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monochorionic twin pregnancy

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https://www.readbyqxmd.com/read/29792095/what-is-the-effect-of-intertwin-delivery-interval-on-the-outcome-of-the-second-twin-delivered-vaginally
#1
Paola Algeri, Clelia Callegari, Salvatore Andrea Mastrolia, Letizia Brienza, Isadora Vaglio Tessitore, Giuseppe Paterlini, Maddalena Incerti, Sabrina Cozzolino, PatriziaVergani
OBJECTIVE: Optimal management of twin deliveries is controversial. We aimed to assess if intertwin delivery interval, after vaginal delivery of the first twin, may have an influence on adverse neonatal outcomes of the second twin Study design: This is a retrospective observational study including diamniotic twin pregnancies with vaginal delivery of the first twin, between January 2000 and July 2017. Inclusion criteria were diamniotic pregnancies and vaginal delivery of the first twin...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29765784/use-of-the-tei-index-in-the-conservative-management-of-trap-sequence-pregnancies-diagnosed-during-the-periviable-period-a-case-series
#2
Kristina Martimucci, Theresa Kuhn, Robyn Bilinski, Jesus Alvarez-Perez
Twin Reverse Arterial Perfusion (TRAP) Sequence is a rare complication of monochorionic pregnancies. Without intervention, the viable pump twin in a case of TRAP Sequence may develop high output cardiac failure leading to an intrauterine fetal demise. We present 3 cases of TRAP Sequence pregnancy diagnosed during the second or third trimesters of pregnancy. There are minimal sonographic tools for the guidance of a fetal therapeutic interventional procedure during the second trimester or timing of delivery during the third trimester to reduce morbidity and mortality of a viable fetus...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29763608/early-prognostic-factors-of-outcomes-in-monochorionic-twin-pregnancy-systematic-review-and-meta-analysis
#3
REVIEW
Fiona L Mackie, Matthew J Hall, R Katie Morris, Mark D Kilby
OBJECTIVE: Assess ability of first trimester pregnancy related factors (ultrasound measurements, maternal characteristics, biomarkers) to predict complications in monochorionic twin pregnancies DATA SOURCES: MEDLINE, EMBASE, ISI Web of Science, CINAHL, the Cochrane Central Registration of Controlled Trials and Research Registers, and Google Scholar, from inception to 12 May 2017. Grey literature and bibliographies of articles were checked. STUDY ELIGIBILITY CRITERIA: Studies that reported ultrasound measurements, maternal characteristics, or potential biomarkers, measured in the first trimester in monochorionic diamniotic twin pregnancies, where the potential prognostic ability between the variable and twin-twin transfusion syndrome, growth restriction, or intrauterine fetal death could be assessed...
May 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29740835/factors-associated-to-early-intrauterine-fetal-demise-after-laser-for-ttts-by-pre-operative-fetal-heart-and-doppler-ultrasound
#4
Amélie Delabaere, France Leduc, Quentin Reboul, Florent Fuchs, Sandrine Wavrant, Johanne Dubé, Jean-Claude Fouron, François Audibert
OBJECTIVE: To determine the prognostic value of fetal Doppler and echocardiographic parameters for intra-uterine fetal demise (IUFD) within 24 hours and within one week after laser coagulation in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS). METHOD: This retrospective study correlated the preoperative hemodynamic and echocardiography parameters to the outcome in fetuses with TTTS undergoing laser therapy. RESULTS: One hundred and twelve laser coagulations were performed between February 2006 and June 2015...
May 9, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29740832/perinatal-outcomes-of-single-fetal-survivor-after-fetal-intervention-for-complicated-monochorionic-twins
#5
Mallory Hoffman, Mounira Habli, Roopali Donepudi, Noemi Boring, Anthony Johnson, Kenneth J Moise, Ramesha Papanna
OBJECTIVE: To compare perinatal outcomes between acute single fetal demise following FLP to planned selective reduction (SR) in complicated monochorionic (MC) twin pregnancies. METHODS: This was a secondary analysis of prospectively collected data in complicated MC twin pregnancies from two fetal centers from 2011-2016. Group 1 included women undergoing FLP for TTTS who experienced a single fetal demise within 24 hours of the procedure. Group 2 consisted of women undergoing planned SR with TTTS, and Group 3 SR for indications other than TTTS...
May 9, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29730993/outcome-of-twin-pregnancies-complicated-by-a-neural-tube-defect
#6
Vanessa Ross, Karen Reidy, Lex W Doyle, Ricardo Palma-Dias, Mark P Umstad
Twin pregnancies discordant for neural tube defects (NTD) is a management dilemma. Risks of preterm delivery from polyhydramnios must be balanced with the risks of selective termination (ST) of the anomalous fetus. We investigated the prevalence of twin pregnancies discordant for NTD and the rate of pregnancy complications in our institution over a 10-year period. Cases were obtained by searching the hospital ultrasound database and findings were confirmed by expert review of ultrasound images. Outcomes of ST and expectant management were assessed...
May 7, 2018: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/29728153/maternal-bleeding-complications-following-early-versus-delayed-umbilical-cord-clamping-in-multiple-pregnancies
#7
Chayatat Ruangkit, Matthew Leon, Kasim Hassen, Katherine Baker, Debra Poeltler, Anup Katheria
BACKGROUND: In 2015, the American Academy of Pediatrics recommended delayed umbilical cord clamping for at least 30-60 s for all infants. However, there is limited data regarding the maternal safety of delayed cord clamping in multiple pregnancies. We aimed to compare the maternal bleeding complications following early cord clamping (ECC) versus of delayed cord clamping (DCC) in multiple pregnancies. METHODS: A retrospective cohort study of pregnant women with multiples who delivered live-born infants at Sharp Healthcare Hospitals in San Diego, CA, USA during January 1st, 2016 - September 30th, 2017...
May 4, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29723347/type-ii-and-iii-selective-fetal-growth-restriction-perinatal-outcomes-of-expectant-management-and-laser-ablation-of-placental-vessels
#8
Mariana Yumi Miyadahira, Maria de Lourdes Brizot, Mário Henrique Burlacchini de Carvalho, Sckarlet Ernandes Biancolin, Rita de Cássia Alam Machado, Vera Lúcia Jornada Krebs, Rossana Pulcineli Vieira Francisco, Cleisson Fábio Andrioli Peralta
OBJECTIVES: To describe the perinatal outcomes of type II and III selective fetal growth restriction (sFGR) in monochorionic-diamniotic (MCDA) twin pregnancies treated with expectant management or laser ablation of placental vessels (LAPV). METHODS: Retrospective analysis of cases of sFGR that received expectant management (type II, n=6; type III, n=22) or LAPV (type II, n=30; type III, n=9). The main outcomes were gestational age at delivery and survival rate. RESULTS: The smaller fetus presented an absent/reversed "a" wave in the ductus venosus (arAWDV) in all LAPV cases, while none of the expectant management cases presented arAWDV...
2018: Clinics
https://www.readbyqxmd.com/read/29704280/prediction-of-adverse-pregnancy-outcome-in-monochorionic-diamniotic-twin-pregnancies-complicated-by-selective-fetal-growth-restriction
#9
Caitriona Monaghan, Erkan Kalafat, Julia Binder, Baskaran Thilaganathan, Asma Khalil
OBJECTIVE: To identify key factors implicated in adverse perinatal outcome in monochorionic twin pregnancies complicated by selective fetal growth restriction. METHODS: This is a retrospective cohort study conducted in a single tertiary referral centre included all monochorionic diamniotic (MCDA) twin pregnancies complicated by selective fetal growth restriction (sFGR). The presence of co-existing twin to twin transfusion syndrome (TTTS) was noted. Fetal biometry and Doppler indices, including the umbilical artery (UA) and ductus venosus (DV), were recorded at the time of diagnosis...
April 28, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29688161/brain-injured-survivors-of-monochorionic-twin-pregnancies-complicated-by-single-intrauterine-death-mr-findings-in-a-multicenter-study
#10
Giorgio Conte, Andrea Righini, Paul D Griffiths, Mariangela Rustico, Mariano Lanna, Fiona L Mackie, Lorenzo Pinelli, Federico Prefumo, Nicola Persico, Mark S Igra, Cecilia Parazzini, Chiara Doneda, Anna Fichera, Claudia Ambrosi, Mark Kilby, Mariasavina Severino, Fabio Triulzi, Andrea Rossi, Nicholas Skipper
Purpose To describe and classify the range of brain injuries present at prenatal, in-utero magnetic resonance (MR) imaging in co-twin survivors of monochorionic (MC) twin pregnancies complicated by single intrauterine death (SIUD). Materials and Methods This retrospective, observational study from six tertiary fetal medicine centers that perform tertiary-level prenatal in-utero MR studies reviewed cases in which prenatal in-utero MR imaging had shown a brain injury in a surviving co-twin of a twin pregnancy with a MC component complicated by SIUD...
April 24, 2018: Radiology
https://www.readbyqxmd.com/read/29675904/risk-factors-for-fetal-death-after-radiofrequency-ablation-for-complicated-monochorionic-twin-pregnancies
#11
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/29661565/fetal-growth-restriction-in-twins
#12
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/29660172/predictive-accuracy-of-the-southwest-thames-obstetric-research-collaborative-stork-chorionicity-specific-twin-growth-charts-for-stillbirth-a-validation-study
#13
Erkan Kalafat, Mercedes Sebghati, Basky Thilaganathan, Asma Khalil
OBJECTIVE: Twin pregnancy is associated with 2-3 fold increased risk of stillbirth compared to singletons. Despite the fact that the growth pattern has been shown to differ in twins compared to singletons, it is controversial whether twin-specific growth charts should be routinely used. A major goal of prenatal ultrasound is to identify fetuses suffering from growth restriction at risk of stillbirth. The main aim of this study was to compare the performance of chorionicity-specific twin charts with singleton charts, both customized and non-customized, in the antenatal prediction of small-for-gestational age (SGA) stillborn and liveborn fetuses...
April 16, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29657701/early-prenatal-diagnosis-of-parapagus-conjoined-twins
#14
Ângela Melo, Rita Dinis, António Portugal, Ana Isabel Sousa, Isabel Cerveira
Conjoined twinning occurs in 1/100 of monozygotic twins, 1/50,000 gestations and 1/250,000 live births. It is the consequence of a division event at the primitive streak stage of the human embryonic development, about 13-14 days after fertilisation, in monochorionic monoamniotic gestations. A healthy pregnant woman, Gravida 2 Para 1, was admitted into our Fetal Medicine Unit to perform the first trimester ultrasound. A diagnosis of conjoined parapagus twinning based on ultrasound features was made at 11 weeks of gestation, and the couple decided to terminate the pregnancy...
March 28, 2018: Clinics and Practice
https://www.readbyqxmd.com/read/29607558/outcome-reporting-across-randomised-trials-and-observational-studies-evaluating-treatments-for-twin-twin-transfusion-syndrome-a-systematic-review
#15
REVIEW
Helen Perry, James M N Duffy, Ogochukwu Umadia, Asma Khalil
BACKGROUND: Twin-Twin Transfusion syndrome is associated with significant mortality and morbidity. Potential treatments require robust evaluation. The aim of this study was to evaluate outcome reporting across observational studies and randomised controlled trials assessing treatments for twin-twin transfusion syndrome (TTTS). METHODS: Cochrane Central Register of Controlled Trials, EMBASE and Medline were searched from inception to August 2016. Observational studies and randomised controlled trials reporting outcomes following a treatment for TTTS in monochorionic-diamniotic twin pregnancies and monochorionic-triamniotic or dichorionic-triamniotic triplet pregnancies were included...
April 1, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29582948/-advances-in-fetal-therapy-in-complicated-monochorionic-pregnancies-and-in-severe-congenital-diaphragmatic-hernia-five-years-experience
#16
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/29573746/effects-of-inter-twin-vascular-anastomoses-of-monochorionic-twins-with-selective-intrauterine-growth-restriction-on-the-contents-of-placental-mitochondria-dna
#17
Yao-Lung Chang, An-Shine Chao, Hsiu-Huei Peng, Shuenn-Dyh Chang, Sheng-Yuan Su, Kuan-Ju Chen, Tzu-Hao Wang
BACKGROUND: Placental mitochondrial DNA (mtDNA) has been proposed to be an indicator for placental hypoxia. This study was designed to evaluate the effect of vascular anastomoses between monochorionic (MC) twins on placental mtDNA. METHODS: In this study, twin-twin transfusion syndrome (TTTS) treated with laser therapy and MC twins without TTTS (without laser therapy) resulting in two live babies were included in this study. The placental mtDNA fold changes (FC) between the small and large twins were analyzed using real-time quantitative PCR...
March 24, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29569732/unusual-twinning-additional-findings-during-prenatal-diagnosis-of-twin-zygosity-by-single-nucleotide-polymorphism-snp-array
#18
Zhiyong Zou, Linhuan Huang, Shaobin Lin, Zhiming He, Yanmin Luo
OBJECTIVE: To evaluate the incidence and characteristics of unusual twinning by using single nucleotide polymorphism (SNP) array to identify twin zygosity. METHODS: This study reviewed 386 twin pairs who were seen for prenatal or postnatal diagnosis and underwent SNP array to detect zygosity. RESULTS: The incidence of monozygotic (MZ) twins was 11.36% (25/220) in the assisted reproductive technology (ART)-conceived group. Monochorionic dizygotic twins represented 3 of 24 monochorionic ART-conceived twin pairs (3/24, 12...
March 23, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29558751/sudden-fetal-hematologic-changes-as-a-complication-of-amnioreduction-in-twin-twin-transfusion-syndrome
#19
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/29533957/in-utero-partial-exchange-transfusion-combined-with-in-utero-blood-transfusion-for-prenatal-management-of-twin-anemia-polycythemia-sequence
#20
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
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