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Complications of twin pregnancies

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https://www.readbyqxmd.com/read/29034746/clinical-characteristics-of-acute-fatty-liver-of-pregnancy-in-a-tertiary-indonesian-hospital
#1
Muhammad Ilham Aldika Akbar, Indah Mayang Sari, Aditiawarman, Erry Gumilar Dachlan, Gustaaf Dekker
Acute fatty liver of pregnancy (AFLP) is a rare, often autosomal recessive disorder with a major risk for maternal and perinatal mortality and morbidity. In order to achieve a more favorable outcome, awareness of its clinical signs and symptoms and early recognition are of pivotal importance. Over a 5-year period 18 patients were diagnosed with AFLP (one twin, 19 babies). The most common sign and symptoms were jaundice, hypoglycemia, nausea and vomiting, encephalopathy, and hypertension. Abnormal laboratory test results included: elevated total/ conjugated (direct) bilirubin, AST, ALT, PT, APTT, creatinine, leukocyte count, and hypoalbuminemia...
October 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29028139/birthweight-discordance-and-neonatal-morbidity-in-twin-pregnancies-analysis-of-the-stork-multiple-pregnancy-cohort
#2
Francesco D'Antonio, Basky Thilaganathan, Arianna Laoreti, Asma Khalil
OBJECTIVES: The main aim of this study was to investigate the relationship between weight discordance and neonatal morbidity in twin pregnancies progressing beyond 34 weeks of gestation. The secondary aim was to determine the predictive accuracy of different weight discordant cut-offs in predicting neonatal morbidity in twin pregnancies. METHODS: This was a retrospective multicentre cohort study of all twin pregnancies booked for antenatal care in four hospitals in the Southwest Thames region of London Obstetric Research Collaborative (STORK) over a period of ten years...
October 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29027529/-twin-pregnancy-with-complete-hydatidiform-mole
#3
I N Voloshchuk, I V Barinova, N I Kondrikov, R A Barto
The paper describes a case of twin pregnancy with complete hydatidiform mole (CHM). According to the data available in the literature, the concurrence of CHM with a normal placenta and a viable fetus occurs in 1 per 20,000-100,000 pregnancies, requires a differential diagnosis with partial hydatidiform mole and placental mesenchymal dysplasia, and is characterized by a high rate of complications. In this concurrence, the frequency of persistent trophoblastic disease is as high as 50%. In this case, the pregnancy ended in a spontaneous abortion at 16-17 weeks of pregnancy...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/29027307/transient-amniotic-fluid-leakage-after-fetoscopic-laser-photocoagulation-for-twin-twin-transfusion-syndrome
#4
Shiyo Ota, Keisuke Ishii, Hiroshi Kawamura, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Takeshi Kanagawa, Nobuaki Mitsuda
AIM: Iatrogenic premature rupture of membrane (PROM) is one of the major complications related to fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS). However, amniotic fluid leakage (AFL) sometimes spontaneously disappears. This study evaluated the incidence and clinical characteristics of transient AFL after FLP. METHODS: We retrospectively reviewed pregnancies that underwent FLP for TTTS at a single center. Patients with apparent AFL within 2 weeks after FLP were divided into two groups: transient AFL, defined by the disappearance of fluid leakage within a week; and PROM, if AFL persisted continuously for more than a week or premature birth occurred, including miscarriage, within a week of the first symptom of AFL...
October 13, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29024208/does-the-site-of-the-cord-insertion-increase-the-risk-of-adverse-outcome-twin-to-twin-transfusion-syndrome-and-discordant-growth-in-monochorionic-twin-pregnancies
#5
Isabel Couck, Nada Mourad Tawfic, Jan Deprest, Luc De Catte, Roland Devlieger, Liesbeth Lewi
BACKGROUND: It is insufficiently known to what degree the site of the cord insertions influences the risk of a complicated outcome in monochorionic twin pregnancies. OBJECTIVES: The purpose is to examine if the site of cord insertions as determined on prenatal ultrasound scan increases the risk of adverse outcome -defined as fetal or neonatal loss or birth prior to 32 weeks-, twin-to-twin transfusion syndrome (TTTS) and discordant growth. METHODS: We retrospectively studied a consecutive cohort of monochorionic diamniotic twin pregnancies followed from the first trimester...
October 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29020780/-selective-feticide-in-monochorionic-twin-pregnancies-with%C3%A2-discordant-fetal-anomalies-management-and-outcome
#6
J Vojtěch, L Hašlík, R Pock, K Běhávková, K Macková, P Hanulíková, H Heřman, L Krofta
OBJECTIVE: To analyze results and outcome after selective feticide for discordant anomalies in monochorionic twins. DESIGN: Prospective cohort study. SETTING: Fetal medicine center, Institute for the Care of Mother and Child, Praha. METHODS: Analysis of outcome of monochorionic pregnancies after intrauterine surgery for structural abnormalities between January 2013 and June 2016. RESULTS: We performed 13 intrauterine operations in monochorionic twins with structural anomalies during the period...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28981984/obstetrical-complications-in-dichorionic-twin-pregnancies-in-women-with-polycystic-ovary-syndrome
#7
Fjola Jonsdottir, Lisbeth Nilas, Kirsten R Andreasen, Jørgen Grinsted, Michael Christiansen, Paula L Hedley, Klara V Naver
INTRODUCTION: Both women with polycystic ovary syndrome (PCOS) and women with twin pregnancies have increased risk of adverse pregnancy outcome. The aim of this study was to investigate the impact of PCOS and maternal androgen levels on the outcome of dichorionic twin pregnancy. MATERIAL AND METHODS: A retrospective study of 360 women with dichorionic twin pregnancies: 72 PCOS women from a fertility clinic (years 1997 to 2010) and 288 non-PCOS women from a hospital cohort (years 2005 to 2007)...
October 5, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28976606/the-significance-of-placental-cord-insertion-site-in-twin-pregnancy
#8
Erkan Kalafat, Basky Thilaganathan, Aris Papageorghiou, Amar Bhide, Asma Khalil
OBJECTIVE: The aim of this study was to investigate the association between abnormal cord insertion and the development of the twin-specific complications, including birthweight discordance, selective fetal growth restriction (sFGR) and twin-to-twin transfusion syndrome (TTTS). METHODS: A single-center cohort study of twin pregnancies. Abnormal cord insertion was defined as either marginal (cord attachment site less than 2cm to the nearest margin of the placental disc) or velamentous (when the umbilical cord was attached to the membrane before reaching the placental disc with clear evidence of vessels traversing the membranes to connect with the placental disc), as described in placental pathology reports...
October 4, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28969512/placental-histopathology-differences-and-neonatal-outcome-in-dichorionic-diamniotic-as-compared-to-monochorionic-diamniotic-twin-pregnancies
#9
Eran Weiner, Elad Barber, Ohad Feldstein, Ann Dekalo, Letizia Schreiber, Jacob Bar, Michal Kovo
OBJECTIVE: We aimed to compare the differences in placental histopathology lesions and pregnancy outcome in dichorionic-diamniotic (DCDA) versus uncomplicated monochorionic-diamniotic (MCDA) twin gestations. STUDY DESIGN: Maternal characteristics, neonatal outcome, and placental histopathology reports of all twin deliveries between 24 and 41 weeks were reviewed. Excluded were pregnancies complicated by twin-to-twin transfusion syndrome, twin anemia-polycythemia sequence, selective intrauterine growth restriction, placenta previa, intrauterine fetal death, and malformation...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28969220/pregnancy-outcomes-in-isolated-oligohydramnios-during-second-trimester-a-case-series
#10
Ashima Taneja, Kamaldeep Arora, Isha Chopra, Sushree Samiksha Naik
Oligohydramnios is associated with increased maternal and foetal morbidities. However, some of the recent studies have shown no adverse effect of isolated oligohydramnios on perinatal outcome and recommends continuation of pregnancy. Pregnancies between 18-28 weeks with isolated Oligohydramnios were included. History and physical examination was recorded in a pre-designed proforma. All the cases received care as per the protocol. A total of seven patients were recruited of which one was a twin pregnancy with Oligohydramnios in both sacs...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28964964/expectant-management-and-laser-photocoagulation-in-isolated-selective-intra-uterine-growth-restriction-a-single-center-series
#11
A Koch, R Favre, B Viville, G Fritz, M Kohler, F Guerra, L Lecointre, A Gaudineau, B Langer, A-S Weingertner, N Sananès
INTRODUCTION: The objective was to report on a consecutive series of monochorionic diamniotic pregnancies complicated by selective Intra-Uterine Growth Restriction (sIUGR) and to describe perinatal outcomes based on whether or not there were umbilical Doppler findings, and specifically to study those pregnancies treated by laser. MATERIAL AND METHODS: This was a retrospective cohort study enrolling monochorionic diamniotic pregnancies presenting isolated sIUGR after 16 weeks' gestation (WG)...
September 28, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28960292/case-report-of-a-potential-association-between-burkholderia-cepacia-and-preterm-delivery-of-a-twin-pregnancy-following-in-vitro-fertilization
#12
Stavroula Baka, Mariana Dramountani, Charalambos Karachalios, Iraklis Michaliadis, Evangelia Kouskouni, Konstantinos Panoulis
Vaginal colonization of Burkholderia cepacia was identified as a potentially complicating factor during a high-risk pregnancy. Although first described as a phytopathogen and used as a bio-pesticide, Burkholderia cepacia, an aerobic, glucose non-fermenting, multidrug-resistant Gram-negative rod, has emerged as a significant opportunistic pathogen causing severe pulmonary infections, mostly in patients who have cystic fibrosis and are immunocompromised [1]. Owing to its ability to survive and proliferate in nutrient-poor liquids and moist environments, hospital outbreaks have been associated with contaminated intravenous solutions, disinfectants, hospital equipment, and person-to-person contact [1,2]...
September 28, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28938429/effect-of-preconception-impaired-glucose-tolerance-on-pregnancy-outcomes-in-women-with-polycystic-ovary-syndrome
#13
Daimin Wei, Bo Zhang, Yuhua Shi, Lin Zhang, Shigang Zhao, Yanzhi Du, Lizhen Xu, Richard S Legro, Heping Zhang, Zi-Jiang Chen
Context: Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective: To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Intervention(s) and Main Outcome Measure(s): This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer...
August 14, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28929000/successful-vaginal-delivery-of-naturally-conceived-dicavitary-twin-in-didelphys-uterus-a-rare-reported-case
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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