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Complications of twin pregnancies

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https://www.readbyqxmd.com/read/29681134/an-audit-of-pregnancy-outcomes-in-solid-organ-transplant-recipients-at-a-metropolitan-hospital
#1
Yunjing E Fang, Roshini Nayyar, Hayley Diplock
BACKGROUND: Pregnancies in patients with solid organ transplants have higher rates of complications and caesarean sections (CS). AIM: To perform an audit of the pregnancy outcomes in transplant recipients, to determine the rate of CS in our cohort, the appropriate skin incision for CS in these patients and to formulate recommendations for preoperative planning. MATERIALS AND METHODS: This is a retrospective cohort study. All patients who had a solid organ transplant were identified from the obstetrics database...
April 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29678353/the-predictive-value-of-the-sflt-1-plgf-ratio-on-short-term-absence-of-preeclampsia-and-maternal-and-fetal-or-neonatal-complications-in-twin-pregnancies
#2
Langeza Saleh, Sarea I M Tahitu, A H Jan Danser, Anton H van den Meiracker, Willy Visser
OBJECTIVE: A sFlt-1/PlGF ratio of ≤38 has been reported to predict the absence of preeclampsia (PE) in singleton pregnancies. We evaluated whether a sFlt-1/PlGF ratio of ≤38 could be used to predict the absence of PE in twin pregnancies and maternal and fetal/neonatal complications. METHODS: This is a secondary analysis of a prospective multicenter cohort study that enrolled women with suspected or confirmed PE with the aim of evaluating the use of the sFlt-1, PlGF and their ratio to predict maternal and fetal/neonatal complications...
March 26, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29676599/psoriasis-in-pregnancy-case-series-and-literature-review-of-data-concerning-exposure-during-pregnancy-to-ustekinumab
#3
M Galluzzo, S D'Adamio, L Bianchi, M Talamonti
Psoriasis tends to improve for approximately half of patients during pregnancy, but an equal number of patients report no change or worsening during this period, when lots of medications, like biologics, are not indicated. The aim of our study was to review data of patient that had been pregnant during ustekinumab treatment, analyzing data of our data set between September 2010 and February 2018. We found data of three patients that had been pregnant during ustekinumab treatment. All three patients successfully completed the pregnancy without complications...
April 20, 2018: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29675904/risk-factors-for-fetal-death-after-radiofrequency-ablation-for-complicated-monochorionic-twin-pregnancies
#4
Luming Sun, Gang Zou, Yingjun Yang, Fenhe Zhou, Duan Tao
OBJECTIVE: Radiofrequency ablation (RFA) is a management alternative for complicated monochorionic twin pregnancies. The purpose of this study is to evaluate risk factors for fetal death after RFA. METHODS: An observational study was performed to document the perinatal outcomes of all cases undergoing fetal reduction using RFA from 2010 to 2016 at the Shanghai First Maternity and Infant Hospital. A multiple regression model was built to identify predictors of the death of the remaining fetus after RFA...
April 19, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29673002/incidence-of-and-risk-factors-for-severe-maternal-complications-associated-with-hypertensive-disorders-after-36-weeks-gestation-in-uncomplicated-twin-pregnancies-a-prospective-cohort-study
#5
Ryo Yamamoto, Keisuke Ishii, Haruka Muto, Shiyo Ota, Haruna Kawaguchi, Shusaku Hayashi, Nobuaki Mitsuda
AIM: To elucidate the incidence of and risk factors for severe hypertensive disorders (HD) and related maternal complications in uncomplicated twin pregnancies that reached 36 weeks' gestation. METHODS: We conducted a prospective cohort study of twin pregnancies delivered after 36 weeks' gestation. Cases of twin-twin transfusion syndrome, twin anemia-polycythemia sequence, malformed fetuses, monoamniotic twins, selective reduction, fetal therapy and HD or fetal death before 35 weeks' gestation were excluded...
April 19, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29667377/the-usefulness-of-determination-of-the-procalcitonin-pct-concentration-in-gbs-piositive-pregnant-womens-blood-serum-for-anticipations-of-infections-in-newborns
#6
Wojciech Cnota, Dominika Mucha, Jan Mucha
Group-B streptococci (GBS) are commensal bacteria of the human body. They may, however, pose a serious life hazard to pregnant women. During labour, newborns of GBS-positive mothers run the risk of infections that may eventually lead to severe complications, sepsis or even death. For this reason, it is very important to find new diagnostic markers that will enable fast and effective diagnostics and control of the disease process. The level of procalcitonin emerges as a promising diagnostic parameter. AIM. Analysis of the impact of the procalcitonin (PCT) level in GBS-positive pregnant women on the possibility of complications and infections in mothers and newborns MATERIAL AND METHODS...
2018: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/29661565/fetal-growth-restriction-in-twins
#7
REVIEW
R Townsend, A Khalil
Twin pregnancies are more likely to be affected by fetal growth restriction (FGR), preterm birth and perinatal loss. The management of fetal growth restriction in multiple pregnancy, particularly where only one fetus is affected is complicated by the need to consider the interests of both twins. Selective growth restriction in monochorionic (MC) twins is a pathophysiological process distinct from FGR in dichorionic (DC) pregnancies and management demands an understanding of the monochorionic placental structure and interdependent fetal circulations...
February 24, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29626712/treatment-of-twin-reversed-arterial-perfusion-sequence-with-radiofrequency-ablation-and-expectant-management-a-single-center-study-in-china
#8
Zhi-Tao Zhang, Tian Yang, Cai-Xia Liu, Na Li
OBJECTIVE: To evaluate the treatment of pregnancies in different stages complicated by TRAP sequence at a single medical center in China. STUDY DESIGN: A retrospective study evaluating 25 pregnancies with TRAP sequence was performed at Shengjing Hospital in Shenyang, Liaoning between 2012 and 2016. Patients were diagnosed by ultrasound and categorized into three groups (Ia, IIa and IIb) and were expectantly managed or performed RFA (radiofrequency ablation) according to their stage of TRAP sequence...
March 30, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29594002/obstetric-management-of-delayed-interval-delivery
#9
Maria Inês Raposo, Mariana Cardoso, Mariana Ormonde, Sarah Stokreef, Laura Correia, Andrea Pereira
The delayed-interval delivery is a rare, flexible and complex procedure. In light of these facts, there is no consensus on the best approach to achieve it successfully. This case report is of an asynchronous delivery, in a twin pregnancy, with a 32-day interval between births of siblings. Our obstetric management at a critical gestational age improved the outcome of the second newborn. The probability of success of delayed-interval delivery depends on the proper selection of the candidates, the appropriate active management and the continuous monitoring for early detection of complications...
October 2017: Case Reports in Women's Health
https://www.readbyqxmd.com/read/29582948/-advances-in-fetal-therapy-in-complicated-monochorionic-pregnancies-and-in-severe-congenital-diaphragmatic-hernia-five-years-experience
#10
Yuval Gielchinsky, Dan V Valsky, Nili Yanai, Firas J Abdeljawad, Mazen A Muhaisen, Dan Arbell, Yehuda Ginosar, Orna Ben-Yosef, Orite Winograd, Benjamin Bar-Oz, Simcha Yagel, Smadar Eventov-Friedman
INTRODUCTION: : Minimally invasive fetal therapeutic procedures reduce the morbidity and mortality in monochorionic (MC) twins and in fetuses with congenital diaphragmatic hernia (CDH). MC pregnancies share their blood systems due to communicating vessels over their single placenta and may develop specific complications: Twin-to-Twin transfusion syndrome (TTTS), Selective intrauterine growth restriction (sIUGR), Twin Anemia-Polycythemia Sequence (TAPS), Twin Reverse Arterial Perfusion Syndrome (TRAP) or anomalies in one...
March 2018: Harefuah
https://www.readbyqxmd.com/read/29574986/outcome-of-pregnancies-in-a-large-cohort-of-women-with-acromegaly
#11
R S Jallad, I Shimon, M Fraenkel, V Medvedovsky, A Akirov, F H Duarte, M D Bronstein
OBJECTIVE: To assess the outcome of pregnancies in a large cohort of women with acromegaly. DESIGN AND METHODS: This is a retrospective analysis of 31 pregnancies in 20 acromegalic patients. RESULTS: Twenty-seven pregnancies resulted in healthy offspring and four resulted in abortion. Three patients underwent transsphenoidal surgery during pregnancy. IGF-1 levels remained elevated during pregnancy in four pregnancies and normalized in 23 cases...
March 25, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29563502/placenta-and-appetite-genes-gdf15-and-igfbp7-are-associated-with-hyperemesis-gravidarum
#12
Marlena S Fejzo, Olga V Sazonova, J Fah Sathirapongsasuti, Ingileif B Hallgrímsdóttir, Vladimir Vacic, Kimber W MacGibbon, Frederic P Schoenberg, Nicholas Mancuso, Dennis J Slamon, Patrick M Mullin
Hyperemesis gravidarum (HG), severe nausea and vomiting of pregnancy, occurs in 0.3-2% of pregnancies and is associated with maternal and fetal morbidity. The cause of HG remains unknown, but familial aggregation and results of twin studies suggest that understanding the genetic contribution is essential for comprehending the disease etiology. Here, we conduct a genome-wide association study (GWAS) for binary (HG) and ordinal (severity of nausea and vomiting) phenotypes of pregnancy complications. Two loci, chr19p13...
March 21, 2018: Nature Communications
https://www.readbyqxmd.com/read/29558751/sudden-fetal-hematologic-changes-as-a-complication-of-amnioreduction-in-twin-twin-transfusion-syndrome
#13
Katarzyna Kosinska-Kaczynska, Michal Lipa, Iwona Szymusik, Dorota Bomba-Opon, Robert Brawura-Biskupski-Samaha, Szymon Kozlowski, Lisanne S A Tollenaar, Dick Oepkes, Miroslaw Wielgos, Enrico Lopriore
We present the first case of a monochorionic twin pregnancy in which sudden hematologic changes occurred as a complication of the amnioreduction procedure for twin-twin transfusion syndrome (TTTS). At 33 weeks of gestation, 4 days after the amnioreduction, the recipient developed severe anemia while the donor developed severe polycythemia. Postnatal placental examination revealed several arteriovenous and venoarterial anastomoses, a pale placental mass of the recipient and a congested and plethoric placental mass of the donor...
March 20, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29538675/determinants-of-monozygotic-twinning-in-art-a-systematic-review-and-a-meta-analysis
#14
Kathrine Vauvert R Hviid, Sara Sofia Malchau, Anja Pinborg, Henriette Svarre Nielsen
BACKGROUND: The incidence of monozygotic twins (MZT) after ART appears to be higher than the incidence after spontaneous conceptions contradicting the aim of ART to avoid multiple pregnancies because of the associated risks. OBJECTIVE AND RATIONALE: The aim was to study the frequency of MZT after IVF and ICSI and how it is influenced by the day of embryo transfer, maternal age, zona pellucida manipulation, controlled ovarian stimulation, stimulation protocol, culture media and embryo quality...
March 12, 2018: Human Reproduction Update
https://www.readbyqxmd.com/read/29533957/in-utero-partial-exchange-transfusion-combined-with-in-utero-blood-transfusion-for-prenatal-management-of-twin-anemia-polycythemia-sequence
#15
Mert Ozan Bahtiyar, Emre Ekmekci, Emine Demirel, Roxanna A Irani, Joshua A Copel
Monochorionic twin pregnancies are at risk of unique complications due to placental sharing and vascular connections between placental territories assigned for each twin. Twin anemia-polycythemia sequence (TAPS) is an infrequent but potentially dangerous complication of abnormal placental vascular connections. TAPS occurs due to very-small-caliber (< 1 mm) abnormal placental vascular connections which lead to chronic anemia in the donor twin and polycythemia in the recipient twin. TAPS may occur spontaneously or following fetoscopic laser photocoagulation of communicating placental vessels for twin-twin transfusion syndrome...
March 13, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29507303/impacts-of-different-methods-of-conception-on-the-perinatal-outcome-of-intrahepatic-cholestasis-of-pregnancy-in-twin-pregnancies
#16
Chun Feng, Wen-Juan Li, Rong-Huan He, Xi-Wen Sun, Guirong Wang, Li-Quan Wang
Twin pregnancies have a higher prevalence of intrahepatic cholestasis of pregnancy (ICP) than single pregnancies. It is unknown whether in vitro fertilization-embryo transfer (IVF-ET) influences the fetal outcomes in twin pregnancies complicated by ICP. This study aimed to explore the impact of IVF-ET on the perinatal outcomes of ICP in twin pregnancy. Clinical data from 142 twin pregnant women complicated with ICP were retrospectively analyzed, including 51 patients who conceived through IVF-ET (IVF group) and 91 patients with spontaneous conception (SC group)...
March 5, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29492669/alport-syndrome-and-pregnancy-a-case-series-and-literature-review
#17
Francesca Brunini, Barbara Zaina, Davide Gianfreda, Wally Ossola, Marisa Giani, Luigi Fedele, Piergiorgio Messa, Gabriella Moroni
PURPOSE: To assess pregnancy outcome in women with Alport syndrome and the impact of pregnancy on the disease progression. METHODS: We describe one of the largest series of pregnancies in Alport syndrome. Seven pregnancies of six women were monitored by a multidisciplinary team of nephrologists and gynecologists. After delivery, patients were followed for at least 3 years. We compare our results with those in the literature. RESULTS: Pregnancy course was uneventful in the patient with isolated microscopic hematuria...
February 28, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29486855/the-placental-component-and-neonatal-outcome-in-singleton-vs-twin-pregnancies-complicated-by-gestational-diabetes-mellitus
#18
Eran Weiner, Elad Barber, Ohad Feldstein, Letizia Schreiber, Ann Dekalo, Yossi Mizrachi, Jacob Bar, Michal Kovo
OBJECTIVE: We aimed to compare placental histopathological lesions and neonatal outcome in singleton vs. twin pregnancies complicated by gestational diabetes mellitus (GDM). METHODS: Maternal characteristics, neonatal outcomes, and placental histopathology reports of pregnancies complicated by GDM, between 1/2008-10/2016, were reviewed. Results were compared between singletons (singleton group) and dichorionic-diamniotic twins (twin group). Placental lesions were classified as placental weight abnormalities, maternal and fetal vascular malperfusion lesions (MVM, FVM), inflammatory lesions, and lesions associated with chronic villitis...
March 2018: Placenta
https://www.readbyqxmd.com/read/29467101/ultrasound-screening-for-complications-in-twin-pregnancy
#19
Rosemary Townsend, Asma Khalil
In the decades since the introduction of ultrasound into routine obstetric practice, the advantages of ultrasound have moved beyond the simple ability to identify multiple pregnancies antenatally to the possibility of screening them for fetal anomalies, pre-eclampsia, preterm birth, and the complications specific to monochorionic pregnancies. Screening studies have often excluded twins because physiological differences impact on the validity and sensitivity of the screening tests in routine use in singletons, and therefore, the evidence of screening performance in multiple pregnancy lags behind the evidence from singleton pregnancies...
February 18, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29436080/fetoscopic-laser-photocoagulation-for-twin-twin-transfusion-syndrome
#20
Haruhiko Sago, Keisuke Ishii, Rika Sugibayashi, Katsusuke Ozawa, Masahiro Sumie, Seiji Wada
The aim of this study was to review fetoscopic laser photocoagulation (FLP), which ablates placental vascular anastomoses to treat twin-twin transfusion syndrome (TTTS). A review of studies reporting on the procedures, outcomes, complications and nonconventional applications of FLP for TTTS was conducted. FLP has been established as the primary treatment for monochorionic twin pregnancy associated with TTTS at 16-26 weeks. FLP is the only therapy that directly addresses the underlying pathophysiology. The recent technique modification of FLP, referred to as the 'Solomon technique', induces selective coagulation to connect the anastomoses ablation sites and has been introduced to reduce residual anastomoses...
February 13, 2018: Journal of Obstetrics and Gynaecology Research
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