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Twin pregnancies complications

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https://www.readbyqxmd.com/read/28231064/three-dimensional-ultrasound-for-prenatal-assessment-of-conjoined-twins-additional-advantages
#1
Tuangsit Wataganara, Pornpimol Ruangvutilert, Prasert Sunsaneevithayakul, Kusol Russameecharoen, Katika Nawapun, Nisarat Phithakwatchara
Conjoined twins are a rare, but serious, complication of monozygotic twins. Early prenatal diagnosis of conjoined twins is increasingly made with transvaginal ultrasound and color Doppler studies. Most prenatally diagnosed conjoined twins are terminated due to the high perinatal mortality, but advancement in pediatric surgery has allowed for successful postnatal separation in a small number of cases, and some parents may consider this option over termination of pregnancy. It is important to get a detailed prenatal ultrasound for the site and extent of fusion for an accurate categorization...
February 23, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#2
Craig V Towers, Angela Yates, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: To prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with the newborns that delivered from mothers that did not have an intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28210482/delayed-interval-delivery-can-save-the-second-twin-evidence-from-a-systematic-review
#3
REVIEW
S Feys, Y Jacquemyn
BACKGROUND: In case of preterm birth in twins, it is not well established if the second twin benefits from a delayed-interval delivery. OBJECTIVE: The main objective of this systematic review is to evaluate survival benefit of the second twin from delayed interval delivery compared to the first twin. Secondly, we will evaluate the survival benefit of the procedure when performed equal to or after 24 weeks gestational age of the first born. METHODS: Delayed interval delivery was defined as every attempt to perform a delayed interval delivery with at minimum placement of a high ligature of the umbilical cord and a delay of delivery of at least 24 hours...
December 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28208945/perinatal-outcome-of-second-twin-with-respect-to-mode-of-delivery-an-observational-study
#4
Rujul Rashmin Jhaveri, Trupti K Nadkarni
INTRODUCTION: With the advent of assisted reproductive techniques, multi-fetal pregnancies are on the rise. While caesarean section is the defined mode of delivery for triplets and higher order pregnancies, the picture for twin delivery is not so clear. While a trial for vaginal delivery is attempted, the second twin is considered vulnerable to complications. Whether this translates into worsened perinatal outcomes is not well defined. AIM: To study the perinatal outcome and to identify the various factors influencing the perinatal outcome of second twin with respect to mode of delivery...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28186636/triplet-pregnancy-from-the-transfer-of-two-blastocysts-demonstrating-a-twin-reversed-arterial-perfusion-sequence-with-a-conjoined-twins-pump-fetus
#5
Hongxia Yuan, Qichang Zhou, Jing Li, Shi Zeng
The incidence of monochorionic gestation is increased eight-fold following assisted reproductive techniques [1]. Monochorionic triplet pregnancies are rare, occurring in 1 in 45 500 deliveries [2], and are associated with high mortality and morbidity. Both conjoined twins and the twin reversed arterial perfusion (TRAP) sequence are unique complications of monochorionic pregnancy. The present study describes transvaginal ultrasonography findings from a monochorionic diamniotic triplet pregnancy at 10 weeks of gestation following double embryo transfer; a TRAP sequence, with a pair of conjoined twins as a "pump" fetus was identified...
February 10, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28166593/impact-of-rare-bleeding-disorders-during-pregnancy-on-maternal-and-fetal-outcomes-review-of-29-pregnancies-at-a-single-center
#6
Gokcen Orgul, Fatih Aktoz, M Sinan Beksac
Objective This study aims to give information about the relationship between different types of factor deficiencies and maternal/obstetric outcomes. Methods We retrospectively reviewed the medical records of eight women with factor deficiency disorders. The demographic and clinical features of the patients after their last pregnancies were registered retrospectively. Results There were 29 pregnancies among the 8 patients. The spontaneous abortion rate was relatively high in two patients with factor XIII deficiency (80% and 57...
February 6, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28153653/prenatal-diagnosis-and-management-of-vasa-previa-in-twin-pregnancies-a-case-series-and-systematic-review
#7
REVIEW
Eric Jauniaux, Yaakov Melcer, Ron Maymon
BACKGROUND: Twin pregnancies are at higher risks of velamentous cord insertion (VCI) and vasa previa. In-vitro fertilization (IVF) is an additional risk factor of abnormal cord insertion and thus the incidence of vasa previa is likely to increase over the next decades. OBJECTIVE: To evaluate the role of ultrasound imaging in optimizing the management of twins diagnosed with vasa previa antenatally. STUDY DESIGN: We searched our database for twin pregnancies diagnosed with vasa previa and managed antenatally using measurements of cervical length (CL) and performed a systematic review of articles which correlated prenatal diagnosis of vasa previa in twins and pregnancy outcome...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28150444/the-influence-of-chorionicity-and-gestational-age-at-single-fetal-loss-on-the-risk-of-preterm-birth-in-twin-pregnancies-analysis-of-the-stork-multiple-pregnancy-cohort
#8
Francesco D'Antonio, Basky Thilaganathan, Tiran Dias, Asma Khalil
BACKGROUND: Single intrauterine death (sIUD) in twin pregnancies is associated with a significant risk of co-twin demise and preterm birth (PTB), especially in monochorionic (MC) twins. However, it is yet to be established whether the gestational age at loss may influence the pregnancy outcome. The aim of this study was to explore the risk of PTB according to the gestational age at the diagnosis of sIUD. METHODS: A cohort study of all twin pregnancies from a large regional network of 9 hospitals over a ten-year period...
February 2, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28141940/are-early-pregnancy-complications-more-common-in-women-with-hyperemesis-gravidarum
#9
Sinead R Morgan, Lisa Long, Jemma Johns, Chloe Angwin, Supriya Maitra, Jackie A Ross
Ultrasound evaluation is usually requested for women presenting with hyperemesis gravidarum (HG) in early pregnancy. This is to check viability as well as to diagnose multiple pregnancies and exclude gestational trophoblastic disease (GTD). The aim of this retrospective case control study was to evaluate the early pregnancy outcomes in women with HG and to compare them with an asymptomatic control group. 790 women referred with HG between 2002 and 2014 were matched for gestational age and maternal age with an asymptomatic patient attending for a reassurance or dating scan...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28138191/intestinal-obstruction-due-to-congenital-malrotation-complicating-a-multiple-pregnancy-a-rare-case-report
#10
Yuzhu Yin, Chuo Li, Chengfang Xu, Lingling Wu, Ni Deng, Hongying Hou, Bin Wu
Intestinal obstruction due to congenital intestinal malrotation is usually diagnosed in neonates but may, in rare cases, occur during pregnancy. The absence of specific symptoms in combination with its low incidence makes timely detection of intestinal malrotation-related obstruction difficult in expectant mothers. We present a rare case of a 23-year-old woman with a twin pregnancy following in vitro fertilization-embryo transfer (IVF-ET) who presented with symptoms of intestinal obstruction at 22+4 weeks of gestation...
February 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28130929/use-of-antenatal-corticosteroids-in-special-circumstances-a-comprehensive-review
#11
Everett F Magann, Kjell Haram, Songthip Ounpraseuth, Jan Helge Mortensen, Horace J Spencer, John C Morrison
OBJECTIVE: To determine in pregnancies complicated by preterm premature rupture of membranes (PPROM), hypertension, intrauterine growth restriction, multi-fetal gestations and pregnancies 23- 26 weeks≥ 34 weeks gestation whether antenatal corticosteroids benefit the fetus. DATA SOURCES: Literature review using PubMed, Web of Science, Clinical trials. gov, Cochrane Database of Systematic Reviews (1990 - 2015). METHODS OF STUDY SELECTION: Search terms linked special circumstances with corticosteroids...
January 28, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28114847/virtual-three-dimensional-placentoscopy-a-new-approach-to-assess-residual-anastomoses-following-laser-photocoagulation-in-twin-to-twin-transfusion-syndrome
#12
Roberto Noya Galluzo, Mario Júlio Franco, Leila Wessler Faust, Karine Souza Dacorégio, Jair Roberto da Silva Braga, Heron Werner, Edward Araujo Júnior
Twin-to-twin transfusion syndrome (TTTS) complicates 10% of monochorionic twin pregnancies and it is consequence of an unbalanced exchange blood through the vascular anastomoses at placental surface. If not treated, mortality rates in TTTS may be as high as 80 to 100%. Laser photocoagulation of the placental anastomoses is the first treatment option, however in some situations the damage of the placenta in the postpartum may become difficult the residual anastomoses identification. We propose a new non-invasive technique to assess the residual anastomoses using computed tomography (CT) scan data to generate a three-dimensional (3D) virtual placentoscopy...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28112003/predictors-of-twin-pregnancy-after-ovarian-stimulation-and-intrauterine-insemination-in-women-with-unexplained-infertility
#13
Arie Berkovitz, Tal Biron-Shental, Yael Pasternak, Reuven Sharony, Anat Hershko-Klement, Amir Wiser
Multi-foetal gestation is a well-known, adverse outcome of infertility treatment. Maternal and obstetrical complications are more frequent in multiple pregnancies compared to singletons. The aim of this study was to determine parameters that affect the risk for multiple pregnancies after ovarian stimulation (OS) with intrauterine insemination (IUI). We retrospectively evaluated all cases of OS with IUI cycles that ended with successful clinical pregnancy. A total of 259 pregnancies were analysed (175 singletons, 63 twins and 21 triplets)...
January 22, 2017: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/28100569/multiple-pregnancy-in-a-primigravida-with-uncorrected-pentalogy-of-fallot
#14
Pamela Partana, Jarrod Kah Hwee Tan, Ju Le Tan, Lay Kok Tan
Pentalogy of Fallot is a cyanotic congenital heart disease that has guarded prognosis without surgical intervention in infancy. Women with uncorrected defects rarely survive into childbearing age and pregnancy in this group is associated with a high rate of perinatal loss. Physiological cardiovascular changes in pregnancy can lead to maternal haemodynamic instability with subsequent adverse cardiac sequelae with or without fetal decompensation. Optimum management and pregnancy outcomes in mother with uncorrected Pentalogy of Fallot and twin pregnancy have not been described in the literature...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28095812/maternal-sepsis-complicating-arabin-cervical-pessary-placement-for-the-prevention-of-preterm-birth-a-case-report
#15
Begoña Martinez de Tejada
BACKGROUND: Preterm delivery is a major health problem and contributes to more than 50% of all neonatal and infant deaths. Recently, there has been a renewed interest in the use of cervical pessaries as a safe and effective intervention with few maternal side-effects for the prevention of preterm birth in both single and twin pregnancies. CASE PRESENTATION: A 43-year-old gravida 5, para 1 (previous preterm birth at 24 weeks) patient with an in vitro fertilization twin pregnancy had an Arabin cervical pessary placed at 19 weeks of pregnancy due to the presence of cervical funneling identified by ultrasound screening...
January 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28089975/in-vitro-fertilization-in-37-women-with-systemic-lupus-erythematosus-or-antiphospholipid-syndrome-a-series-of-97-procedures
#16
Pauline Orquevaux, Agathe Masseau, Véronique Le Guern, Vanessa Gayet, Danièle Vauthier, Gaelle Guettrot-Imbert, Du Le Thi Huong, Bertrand Wechsler, Nathalie Morel, Patrice Cacoub, Jean-Loup Pennaforte, Jean-Charles Piette, Nathalie Costedoat-Chalumeau
OBJECTIVE: To compile and assess data about complication and success rates for in vitro fertilization (IVF) of women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). To date, such data are sparse. METHODS: This retrospective study described women with SLE and/or APS who have had at least 1 IVF cycle. RESULTS: Thirty-seven women with SLE (n = 23, including 8 with antiphospholipid antibodies), SLE with APS (n = 4), or primary APS (n = 10) underwent 97 IVF procedures...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28079866/outcomes-of-twin-pregnancies-complicated-by-gestational-diabetes-a-meta-analysis-of-observational-studies
#17
R T McGrath, S L Hocking, E S Scott, S K Seeho, G R Fulcher, S J Glastras
OBJECTIVE: Gestational diabetes mellitus (GDM) in singleton pregnancy is associated with large for gestational age neonates and adverse perinatal outcomes; however, the impact of GDM in twin pregnancy is unclear. Thus, the aim of this study is to assess the perinatal outcomes of twin pregnancies complicated by GDM by performing a meta-analysis of observational studies. STUDY DESIGN: Studies investigating GDM in twin pregnancy were identified through an online search of three databases: Medline, Embase and Web of Science...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28033658/multiple-exposures-to-environmental-pollutants-and-oxidative-stress-is-there-a-sex-specific-risk-of-developmental-complications-for-fetuses
#18
REVIEW
Kaïs H Al-Gubory
Medically assisted procreation significantly contributes to an increase in twin pregnancies. One of the major factors contributing to more twin births is the use of fertility treatments. Twin pregnancy is not without a risk for fetal organ development and the health outcome of new-borns, children, and adults. Multiple pregnancies are associated with an increased risk of developmental complications, such as perinatal mortality, premature births, and low birth weight. Oxidative stress is involved in pregnancy disorders such as abortion, intrauterine growth retardation, and prenatal mortality...
December 2016: Birth Defects Research. Part C, Embryo Today: Reviews
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#19
L Marcellin
OBJECTIVE: To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. RESULTS: Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28017976/acute-abdomen-in-the-17th-week-of-twin-pregnancy-due-to-ovarian-torsion-a-late-complication-of-ivf
#20
D Habek, R Bauman, L Rukavina Kralj, T Hafner, T Turudic, S Vujisic
Background: A 32-year-old woman with tubal factor infertility due to bilateral laparoscopic salpingectomy conceived twins with in vitro fertilization (IVF). She developed moderate ovarian hyperstimulation syndrome which was treated with anticoagulant therapy. The subsequent course of the twin pregnancy was normal until the 17th week of gestation when she presented to hospital because of a sharp pain in the right lower abdomen which ceased after admission. Case: Except for a single incident of vomiting, patient had no other subjective symptoms...
December 2016: Geburtshilfe und Frauenheilkunde
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