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Twin gestation

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
Jun Xi Liu, Shiu Lun Au Yeung, Man Ki Kwok, June Yue Yan Leung, Shi Lin Lin, Lai Ling Hui, Gabriel Matthew Leung, C Mary Schooling
Birth weight (BW) is inversely associated with diabetes and liver function in Mendelian Randomization studies. Observationally, lower BW is usually also associated with poorer liver function. However, these studies could be confounded by socioeconomic position. Here we assessed if BW is associated with liver function in a unique population with little socio-economic patterning of BW, using both instrumental variable and an observational analysis. We used instrumental variable analysis (IVA) to assess the association of BW with liver function (alanine transaminase (ALT), alkaline phosphatase (ALP), bilirubin, and albumin) at ~17 years with twin status as an instrumental variable in the prospective population-representative "Children of 1997" birth cohort (n = 8327)...
March 13, 2018: Preventive Medicine
Jessica Smith, Marjorie C Treadwell, Deborah R Berman
Twins represent 1%-2% of all pregnancies, yet continue to account for a disproportionate share of neonatal adverse events including neonatal intensive care admission, morbidity, and mortality. Ultrasonography is central to the proper diagnosis of the type of twinning. Ideally, ultrasonography is performed before 14 weeks of gestation to determine chorionicity and amnionicity. Correct identification of the chorionicity in a twin pregnancy facilitates proper counseling and management of the gestation, including ultrasonography follow-up...
March 13, 2018: International Journal of Gynaecology and Obstetrics
S Debruyne, A Ruiz-González, E Artiles-Ortega, B Ampe, W Van Den Broeck, E De Keyser, L Vandaele, K Goossens, V Fievez
The aim of this study was to investigate the methane (CH4) reducing potential of a combination of pre- and/or postnatal treatment with coconut oil medium chain fatty acids (CO MCFA) in goat kids. The hypothesis is that influencing rumen function during early life has more chances for success than in the adult life, related to the resilience of the mature rumen microbiota. Forty-eight pregnant does were split into 2 experimental groups: treated does (D+) received 40 g/d of CO MCFA in a test compound feed, while control does (D-) received a control compound feed, during the last 3 wk of gestation...
February 24, 2018: Journal of Animal Science
Erin E Washburn, Teresa N Sparks, Kristen A Gosnell, Larry Rand, Juan M Gonzalez, Vickie A Feldstein
OBJECTIVE:  This article describes the natural history of stage I twin-twin transfusion syndrome (TTTS) including risk of progression to higher stage TTTS and pregnancy outcomes, and to identify risk factors for progression. STUDY DESIGN:  Retrospective cohort study of monochorionic diamniotic (MCDA) twin pregnancies from 2006 to 2016 with expectantly managed Quintero stage I TTTS. RESULTS:  A total of 30 MCDA twin pregnancies with expectantly managed stage I TTTS were identified...
February 8, 2018: American Journal of Perinatology
Paola Algeri, Clelia Callegari, Davide Paolo Bernasconi, Maddalena Incerti, Sabrina Cozzolino, Giuseppe Paterlini, Salvatore Andrea Mastrolia, Francesca Pellizzoni, Patrizia Vergani
OBJECTIVE: Optimal management of twin deliveries is controversial. We aimed to assess potential risk factors correlated to the development of hypoxia in the second twin after vaginal delivery of the first twin. STUDY DESIGN: This is a retrospective observational study including diamniotic twin pregnancies delivering at our Institution at 35 weeks of gestational age or more, weighing ≥ 1800 g. Hypoxia was defined as at least one of the following: Apgar score < 5 at 10', neonatal resuscitation for > 10 minutes, neonatal acidosis (pH ≤ 7 and/or BE ≥ 12 mmol/L)...
March 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
Kathryn M Reese, Jennifer Czerwinski, Sandra Darilek, Anthony Johnson, Malorie Jones, Claire N Singletary
The rate of twinning is rising and since the introduction of non-invasive prenatal testing, interest in and uptake of genetic screening and testing in twin pregnancies has not been investigated. This study aimed to explore the attitudes toward and uptake of current prenatal genetic screening and diagnostic testing options for fetal aneuploidy in twin pregnancies. Women being seen for genetic counseling with twin gestations were recruited for participation in a descriptive study with questionnaire (n = 42) and semi-structured phone interview (n = 15)...
March 10, 2018: Journal of Genetic Counseling
Fernanda Spadotto Baptista, Maria Rita de Figueiredo Lemos Bortolotto, Fabiola Roberta Marim Bianchini, Vera Lucia Jornada Krebs, Marcelo Zugaib, Rossana Pulcinelli Vieira Francisco
OBJECTIVE: To evaluate whether thrombophilia worsens maternal and foetal outcomes among patients with severe preeclampsia (PE). METHOD: From October 2009 to October 2014, an observational retrospective cohort study was performed on pregnant women with severe PE diagnosed before 34 weeks of gestation and their newborns hospitalized at the Clinics Hospital, FMUSP. Patients who had no heart disease, nephropathies, pre-gestational diabetes, gestational trophoblastic disease, foetal malformation, or twin pregnancy and who underwent thrombophilia screening during the postnatal period were included...
January 2018: Pregnancy Hypertension
Akiko Ohwaki, Haruki Nishizawa, Noriko Aida, Takema Kato, Asuka Kambayashi, Jun Miyazaki, Mayuko Ito, Makoto Urano, Yuka Kiriyama, Makoto Kuroda, Masahiro Nakayama, Shin-Ichi Sonta, Kaoru Suzumori, Takao Sekiya, Hiroki Kurahashi, Takuma Fujii
No abstract text is available yet for this article.
March 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Jaimin S Shah, Susan Hosseini Nasab, Neil Chappell, Han-Yang Chen, Amy Schutt, Hector Mendez-Figueroa
PURPOSE: To investigate whether twin pregnancies conceived by different forms of fertility treatments are associated with adverse neonatal outcomes and to examine the difference in maternal and obstetrical characteristics between patients. METHODS: Our study was a retrospective analysis of twin pregnancies conceived by fertility treatments from a prospectively collected database. Treatments were stratified into two groups: group 1 (ART) consisted of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), and group 2 (non-ART) included intrauterine insemination (IUI) and ovulation induction (OI)...
March 9, 2018: Journal of Assisted Reproduction and Genetics
Gali Shapira-Zaltsberg, David Grynspan, Deepti Reddy, Elka Miller
Previous studies in singleton pregnancies reported conflicting trends in apparent diffusion coefficient (ADC) values with gestational age (GA) and stable relative ADC (rADC; ADC placenta divided by ADC globe) throughout pregnancy. The purpose of our study was to compare the ADC and rADC of placentas of twin and singleton pregnancies. MATERIALS AND METHODS: Fetal MRI of 11 twin and 23 singleton pregnancies were retrospectively analyzed. Each group was further divided by GA (≤24 and >24 weeks)...
March 8, 2018: Fetal Diagnosis and Therapy
Gonzague Jourdain, Nicole Ngo-Giang-Huong, Linda Harrison, Luc Decker, Woottichai Khamduang, Camlin Tierney, Nicolas Salvadori, Tim R Cressey, Wasna Sirirungsi, Jullapong Achalapong, Prapap Yuthavisuthi, Prateep Kanjanavikai, Orada P Na Ayudhaya, Thitiporn Siriwachirachai, Sinart Prommas, Prapan Sabsanong, Aram Limtrakul, Supang Varadisai, Chaiwat Putiyanun, Pornnapa Suriyachai, Prateung Liampongsabuddhi, Suraphan Sangsawang, Wanmanee Matanasarawut, Sudanee Buranabanjasatean, Pichit Puernngooluerm, Chureeratana Bowonwatanuwong, Thanyawee Puthanakit, Virat Klinbuayaem, Satawat Thongsawat, Sombat Thanprasertsuk, George K Siberry, Diane H Watts, Nahida Chakhtoura, Trudy V Murphy, Noele P Nelson, Raymond T Chung, Stanislas Pol, Nantasak Chotivanich
BACKGROUND: Pregnant women with an elevated viral load of hepatitis B virus (HBV) have a risk of transmitting infection to their infants, despite the infants' receiving hepatitis B immune globulin. METHODS: In this multicenter, double-blind clinical trial performed in Thailand, we randomly assigned hepatitis B e antigen (HBeAg)-positive pregnant women with an alanine aminotransferase level of 60 IU or less per liter to receive tenofovir disoproxil fumarate (TDF) or placebo from 28 weeks of gestation to 2 months post partum...
March 8, 2018: New England Journal of Medicine
Luiz Felipe Lessa Ortiz, Julio Elito Júnior, Edward Araujo Júnior, Alberto Borges Peixoto, Nelson Sass, Antonio Fernandes Moron
We report the case of a 20-year-old patient, primigravida, with twin monochorionic pregnancy, with a weight gain of 6 kg in one week and increased blood pressure. During the ultrasound diagnostic investigation, placental edema and hydrops were identified in both fetuses, which, in association with maternal anasarca and pressure control, constitute the triad for mirror syndrome, also known as triple edema. In addition to being hydropic, one of the twins was an acardiac fetus, which is a rare combination of events...
2018: Case Reports in Obstetrics and Gynecology
Elizabeth M Widen
No abstract text is available yet for this article.
March 6, 2018: Paediatric and Perinatal Epidemiology
Ravi Shankar Swamy, Helen McConachie, Jane Ng, Judith Rankin, Murthy Korada, Stephen Sturgiss, Nicholas D Embleton
AIM: Intrauterine growth restriction (IUGR) is associated with poorer outcomes in later life. We used a monochorionic twin model with IUGR in one twin to determine its impact on growth and neurocognitive outcomes. METHODS: Monochorionic twins with ≥20% birth weight discordance born in the north of England were eligible. Cognitive function was assessed using the British Ability Scales. The Strength and Difficulties Questionnaire was used to identify behavioural problems...
March 2, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Hyun Sun Ko, Sae Kyung Choi, Jeong Ha Wie, In Yang Park, Yong Gyu Park, Jong Chul Shin
BACKGROUND: The purpose of this study was to compare the fetal/infant mortality risk associated with each additional week of expectant management to that associated with immediate delivery in women with multiple gestations. METHODS: This was a retrospective national cohort study of 94,170 multiple deliveries, 92,619 (98.4%) twin and 1,352 (1.44%) triplet pregnancies, between 32 0/7 and 42 6/7 weeks of gestation recorded in the Korean vital statistics database. We investigated the risks of stillbirth and infant death after birth in Korea according to the week of gestation in twin and triplet pregnancies...
March 5, 2018: Journal of Korean Medical Science
Eran Weiner, Elad Barber, Ohad Feldstein, Letizia Schreiber, Ann Dekalo, Yossi Mizrachi, Jacob Bar, Michal Kovo
OBJECTIVE: We aimed to compare placental histopathological lesions and neonatal outcome in singleton vs. twin pregnancies complicated by gestational diabetes mellitus (GDM). METHODS: Maternal characteristics, neonatal outcomes, and placental histopathology reports of pregnancies complicated by GDM, between 1/2008-10/2016, were reviewed. Results were compared between singletons (singleton group) and dichorionic-diamniotic twins (twin group). Placental lesions were classified as placental weight abnormalities, maternal and fetal vascular malperfusion lesions (MVM, FVM), inflammatory lesions, and lesions associated with chronic villitis...
March 2018: Placenta
Chao Tong, Li Wen, Yinyin Xia, Pamela Leong, Lan Wang, Xin Fan, Ting-Li Han, Jeffrey M Craig, Philip Baker, Richard Saffery, Hongbo Qi
INTRODUCTION: Non-communicable diseases (NCD) now represent the major burden of adverse health in most countries. It is clear that much of the risk of such conditions begins very early in life, potentially in utero. Given their complex aetiology, an understanding of the origins of NCD requires an in-depth analysis of the interplay between genetic variation and environment, preferably over time. For decades, twin studies have played a key role in understanding such traits. Their strength lies in the ability to disentangle genetic and environmental factors that contribute to a phenotype...
February 22, 2018: BMJ Open
Nina K Ayala, Linda M Ernst, Emily S Miller
OBJECTIVE: Abnormal umbilical cord coiling is associated with adverse perinatal outcomes; however, the etiology of the umbilical coiling pattern is poorly understood. STUDY DESIGN: Retrospective cohort of all twin deliveries >20 weeks in 2014. Pregnancies were dichotomized by chorionicity and the umbilical coiling index (UCI) and placental cord insertion location were compared. In cases with one or both cords hypercoiled, the direction and pattern of coiling were compared by chorionicity...
February 21, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Keisuke Ishii, Seiji Wada, Mayumi Takano, Masahiko Nakata, Takeshi Murakoshi, Haruhiko Sago
INTRODUCTION: We aimed to clarify the survival rate without brain abnormalities (BA) after fetoscopic laser photoco-agulation (FLP) for monochorionic diamniotic twin gestations (MCDA) with selective intrauterine growth restriction (sIUGR) accompanied by abnormal umbilical artery (UA) Doppler waveforms and isolated oligohydramnios in the sIUGR twin. MATERIALS AND METHODS: This retrospective study included 52 cases that underwent FLP. The main outcome was survival rate without BA of the twins at age 28 days...
February 20, 2018: Fetal Diagnosis and Therapy
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