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Twin gestation

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https://www.readbyqxmd.com/read/29155475/weight-discordance-and-perinatal-mortality-in-twin-pregnancies-a-systematic-review-and-meta-analysis
#1
REVIEW
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 Clinicaltrials.gov 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
https://www.readbyqxmd.com/read/29153672/an-intermediate-sflt-1-plgf-ratio-indicates-an-increased-risk-for-adverse-pregnancy-outcome
#2
Janine Hoffmann, Victoria Ossada, Marie Weber, Holger Stepan
OBJECTIVE: The sFlt-1/PlGF ratio is a valid marker in diagnosing or excluding preeclampsia. The currently used cut offs frame an intermediate zone of 33-85 (<34(0) weeks) or 33-110 (≥34(0) weeks), respectively. In this study we sought to evaluate the relevance of an intermediate sFlt-1/PlGF ratio for the clinical pregnancy course and outcome. MATERIAL AND METHODS: We retrospectively analysed 533 consecutive patients with sFlt-1/PlGF ratio measurements for suspected preeclampsia...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29153312/discordant-intrauterine-transfusion-in-dichorionic-twin-pregnancy-with-rh-isoimmunization
#3
Jing Wu, Lin-Huan Huang, Yan-Min Luo, Qun Fang
Discordant intrauterine transfusion (IUT) in twin pregnancy with Rh isoimmunization is uncommon and complicated. We report a gravida 3, para 2 woman with a dichorionic diamniotic (DCDA) twin pregnancy and two fetuses received discordant transfusions. Middle cerebral artery peak systolic velocity (MCA-PSV) was used to evaluate the anemic degree in each foetus. IUT was performed 3 times in twin A and 4 times in twin B to reverse foetal anaemia. Transfusions were distinct due to the different tolerance to IUT, and the procedure could be continued in one foetus even if the other one underwent complications...
November 7, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29152887/association-between-maternal-sleep-practices-and-late-stillbirth-findings-from-a-stillbirth-case-control-study
#4
Aep Heazell, M Li, J Budd, Jmd Thompson, T Stacey, R S Cronin, B Martin, D Roberts, E A Mitchell, Lme McCowan
OBJECTIVE: To report maternal sleep practices in women who experienced a stillbirth compared with controls with ongoing live pregnancies at similar gestation. DESIGN: Prospective case-control study. SETTING: Forty-one maternity units in the United Kingdom. POPULATION: Women who had a stillbirth after ≥ 28 weeks' gestation (n = 291) and women with an ongoing pregnancy at the time of interview (n = 733). METHODS: Data were collected using an interviewer-administered questionnaire that included questions on maternal sleep practices before pregnancy, in the four weeks prior to, and on the night before the interview/stillbirth...
November 20, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29146625/cyanotic-congenital-heart-disease-following-fertility-treatments-in-the-united-states-from-2011-to-2014
#5
Alireza A Shamshirsaz, Zhoobin H Bateni, Haleh Sangi-Haghpeykar, Sara E Arian, Hadi Erfani, Amir A Shamshirsaz, Alfred Abuhamad, Karin A Fox, Susan M Ramin, Amirhossein Moaddab, Shiraz A Maskatia, Bahram Salmanian, Keila N Lopez, Pardis Hosseinzadeh, Amy K Schutt, Ahmed A Nassr, Jimmy Espinoza, Gary A Dildy, Michael A Belfort, Steven L Clark
OBJECTIVE: To examine the risk for cyanotic congenital heart diseases (CCHDs) among live births in the USA, resulting from various forms of infertility treatments. METHODS: This study is a cross-sectional analysis of live births in the USA from 2011 to 2014. Infertility treatments are categorised into two of the following groups on birth certificates: assisted reproductive technology (ART) fertility treatment (surgical egg removal; eg, in vitro fertilisation and gamete intrafallopian transfer) and non-ART fertility treatment (eg, medical treatment and intrauterine insemination)...
November 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29142885/successful-glycemic-control-using-a-flash-glucose-monitoring-system-for-a-pregnant-woman-with-diabetes-a-case-report
#6
Miyako Kishimoto, Saori Tamada, Yoko Oshiba
Background: Glucose control for pregnant women with glucose intolerance is important, as hyperglycemia may adversely affect the mother and the fetus. Case presentation: We report the case of a pregnant Japanese woman who experienced gestational diabetes mellitus during her first pregnancy and developed impaired glucose tolerance after the delivery. During her second pregnancy with twins, she required up to 75 units of injected insulin to control her postprandial hyperglycemia and occasionally experienced hypoglycemia...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/29140454/gestational-age-specific-perinatal-mortality-rates-for-assisted-reproductive-technology-art-and-other-births
#7
Abrar A Chughtai, Alex Y Wang, Lisa Hilder, Zhuoyang Li, Kei Lui, Cindy Farquhar, Elizabeth A Sullivan
STUDY QUESTION: Is perinatal mortality rate higher among births born following assisted reproductive technology (ART) compared to non-ART births? SUMMARY ANSWER: Overall perinatal mortality rates in ART births was higher compared to non-ART births, but gestational age-specific perinatal mortality rate of ART births was lower for very preterm and moderate to late preterm births. WHAT IS KNOWN ALREADY: Births born following ART are reported to have higher risk of adverse perinatal outcomes compared to non-ART births...
November 13, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29119673/efficacy-of-antenatal-corticosteroids-in-preterm-twins-the-epipage2-cohort-study
#8
Déborah Palas, Virginie Ehlinger, Corinne I Alberge, Patrick Truffert, Gilles Kayem, François Goffinet, Pierre-Yves Ancel, Catherine Arnaud, Christophe Vayssiere
OBJECTIVES: To investigate the efficacy of ACS therapy on short-term neonatal outcomes in preterm twins and further document the influence of the ACS-to-delivery interval. DESIGN: EPIPAGE2 is a nationwide observational multicentre prospective cohort study of neonates born between 22 and 34 completed weeks of gestation. SETTING: All French maternity units, except in a single administrative regions, between March and December 2011. POPULATION: 750 twin neonates born between 24 and 31 weeks of gestation...
November 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29117757/the-effect-of-prenatal-vaginal-progesterone-on-cervical-length-in-twin-pregnancies
#9
Isabela K R Agra, Mário H B Carvalho, Wagner R Hernandez, Rossana P V Francisco, Marcelo Zugaib, Maria L Brizot
PURPOSE: The aim of this study was to investigate the influence of vaginal progesterone on cervical length in asymptomatic nonselected twin gestations. METHODS: This was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies exposed to vaginal progesterone or placebo. The cervical length was examined at six different time periods: 18-21(+6) weeks (T1), 21-23(+6) weeks (T2), 24-26(+6) weeks (T3), 27-29(+6) weeks (T4), 30-32(+6) weeks (T5) and 33-34(+6) weeks (T6)...
November 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29116935/outcomes-of-physical-examination-indicated-cerclage-in-twin-pregnancies-with-acute-cervical-insufficiency-compared-to-singleton-pregnancies
#10
Jee Yoon Park, Soo-Hyun Cho, Se Jeong Jeon, Song Yi Kook, Hyunsoo Park, Kyung Joon Oh, Joon-Seok Hong
OBJECTIVES: To compare pregnancy outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency with that of singletons. METHODS: This retrospective cohort study included 88 consecutive women (17 twins and 71 singletons) who had undergone physical examination-indicated cerclage because of acute cervical insufficiency (defined as painless cervical dilation with (1) prolapsed and/or visible membranes at the external cervical os on speculum examination and (2) a functional cervical length of zero on transvaginal ultrasound) between 160/7 and 236/7 weeks...
November 8, 2017: Journal of Perinatal 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/29108135/regimens-of-ultrasound-surveillance-for-twin-pregnancies-for-improving-outcomes
#12
REVIEW
Jane G Woolcock, Rosalie M Grivell, Jodie M Dodd
BACKGROUND: Increased ultrasound surveillance of twin pregnancies has become accepted practice due to the higher risk of complications. There is no current consensus however as to the method and frequency of ultrasound monitoring that constitutes optimal care. OBJECTIVES: To systematically review the effects of different types and frequency of ultrasound surveillance for women with a twin pregnancy on neonatal, fetal and maternal outcomes. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials...
November 7, 2017: Cochrane Database of Systematic Reviews
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
#13
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/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/29103351/cervical-pessary-for-preventing-preterm-birth-a-meta-analysis
#15
Zhen Jin, Liqin Chen, Dongyan Qiao, Chhavi, Astha, Baiyun Sun, Lina Wang, Hong Yu
OBJECTIVE: To evaluate the efficacy of cervical pessary in the prevention of preterm birth and its influence on pregnancy and maternal outcomes, so as to provide a clinical basis for cervical pessary to prevent premature delivery. METHOD: The databases of PubMed, Web of Science, CNKI, WanFang Data, etc, were used to search for the eligible articles. The relevant data were abstracted by two independent reviewers and performed with Stata 12.0. RESULT: Pregnancy Result: the PTB rates of pessary and control group before 28, 32, 34 and 37 weeks were analyzed and the combined RR (95%CI) values were 0...
November 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29101996/introduction-biomarkers-of-embryo-viability-the-search-for-the-holy-grail-of-embryo-selection
#16
Zev Rosenwaks
Over the past four decades we have witnessed great progress and increasing pregnancy success rates with in vitro fertilization. However, this apparent success has been accompanied by the burden of multiple pregnancies. While efforts to reduce the number of embryos transferred have had a salutary impact on the incidence of high order multiple pregnancies, twin gestations have not diminished significantly. Thus, the search for a marker of embryo quality with the goal of selecting the single best embryo for transfer continues to be the major challenge facing our field...
November 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29101986/acr-appropriateness-criteria-%C3%A2-multiple-gestations
#17
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/29094369/effect-of-inter-twin-delivery-interval-on-umbilical-artery-ph-and-apgar-score-in-the-second-twin
#18
Alon Tal, Hadar Peretz, Gali Garmi, Noah Zafran, Shabtai Romano, Raed Salim
BACKGROUND: To examine the effect of inter-twin delivery interval on umbilical artery pH and Apgar score of the second twin after vaginal delivery of the first twin. METHODS: Retrospective study conducted at a single teaching hospital. All pregnant women with twin gestation who delivered the first twin vaginally at more than 24 weeks between 1995 and 2015 were included. Major malformations and intrauterine deaths of one or both twins were excluded. Women were divided into those who had an inter-twin delivery interval of less than 30 minutes (group 1) or 30 minutes or more (group 2)...
November 2, 2017: Birth
https://www.readbyqxmd.com/read/29092682/evaluation-of-dynamic-thiol-disulfide-homeostasis-in-very-low-birth-weighted-preterms
#19
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
https://www.readbyqxmd.com/read/29082725/upcoming-strategies-in-obstetrics-how-the-technology-of-clinical-audit-may-reduce-cesarean-birth
#20
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
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