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Şifa Turan, Özhan M Turan
The ductus venosus is a fetal vessel that functions importantly in the transfer of oxygen-and nutrient-rich blood from the umbilical vein to vital organs. Its control under active regulation and its anatomy result in a flow-velocity profile that is typically forward throughout the cardiac cycle. This forward cardiac function reflects afterload, cardiac contractility, compliance, and vascular volume changes. Ductus venosus assessment gives valuable information under different fetal conditions. For example, during first trimester screening, an abnormal ductus venosus measurement changes the screening result...
March 15, 2018: Balkan Medical Journal
Loïc Peter, Marcel Tella-Amo, Dzhoshkun Ismail Shakir, George Attilakos, Ruwan Wimalasundera, Jan Deprest, Sébastien Ourselin, Tom Vercauteren
PURPOSE: The standard clinical treatment of Twin-to-Twin transfusion syndrome consists in the photo-coagulation of undesired anastomoses located on the placenta which are responsible to a blood transfer between the two twins. While being the standard of care procedure, fetoscopy suffers from a limited field-of-view of the placenta resulting in missed anastomoses. To facilitate the task of the clinician, building a global map of the placenta providing a larger overview of the vascular network is highly desired...
March 15, 2018: International Journal of Computer Assisted Radiology and Surgery
Nancy L Segal
This article begins with the story of a 51-year-old Los Angeles, California man, Justin Goldberg, whose daughter caught a glimpse of his striking look-alike at a popular market. Many people have so-called doppelgängers, but this occurrence is especially intriguing - the individual in question, born in New York City in the mid-1960s to an unwed mother, was an adoptee placed by the Louise Wise Adoption Agency. This agency, under the guidance of a prominent psychiatrist, decided to place twins in separate homes...
March 15, 2018: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Marcel Tella-Amo, Loic Peter, Dzhoshkun I Shakir, Jan Deprest, Danail Stoyanov, Juan Eugenio Iglesias, Tom Vercauteren, Sebastien Ourselin
The most effective treatment for twin-to-twin transfusion syndrome is laser photocoagulation of the shared vascular anastomoses in the placenta. Vascular connections are extremely challenging to locate due to their caliber and the reduced field-of-view of the fetoscope. Therefore, mosaicking techniques are beneficial to expand the scene, facilitate navigation, and allow vessel photocoagulation decision-making. Local vision-based mosaicking algorithms inherently drift over time due to the use of pairwise transformations...
April 2018: Journal of Medical Imaging
Nicola Persico, Francesco D'Ambrosi, Isabella Fabietti, Simona Boito, Elisa Aiello, Alessandro Bulfoni, Fabrizio Ciralli, Alessandra Kustermann, Fabio Mosca, Luigi Fedele
OBJECTIVE: To investigate sequential Doppler changes in donors and recipients before and one week after endoscopic laser for twin-to-twin transfusion syndrome (TTTS) and to examine factors that may be associated with such changes. METHODS: In TTTS pregnancies undergoing laser treatment, we examined fetal Doppler changes before and one week post-intervention. Intrauterine death rates and preoperative factors were analysed in relation to Doppler changes. RESULTS: Among 129 (85...
February 13, 2018: Prenatal Diagnosis
Maela Le Lous, Imen Mediouni, Gihad Chalouhi, Laurent Salomon, Laurence Bussières, Aude Carrier, Jean-Pierre Bernard, Yves Ville
OBJECTIVES: The objective of our study was to determine the impact of laser therapy for twin-to-twin transfusion syndrome (TTTs) on subsequent pregnancies. METHODS: This was a monocentric retrospective observational study. Women treated by laser fetoscopy for TTTs were asked to answer a postal questionnaire about subsequent pregnancies. The primary outcome was fecundity (number of pregnancies and time to pregnancy). We also assessed pregnancy complications, birth weight, and gestational age at delivery...
February 8, 2018: Prenatal Diagnosis
Chin Yee Ho, Zong-Rong He, San-Nan Yang, Yung-Ning Yang
RATIONALE: Late-onset transient adrenal insufficiency with circulatory collapse is a rare condition that occurs in preterm infants. Although the incidence of late-onset transient adrenal insufficiency in preterm infants has been reported in Japan, reports from Western countries are lacking. In addition, no study has investigated the effect of twin-to-twin transfusion syndrome (TTTS) in monozygotic twins. PATIENT CONCERNS: A pair of extremely low birth weight twins presented with TTTS...
November 2017: Medicine (Baltimore)
Javier U Ortiz, Ximena Torres, Elisenda Eixarch, Mar Bennasar, Monica Cruz-Lemini, Olga Gómez, Silvia M Lobmaier, Josep M Martínez, Eduard Gratacós, Fatima Crispi
OBJECTIVE: To evaluate left myocardial performance index (MPI) and time intervals in fetuses with twin-to-twin transfusion syndrome (TTTS) before and after laser surgery. METHODS: Fifty-one fetal pairs with TTTS and 47 uncomplicated monochorionic twin pairs were included. Left ventricular isovolumetric contraction time (ICT), ejection time (ET), and isovolumetric relaxation time (IRT) were measured using conventional Doppler. RESULTS: Recipients showed prolonged ICT (46 ± 12 vs...
January 19, 2018: Fetal Diagnosis and Therapy
L Lindroos, A Elfvin, L Ladfors, U-B Wennerholm
BACKGROUND: The objective was to examine the effect of twin-to-twin delivery intervals on neonatal outcome for second twins. METHODS: This was a retrospective, hospital-based study, performed at a university teaching hospital in Western Sweden. Twin deliveries between 2008 and 2014 at ≥32 + 0 weeks of gestation, where the first twin was delivered vaginally, were included. Primary outcome was a composite outcome of metabolic acidosis, Apgar < 4 at 5 min or peri/neonatal mortality in the second twin...
January 19, 2018: BMC Pregnancy and Childbirth
Francesco D'Antonio, Anthony O Odibo, Federico Prefumo, Asma Khalil, Danilo Buca, Maria Elena Flacco, Marco Liberati, Lamberto Manzoli, Ganesh Acharya
OBJECTIVES: The primary aim of this systematic review was to explore the strength of association between birthweight (BW) discordance and perinatal mortality in twin pregnancies; the secondary aim was to ascertain the contribution of gestational age and growth restriction in determining mortality in growth discordant twins. METHODS: Medline, Embase, Cinahl and databases were searched. Only studies reporting the risk of mortality in twin pregnancies affected compared to those not affected by weight discordance were included...
November 20, 2017: Ultrasound in Obstetrics & Gynecology
Nancy L Segal
Findings from twin studies of musical interests and talent are reviewed as a backdrop to the lives and careers of twin jazz musicians, Peter and Will Anderson. The Anderson twins exemplify many aspects of twin research, namely their matched musical abilities, shared musical interests, and common career. This overview is followed by reviews of studies and case reports of bereavement in families who have lost a preterm multiple birth infant, the conception of conjoined twins following in vitro fertilization (IVF), depression in fathers of twins, and twin-to-twin transfusion incidence in monochorionic-diamniotic IVF twin pairs...
December 2017: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Phyllis Glanc, David A Nyberg, Nadia J Khati, Sandeep Prakash Deshmukh, Kika M Dudiak, Tara Lynn Henrichsen, Liina Poder, Thomas D Shipp, Lynn Simpson, Therese M Weber, Carolyn M Zelop
Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model...
November 2017: Journal of the American College of Radiology: JACR
Sezin Unal, Dilek Ulubas Isik, Ahmet Yagmur Bas, Sara Erol, İlter Arifoglu, Murat Alisik, Ozcan Erel, Nihal Demirel
BACKGROUND: Thiols are organic compounds containing sulfhydryl groups which exert antioxidant effects via dynamic thiol-disulfide homeostasis. The shift towards disulfides indicates the presence of oxidative environment. Thiol-disulfide homeostasis has not been evaluated in neonates. We aimed to evaluate dynamic thiol-disulfide homeostasis in preterm infants. METHODS: Preterm infants with birth weight less than 1500 grams (25-32 weeks of gestation) were included...
November 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
Gabriel Levin, Roy Zigron
A patient aged 28 years (gravida 5 para 3) who was at 21 weeks of a monochorionic diamniotic pregnancy, underwent fetoscopic laser ablation of placental blood vessels owing to stage-3 twin-to-twin transfusion syndrome (Figure 1). Ultrasonography on post-operative day 1 demonstrated marked improvement of both embryo urinary bladder filling and Doppler blood flow measurements. This article is protected by copyright. All rights reserved.
October 21, 2017: International Journal of Gynaecology and Obstetrics
Veronica Mugarab-Samedi, Abhay Lodha, Adel ElSharkawy, Essa Al Awad
Monochorionic (MC) twin pregnancies are known to carry a high risk of twin-to-twin transfusion syndrome (TTTS) that could lead to miscarriage and perinatal death. Demise of one fetus is frequently associated with co-fetal death. Fetal reduction by interstitial laser therapy is an effective procedure to prevent this outcome, but it may be associated with significant risks for both mother and fetus. Aplasia Cutis Congenita (ACC) may occur in up to 8% cases of fetal reduction by laser therapy. We report ACC in a preterm infant, a survivor of interstitial laser therapy for fetal reduction in MC pregnancy...
October 10, 2017: International Journal of Surgery Case Reports
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
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
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
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
Ana Miralles-Gutiérrez, Isidoro Narbona-Arias, Ernesto González-Mesa
OBJECTIVE: The main objective of this study was to review the available scientific evidence about mid-term neurological outcomes in twins after laser therapy for twin-to-twin transfusion syndrome (TTTS). METHODS: A systematic review of studies on neurodevelopmental outcomes (cognition, motor development, communication skills and cerebral palsy) of twins after laser therapy for TTTS was conducted. Outcomes at 24 months of age and the use of validated scales for assessment were the selected criteria...
September 29, 2017: Journal of Perinatal Medicine
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