and removed. In this study, we aim to describe our experience with this device in a Canadian tertiary care centre. Primary outcomes were rates of spontaneous or iatrogenic PTB before 37, 34, and 28 weeks gestation in pregnancies complicated by short cervix treated with cervical pessary...
August 16, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28799251/comparison-of-anticoagulation-regimens-for-pregnant-women-with-prosthetic-heart-valves-a-meta-analysis-of-prospective-studies
#9
Jing Wang, Kangqi Li, Hongyan Li, Weiwei Zhu, Haiyan Sun, Congxiao Lu
INTRODUCTION: Pregnancy is associated with a hypercoagulable state, which makes pregnant women with prosthetic heart valves at high risk of thromboembolism. Proper anticoagulation regimen should take both the maternal protection and the fetal outcomes into consideration. However, no consensus on the present anticoagulation regimen for those women has been reached yet, especially in the first trimester of pregnancy. AIMS: The present meta-analysis is conducted to compare anticoagulation efficiency and feto-maternal complications of heparin and warfarin in the first trimester...
August 11, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28764674/arabin-cervical-pessary-for-prevention-of-preterm-birth-in-cases-of-twin-to-twin-transfusion-syndrome-treated-by-fetoscopic-laser-coagulation-the-pecep-laser-randomised-controlled-trial
#10
Carlota Rodó, Sílvia Arévalo, Liesbeth Lewi, Isabel Couck, Bettina Hollwitz, Kurt Hecher, Elena Carreras
BACKGROUND: Fetoscopic LASER coagulation of the placental anastomoses has changed the prognosis of twin-twin transfusion syndrome. However, the prematurity rate in this cohort remains very high. To date, strategies proposed to decrease the prematurity rate have shown inconclusive, if not unfavourable results. METHODS: This is a randomised controlled trial to investigate whether a prophylactic cervical pessary will lower the incidence of preterm delivery in cases of twin-twin transfusion syndrome requiring fetoscopic LASER coagulation...
August 1, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28727976/monozygotic-twins-discordant-for-trisomy-13-a-case-of-trisomic-rescue-supporting-the-continued-need-for-first-trimester-ultrasound
#11
Patrick McFadden, Sarah Smithson, Robert Massaro, Jialing Huang, Gail T Prado, Wendy Shertz
Monozygotic twins with discordant karyotypes for trisomy 13 are rare. We report a case of a spontaneously conceived pregnancy who presented with first-trimester ultrasound finding of umbilical cord cyst and increased nuchal translucency in Twin A and no abnormalities in Twin B. Amniocentesis revealed 47,XY,+13 karyotype in Twin A and 46,XY karyotype in Twin B. Selective fetal reduction was performed for Twin A. Twin B was delivered at 32 weeks gestation with normal phenotype. Peripheral blood karyotype revealed 15% mosaicism for trisomy 13 and skin fibroblast revealed 46,XY karyotype...
July 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28706170/-multiple-factors-in-the-second-trimester-of-pregnancy-on-preterm-labor-symptoms-and-preterm-birth
#12
Jeung Im Kim, Mi Ock Cho, Gyu Yeon Choi
PURPOSE: The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). METHODS: This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts...
June 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28704197/expectant-management-in-di-chorionic-pregnancies-complicated-by-discordant-anomalous-twin
#13
Paola Algeri, Francesca M Russo, Maddalena Incerti, Sabrina Cozzolino, Francesca Pelizzoni, Davido P Bernasconi, Luca Montanelli, Luca Locatelli, Patrizia Vergani
Fetal malformations are more frequent in twins than in singletons. The aim of our study was to define the influence of a malformed twin on di-chorionic pregnancy outcomes. We performed a retrospective cohort study of di-chorionic pregnancies delivered between 2000 and 2015. Exclusion criteria were: both twins affected by fetal malformations, double intra-uterine fetal death in pregnancies without fetal malformation, selective feticide and therapeutic pregnancy termination. We compared maternal and fetal outcomes of di-chorionic pregnancies not complicated by fetal malformations with pregnancies affected by a single malformed fetus with conservative management...
July 12, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28695721/aortic-isthmus-shunt-dynamics-in-normal-and-complicated-monochorionic-pregnancies
#14
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/28674684/effect-of-fetal-sex-on-maternal-and-obstetric-outcomes
#15
REVIEW
Mohammed Al-Qaraghouli, Yu Ming Victor Fang
Fetal sex plays an important role in modifying the course and complications related to pregnancy and may also have an impact on maternal health and well-being both during and after pregnancy. The goal of this article is to review and summarize the findings from published research on physiologic and pathologic changes that may be affected by fetal sex and the effect of these changes on the maternal and obstetrical outcomes. This will help create awareness that fetal sex is not just a random chance event but an interactive process between the mother, the placenta, and the fetus...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28666503/spontaneous-uterine-rupture-due-to-placenta-percreta-in-a-17-week-twin-pregnancy
#16
Fariha Farooq, Rashid Siraj, Sibtain Raza, Nadia Saif
Spontaneous rupture of previous uterine scar due to placenta percreta in early second trimester is a very rare and serious complication. A27-year fourth gravida, second para with previous two lower segment caesarean sections, presented at 17-week of twin pregnancy with acute abdominal pain. Ultrasonograghy revealed 17-week diamniotic-dichorionic twin pregnancy with alive fetuses. The placenta of the first twin was anterior, low lying covering the internal os and penetrating through the entire thickness of the lower uterine wall laterally...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28659187/tuberculous-meningoencephalitis-associated-with-brain-tuberculomas-during-pregnancy-a-case-report
#17
Sadie Namani, Shemsedin Dreshaj, Arieta Zogaj Berisha
BACKGROUND: Tuberculous meningitis is globally highly prevalent and is commoner in resource-limited countries and in patients with immunosuppression. Central nervous system tuberculosis is one of the severest forms of extrapulmonary tuberculosis during pregnancy and associated brain tuberculomas have been rarely reported. With the availability of neuroimaging at our hospital center, we present the first case of tuberculous meningoencephalitis associated with brain tuberculomas during pregnancy...
June 29, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28657383/retrospective-evaluation-of-pregnancy-outcomes-and-clinical-implications-of-34-han-chinese-women-with-unicornuate-uterus-who-received-ivf-et-or-icsi-et-treatment
#18
Junfen Liu, Yuanxia Wu, Suming Xu, Dan Su, Yingli Han, Xueqing Wu
This retrospective study aimed to evaluate pregnancy outcome and newborn health condition for a specific group of infertile patients with unicornuate uterus. A total of 34 patients were confirmed to have unicornuate uterus. These patients received 47 cycles of in vitro fertilisation-embryo transfer (IVF-ET) or intracytoplasmic sperm injection-embryo transfer (ICSI-ET), achieved 21 clinical pregnancies with a clinical pregnancy rate of 60.61%. Full-term delivery rate was 76.47%. Eleven patients gave birth to single neonates, while six patients gave birth to twins...
November 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28648013/-retrospective-analysis-of-anesthetic-and-perioperative-management-in-patients-of-acute-fatty-liver-of-pregnancy
#19
Y Y Qu, H Zeng, X Y Guo, M Li
Objective: To retrospectively analyze the clinical characteristics of patients with acute fatty liver of pregnancy (AFLP), and to discuss perioperative and anesthetic management. Methods: A retrospective review was conducted on the records of pregnant patients with a diagnosis of acute fatty liver of pregnancy in Peking University Third Hospital from January 2007 to December 2015. 12 cases were identified. The clinical features, preoperative laboratory findings, types of delivery, anesthetic techniques for cesarean section, and the outcomes of parturients and fetus were collected and analyzed...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28642442/triplet-pregnancy-with-fetal-reduction-experience-in-hong-kong
#20
W T Tse, L W Law, D S Sahota, T Y Leung, Y Ky Cheng
INTRODUCTION: Triplet and higher-order multiple pregnancies are well known to be associated with increased adverse outcomes. This study reviewed the perinatal outcomes in women with a triplet pregnancy who underwent fetal reduction versus expectant management at a university hospital in Hong Kong. METHODS: This was a retrospective review of triplet pregnancies at Prince of Wales Hospital in Hong Kong from 1 January 2008 to 30 September 2014. Women carrying a triplet pregnancy were classified as having had expectant management, fetal reduction to twins, or fetal reduction to a singleton...
June 23, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
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