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monochorionic twin pregnancy

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https://www.readbyqxmd.com/read/29325265/-clinical-analysis-of-105-intrauterine-fetal-deaths-in-17-years
#1
S Wang, H X Yang
Objective: To study the cause of intrauterine fetal death (IUFD) in 17 years. Methods: From June 1(st), 2000 to May 31(st), 2017, 65 621 women delivered in Peking University First Hospital. Clinical data of 105 cases of IUFD (including 82 singleton pregnancies and 23 twin pregnancies) during the 17 years were analyzed retrospectively. Results: (1) In singleton pregnancies, the leading cause of IUFD was maternal complications, including severe pre-eclampsia (36/82, 43.9%) and diabetes mellitus (6/82, 7.3%). The second reason was umbilical cord factors (13/82, 15...
December 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29316011/roles-of-venovenous-anastomosis-and-umbilical-cord-insertion-abnormalities-in-birthweight-discordance-in-monochorionic-diamniotic-twin-pregnancies-without-twin-twin-transfusion-syndrome
#2
Hiroko Konno, Takeshi Murakoshi, Akiko Yamashita, Mitsuru Matsushita
AIM: We evaluated risk factors for birthweight discordance in monochorionic diamniotic (MCDA) twin pregnancies without twin-twin transfusion syndrome (TTTS). METHODS: We investigated all MCDA twin placentas injected with colored dye at our institution between 2007 and 2015. We excluded pairs of twins with TTTS, fetal demise, or severe fetal malformation. All pairs of twins were assigned to the discordant group (birthweight discordance ≥ 25%) or the concordant group (birthweight discordance < 25%)...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29301441/use-of-the-fetal-myocardial-performance-index-in-monochorionic-diamniotic-twin-pregnancy-a-prospective-cohort-and-nested-case-control-study
#3
Amanda Henry, Saranya Gopikrishna, Aditi Mahajan, Jennifer Alphonse, Neama Meriki, Alec W Welsh
AIMS: Assess clinical utility of the fetal Myocardial Performance Index (MPI) in evaluation and management of monochorionic, diamniotic twin (MCDA) pregnancies. METHODS: Prospective cohort of a) initially uncomplicated MCDA b) Complicated MCDA, including twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and liquor and/or growth discordance (L/GD) not meeting TTTS or sIUGR criteria. TTTS and sIUGR were case-control matched...
January 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29287298/polyhydramnios-affecting-a-recipient-like-twin-risk-of-progression-to-twin-twin-transfusion-syndrome-and-outcomes
#4
Erin E Washburn, Teresa N Sparks, Kristen A Gosnell, Larry Rand, Juan M Gonzalez, Vickie A Feldstein
OBJECTIVE:  The significance of polyhydramnios of one twin in the absence of oligohydramnios of the cotwin in monochorionic diamniotic (MCDA) twin pregnancies (polyhydramnios affecting a recipient-like twin [PART]) is unknown. Our aim is to assess the risk of progression to twin-twin transfusion syndrome (TTTS) with PART, progression to ≥ stage II TTTS, and neonatal survival. STUDY DESIGN:  This study was a retrospective cohort study of MCDA twin pregnancies with PART evaluated at a referral center from 2008 to 2015...
December 29, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29241912/radiofrequency-ablation-for-selective-reduction-in-complex-monochorionic-multiple-pregnancies-a-case-series
#5
Hong-Mei Wang, Hong-Yan Li, Xie-Tong Wang, Yan-Yun Wang, Lei Li, Bo Liang, Jing Wang, Jia Song
OBJECTIVE: To determine the safety and efficacy of radiofrequency ablation (RFA) for selective fetal reduction in complex monochorionic multiple pregnancies. MATERIALS AND METHODS: From July 2011 to January 2015, data on all cases treated with RFA were collected prospectively in our hospital. Indications, procedure details, cause of fetal demise and pregnancy outcomes were analyzed. Sonography and magnetic resonance imaging were performed to detect fetal brain damage...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29207382/incidental-septostomy-after-laser-surgery-for-twin-twin-transfusion-syndrome-perinatal-outcomes-and-antenatal-management
#6
Brian J Gordon, Andrew H Chon, Lisa M Korst, Arlyn Llanes, David A Miller, Ramen H Chmait
INTRODUCTION: Incidental septostomy, or inadvertent perforation of the twins' dividing membranes, can create a functional monoamniotic twin pregnancy. Our aim was to describe the perinatal outcomes and antenatal management of patients with incidental septostomy after laser surgery for twin-twin transfusion syndrome (TTTS). MATERIALS AND METHODS: Monochorionic diamniotic multiple gestations with a gestational age (GA) between 16 and 26 weeks that underwent laser surgery from March 2006 to December 2015 were studied retrospectively...
December 5, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29205694/fetal-sex-discordance-in-a-monochorionic-twin-pregnancy-following-intracytoplasmic-sperm-injection-a-case-report-of-chimerism-and-review-of-the-literature
#7
Nihal Ş Uysal, Çağrı Gülümser, Zerrin Y Çelik, Hulusi B Zeyneloğlu, Filiz F B Yanık
A 39-year-old woman who became pregnant with twins after an intracytoplasmic sperm injection was referred at the ninth gestational week to determine chorionicity. Ultrasonographic examination showed a monochorionic diamniotic twin pregnancy. First trimester nuchal translucency measurements of the fetuses were 1.6 and 2.7 mm. A non-invasive prenatal test was performed and revealed low risk. One fetus appeared to be female and the other male at the 14th gestational week. Second trimester anatomic scanning results were otherwise normal for both fetuses...
December 3, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29179272/-analysis-of-non-invasive-prenatal-screening-detection-in-fetal-chromosome-aneuploidy
#8
A J Cai, C F Zhu, S W Xue, S Y Cui, S Z Qu, N Liu, X D Kong
Objective: To evaluate the efficacy of non-invasive prenatal screening (NIPS) in the detection of fetal aneuploidies. Methods: Cell free DNA was sequenced in 5 566 pregnant women to identify the fetal aneuploidies in the First Affiliated Hospital of Zhengzhou University from January 1(st), 2015 to March 15(th), 2016. Among them, 5 230 (93.96%, 5 230/5 566) were singleton pregnancies and 336 (6.04%, 336/5 566) were twin pregnancies. In singleton pregnancies, 1 809 (34.59%, 1 809/5 230) were women with advanced maternal age, and 3 421 (65...
November 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29169712/-about-twins-epidemiological-genetic-and-obstetrical-aspects-specific-risks-and-outcome
#9
M Tauzin, A Felix, C Michot, C Dedieu, L Aoust, F Fortas, C Guillier, J Ngo, P-Y Wachter, L Petermann, E Kermorvant-Duchemin
The incidence of twin pregnancies has increased steadily for the last 40 years due to assisted reproductive technology and increased maternal childbearing age. Multiple pregnancies, especially monochorionic twin pregnancies, carry a high risk for the mother and the fetuses and require close follow-up. Twins are exposed to a higher risk of perinatal anoxia, in utero fetal demise, preterm birth, congenital malformations, fetal growth restriction, and vascular complications. Compared to singletons, twins are at higher risk of perinatal mortality and impaired neurodevelopmental outcome, justifying a thorough follow-up by pediatricians, including assessment and management of familial and psychosocial impact...
November 20, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29122542/twin-twin-transfusion-syndrome-what-we-have-learned-from-clinical-trials
#10
REVIEW
Fatiha Djaafri, Julien Stirnemann, Imen Mediouni, Claire Colmant, Yves Ville
Monochorionic twin pregnancies are at increased risk for adverse outcome compared to dichorionic twin pregnancies and singletons. Monochorionic-specific complications include twin-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence, single intrauterine fetal demise and its consequences on the co-twin, and selective intrauterine growth restriction. Whereas the natural history of monochorionic-specific complications carries a high risk of fetal death or severe neurologic disability, a framework now exists, based on well-designed clinical trials, for optimal treatment of these entities...
November 6, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29115085/prediction-of-amnionicity-using-the-number-of-yolk-sacs-in-monochorionic-multifetal-pregnancy
#11
Sue Yeon Park, Jin Hoon Chung, You Jung Han, Si Won Lee, Moon Young Kim
The purpose of this article was to evaluate the accuracy of predicting amnionicity using the number of yolk sacs by diagnostic ultrasound examination in monochorionic (MC) multifetal pregnancies between 7 + 0 and 9 + 6 gestational weeks. A total of 97 patients with MC multifetal pregnancies underwent early ultrasound examination from 2004 to 2014 at Cheil General Hospital and Women's Healthcare Center. All patients for whom the number of yolk sacs was reported were included in this study. We compared the number of yolk sacs with amnionicity confirmed by an intertwine membrane...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29107981/prevalence-and-risk-factors-of-monochorionic-diamniotic-twinning-after-assisted-reproduction-a-six-year-experience-base-on-a-large-cohort-of-pregnancies
#12
Bing Song, Zhao-Lian Wei, Xiao-Feng Xu, Xue Wang, Xiao-Jin He, Huan Wu, Ping Zhou, Yun-Xia Cao
OBJECTIVE: To characterize the incidence and risk factors for monochorionic diamniotic(MC-DA) twinning after assisted reproductive technologies (ART). DESIGN: Retrospective population-based study. SETTING: The study was conducted in China; Department of Reproductive Medicine Center at The First Affiliated Hospital of Anhui Medical University. POPULATION: A cohort of 8860 clinical pregnancies after embryo transfer (ET) carried out in our center between 2011 and 2016 were retrospectively analyzed for the incidence of MC-DA twinning...
2017: PloS One
https://www.readbyqxmd.com/read/29105215/re-outcome-of-monochorionic-twin-pregnancy-with-selective-intrauterine-growth-restriction-according-to-umbilical-artery-doppler-flow-pattern-of-smaller-twin-systematic-review-and-meta-analysis-d-buca-g-pagani-g-rizzo-a-familiari-m-e-flacco-l-manzoli-m-liberati
#13
COMMENT
https://www.readbyqxmd.com/read/29103877/ethical-considerations-in-the-care-of-complicated-twin-pregnancies
#14
Naomi T Laventhal, Marjorie C Treadwell
Twin gestations are increasing in prevalence worldwide, and are potentially subject to medical complications which present uniquely complex ethical and psychosocial challenges for the pregnant patient and obstetrician to navigate. In this article, we explore these issues as they relate to medical decision-making in cases of discordant growth and discordant anomalies in both monochorionic and dichorionic twin pregnancies, including those affected by twin-twin transfusion syndrome, with particular attention to scenarios in which the individual fetuses hold competing interests...
November 2, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29101986/acr-appropriateness-criteria%C3%A2-multiple-gestations
#15
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
https://www.readbyqxmd.com/read/29082725/upcoming-strategies-in-obstetrics-how-the-technology-of-clinical-audit-may-reduce-cesarean-birth
#16
Sara Paracchini, Bianca Masturzo, Domenico Tangolo, Enrica Roletti, Annalisa Piazzese, Rossella Attini, Alessandro Rolfo, Tullia Todros
BACKGROUND: The rate of cesarean delivery is currently increasing all over Europe. In Italy it reaches 38% of all child births. Therefore, it is important to identify the clinical and organizational variables that determine the appropriateness of elective cesarean delivery. With this aim we chose the technology of clinical audit, a process that promotes improvement in clinical practice through systematic review of clinical care in relation with explicit standards derived from scientific literature...
December 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/29055131/case-report-of-staphylococcus-epidermidis-maternal-sepsis-and-chorioamnionitis-following-fetoscopy
#17
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
https://www.readbyqxmd.com/read/29046073/influence-of-farewell-rituals-and-psychological-vulnerability-on-grief-following-perinatal-loss-in-monochorionic-twin-pregnancy
#18
Mònica Druguet, Laura Nuño, Carlota Rodó, Silvia Arévalo, Elena Carreras Moratonas, Juana Gómez-Benito
AIM: To analyze whether the absence of farewell rituals and previous psychological vulnerability are associated with the intensity of grief following perinatal loss in monochorionic twin pregnancy. METHOD: The sample comprised 28 women who experienced perinatal loss following fetal surgery. Sociodemographic and clinical data and information about farewell rituals were collected through interview. The women also completed a questionnaire about perinatal grief. RESULTS: A history of psychological and/or psychopharmacological treatment was associated with more intense grief following perinatal loss...
October 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29040903/aplasia-cutis-congenita-as-a-result-of-interstitial-laser-therapy-for-fetal-reduction-in-monochorionic-twins-conservative-approach-and-outcome
#19
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
https://www.readbyqxmd.com/read/29037558/monozygotic-twins-discordant-for-trisomy-21-discussion-of-etiological-events-involved
#20
Yao-Lung Chang, Wu-Pei Yi, An-Shine Chao, Kuan-Ju Chen, Po-Jen Cheng, Tzu-Hao Wang, Shuenn-Dyh Chang
OBJECTIVE: To elucidate the etiologies of discordant trisomy 21 in monozygotic twin pregnancy. CASE REPORT: A monochorionic diamniotic twin pregnancy with hydrops and cleft lip (twin 1) found in one fetus presented at gestational age of 17 weeks. Amniotic fluid karyotyping showed nonmosaic trisomy 21 in twin 1 (47, XY, +21 [20]) and a normal karyotype in twin 2 (46, XY [20]). Short tandem repeat (STR) polymorphism markers revealed that the two fetuses were monozygotic, and the two chromosomes 21 were maternal isodisomy in the trisomy fetus...
October 2017: Taiwanese Journal of Obstetrics & Gynecology
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