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Sample records for twin pregnancies delivered

  1. Twin pregnancy

    DEFF Research Database (Denmark)

    Sperling, Lene; Tabor, A

    2001-01-01

    Determination of chorionicity is one of the most important issues in the management of twin pregnancy. Modern ultrasound equipment has made it possible to accurately assess placentation already in the first trimester with the lambda sign. With regard to prenatal diagnosis, it is important to know...... for clinicians caring for twin pregnancies....

  2. Hypertensive disorders in twin pregnancy

    OpenAIRE

    Santema, Job; Koppelaar, Elin; Wallenburg, Henk

    1995-01-01

    textabstractObjective: To compare the incidence and severity of pregnancy-induced hypertensive disorders in twin pregnancy and in singleton gestation. Study design: Case-control study in the setting of a University Hospital. Each pregnancy of a consecutive series of 187 twin pregnancies attending the antenatal clinic and booked before a gestational age of 24 weeks was matched for maternal age, parity, and gestational age at delivery with a singleton pregnancy delivered in the same year. Prima...

  3. TWIN PREGNANCY WITH ACARDIUS ANCEPS

    Directory of Open Access Journals (Sweden)

    Padma

    2014-02-01

    Full Text Available Acardiac twin is an anomaly unique to monochorionic multiple pregnancies, characterized by formation of malformed fetus with an absent or rudimentary (nonfunctional heart. Acardiac twinning, often results from abnormal placental vascular anastomoses. A 20 year old primigravida admitted to the department of Obstetrics and Gynecology S .S. Medical College, Rewa, on 26th July 2012 at the gestation of 34 week with spontaneous monochorionic monoamniotic twin pregnancy and fetal acardius with oligohydramnios. Patient was taking her treatment from private Hospital; acardius was diagnosed at 27 week due to late booking. In view of oligohydramnios and hypoxic changes in color Doppler, elective LSCS was done on 28/7/13 at 34 week 2 day, after betnesol coverage. She delivered a live, healthy, female child with good APGAR score having apparently no congenital anomaly, with a birth weight of 2.3 kg .The other twin was fetus acardius, of about900 gm. with head and face partially developed . Upper limb was rudimentary and lower limb was partially developed and malformed. External genitalia were developed as female. Placenta was monochorionic and monoamniotic, weighing500 gm. The umbilical cord of the normal twin was20 cm with central attachment, while the other umbilical cord was10 cm long with peripheral attachment

  4. Hypertensive disorders in twin pregnancy

    NARCIS (Netherlands)

    J.G. Santema (Job); E. Koppelaar (Elin); H.C.S. Wallenburg (Henk)

    1995-01-01

    textabstractObjective: To compare the incidence and severity of pregnancy-induced hypertensive disorders in twin pregnancy and in singleton gestation. Study design: Case-control study in the setting of a University Hospital. Each pregnancy of a consecutive series of 187 twin pregnancies attending th

  5. Maternal nutrition in twin pregnancy.

    Science.gov (United States)

    Campbell, D M; MacGillivray, I; Tuttle, S

    1982-01-01

    Energy and protein intake as measured by 24-hour urinary nitrogen values are similar in twin and singleton pregnancies. The relationship between urinary nitrogen and nitrogen intake is equally significant in twin and singleton pregnancies. Dietary zinc, copper, and iron are not different in women with twins, nor are the levels of these elements in plasma. These observations are surprising in view of the extra fetal demands on the mother and the different adaptation of twin pregnancies.

  6. Perinatal outcomes with intrahepatic cholestasis of pregnancy in twin pregnancies.

    Science.gov (United States)

    Liu, Xiaohua; Landon, Mark B; Chen, Yan; Cheng, Weiwei

    2016-01-01

    To describe perinatal outcomes of twin pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP). We conducted a retrospective cohort study of women delivered at a large tertiary obstetric center in Shanghai, China from January 2006 to May 2014. Delivery data were abstracted from medical records of all twin gestations delivered at the hospital. A total of 129/1922(6.7%) twin and 1190/92 273 singleton (1.3%) pregnancies were complicated by ICP. An increased risk of stillbirth among twin pregnancies was observed (3.9% and 0.8% in the ICP and non-ICP groups, respectively; aOR 5.75, 95% CI 2.00-16.6). Stillbirths with ICP and twins occurred between 33 and 35 weeks gestation compared to 36-38 weeks gestation among singletons. ICP in twins was also associated with an increased risk of preterm birth (pregnancies complicated by ICP also had increased meconium staining of amniotic fluid and lower birth weight. Twin pregnancies with ICP have significantly increased risks of adverse perinatal outcomes including stillbirth and preterm birth. Stillbirth occurs at an earlier gestational age in twin gestation compared to singletons, suggesting that earlier scheduled delivery should be considered in these women.

  7. Nutrition in twin pregnancy.

    Science.gov (United States)

    MacGillivray, I

    1979-01-01

    The urinary nitrogen output appears to be related to both protein and energy intake, so that women having heavier babies probably eat more, although this may simply mean that they are larger women. Women with twin pregnancies have been found to have a lesser urinary nitrogen output, but it seems unlikely that this be due to lower intakes. They might simply utilize their diet more efficiently--a hypothesis that is now being tested.

  8. Intravenous nutrition during a twin pregnancy.

    Science.gov (United States)

    Karamatsu, J T; Boyd, A T; Cooke, J; Vinall, P S; McMahon, M J

    1987-01-01

    A case is reported of a woman in the third trimester of a twin pregnancy who required intravenous nutrition because of inadequate absorption of nutrients due to a jejunoileal bypass. Weight gain was poor, and there was evidence of intrauterine growth retardation before commencement of intravenous feeding. She received overnight intravenous nutrition for 6 weeks and gained weight with ultrasound evidence of fetal growth. During the 33rd week of gestation, she was delivered of healthy twin males who were at appropriate birth weights and development for their age of gestation. The considerations in intravenous nutrition for a twin pregnancy after jejunoileal bypass are discussed.

  9. Twin delivery: how should the second twin be delivered?

    Science.gov (United States)

    Olofsson, P; Rydhström, H

    1985-11-01

    In a series of 803 pairs of twins born between 1973 and 1982, 0.33% of second twins were delivered by cesarean section after vaginal delivery of the first twin. During the last year the frequency has increased to 7%, calling attention to the problem of declining obstetric skills and experience. This has caused us to update the routines of intrapartum management of twin gestations. In the present program only commonly available obstetric techniques are used. The potentially hazardous twin delivery is excluded from a trial of vaginal delivery. Hopefully, the program will help other obstetricians to decide in favor of vaginal delivery in selected twin gestations.

  10. Perinatal outcome of twin pregnancies delivered in a teaching hospital Resultado perinatal de gestações gemelares com parto em hospital universitário

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    Renata Almeida de Assunção

    2010-01-01

    Full Text Available OBJECTIVE: This study aimed to evaluate the perinatal outcome of twin pregnancies delivered in a tertiary teaching hospital according to chorionicity. METHODS: A retrospective study involving 289 twin pregnancies delivered from January 2003 to December 2006 was carried out. Maternal and perinatal data were obtained from hospital charts and delivery logs. Chorionicity was determined by ultrasonography or histopathological study. RESULTS: Incidence of twin gestations was 3.4% and 96.4% were spontaneously conceived. 60.5% were dichorionic (DC, 30.8% of monochorionic diamniotic (MCDA, 6.6% monochorionic monoamniotic (MCMA and for 2.1% chorionicity was unknown. The mean gestation age at delivery was respectively 35.4, 33.6, 32.9 for DC, MCDA and MCMA. The mean birth weight was 2.171, 1.832 and 1.760 g respectively for DC, MC and MCMA. The proportion of fetuses delivered with less than 34 weeks in DC was of 21.7%, while in MCDA it was of 39.3% and in MCMA of 42.1%. Birth weight below the 10th centile occurred in 15.7% for DC, 22.5% for MCDA and 26.3% in MCMA. Congenital anomalies were observed in 21.3% in monochorionic and in 7.4% in the dichorionic. Lenght of hospital stay was shorter for DC when compared to MCDA and MCMA twins (13.1, 17.3 and 23.3 days, respectively. The proportion of twin pregnancies with both babies discharged alive were 85.7% in DC and 61.1% in MC. CONCLUSION: The rate of preterm deliveries and low birth weight is higher in monochorionic pregnancies when compared to dichorionic twins. However, when adjusted for complications such as fetal abnormalities and twin-twin transfusion syndrome, double survival rates were similar in the two groups.OBJETIVO: Avaliar o resultado perinatal nas gestações gemelares com partos em hospital universitário segundo a corionicidade. MÉTODOS: Estudo retrospectivo de 289 gestações gemelares com partos no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no per

  11. Cord entanglement in monoamniotic twin pregnancies

    DEFF Research Database (Denmark)

    Lyndrup, J; Schouenborg, Lars Øland

    1987-01-01

    Monoamniotic twin pregnancy involves a heavy risk of fatal umbilical cord entanglement. Two cases are reported. In the first case, both twins were found dead in the 36th week, and the monoamnionicity was recognized at birth. In the second case, the monoamnionicity was discovered during an ultraso......Monoamniotic twin pregnancy involves a heavy risk of fatal umbilical cord entanglement. Two cases are reported. In the first case, both twins were found dead in the 36th week, and the monoamnionicity was recognized at birth. In the second case, the monoamnionicity was discovered during...... an ultrasound examination, and cord entanglement was suspected in the 35th week on the basis of a non-stress test (NST) with variable decelerations. Cesarean section was performed and two healthy children were delivered....

  12. Dichorionic twin pregnancy discordant for fetal anencephaly: a case report.

    Science.gov (United States)

    Taşcı, Yasemin; Karasu, Yetkin; Erten, Ozlem; Karadağ, Burak; Göktolga, Umit

    2012-01-01

    Dichorionic twin pregnancy discordant for fetal anencephaly is a serious condition that threatens the normal co-twin's life by causing polyhydramniosis, preterm labor and sudden death of one or both of the fetuses. We report a case of dichorionic twin pregnancy discordant for fetal anencephaly delivered at the 32(nd) week of gestation because of preterm labor and nonreassuring fetal monitoring. The aim of this case report is to summarize management options in this situation.

  13. Monochorionic twin pregnancies

    NARCIS (Netherlands)

    Hack, K.E.A.

    2008-01-01

    Following widespread application of assisted reproductive technology modalities and the increased age of motherhood, the incidence of twin gestations has increased markedly. Twins are either monozygotic or dizygotic. Dizygotic (i.e. fraternal) twins result from the fertilization of two different egg

  14. CONSERVATIVE MANAGEMENT OF TWIN PREGNANCY WITH SINGLE FETAL DEATH

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. Analysis of the cause of intrauterine death of one fetus of twin and to evaluate the outcome of conservative management of twin pregnancy with single fetal death.Method.A retrospective review was undertaken on PUMC hospital records of women who delivered twin between Jan. 1987 and Dec. 1998.Result.During the recent 12 years, 99 pregnant women were documented as twin pregnancies. Of the twin pregnancies during this period, 13 were complicated by a single intrauterine death. Four women suffered this complication during their first trimester. In the remain 9 cases one fetus died during second or third trimester. The cesarean section was given in three pregnant women soon after a single intrauterine death because of the survival fetal distress. No consumptive coagulopathy was apparent in all 13 pregnant women. It is wise that the pregnancy was managed conservatively, with regular coagulation parameters obtained.Conclusion.Our results support conservative management in twin pregnancies complicated by single fetal death.

  15. CONSERVATIVE MANAGEMENT OF TWIN PREGNANCY WITH SINGLE FETAL DEATH

    Institute of Scientific and Technical Information of China (English)

    刘俊涛; 杨佳欣; 边旭明; 张羽

    2000-01-01

    Objective. Analysis of the cause of intrauterine death of one fetus of twin and to evaluate the outcome of conservative management of twin pregnancy with single fetal death. Method. A retrospective review was undertaken on PUMC hospital records of women who delivered twin between Jan. 1987 and Dec. 1998. Result. During the recent 12 years, 99 pregnant women were documented as twin pregnancies. Of the twin pregnancies during this period, 13 were complicated by a single intrauterine death. Four women suffered this complication during their first trimester. In the remain 9 cases one fetus died dm-ing second or third trimester.The cesarean section was given in three pregnant women soon after a single intrauterine death because of the survival fetal distress. No consumptive coagulopathy was apparent in all 13 pregnant women. It is wise that the pregnancy was managed conservatively, with regular coagulation parameters obtained. Condosion. Our results suptmrt conservative management in twin pregnancies complicated by single fetal death.

  16. Amelia in Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Davari Tanha Fatemeh

    2009-04-01

    Full Text Available Limb bud first appears during the third week of gestation with the upper limb buds appearing a few days before the lower limb buds. Complete absence of one or more limbs, called Amelia, occurs prior to the eighth week of gestation. We report a case of Amelia in a twin gestation.

  17. [The diagnostic algorithm in twin pregnancy].

    Science.gov (United States)

    Ropacka-Lesiak, Mariola; Szaflik, Krzysztof; Breborowicz, Grzegorz H

    2015-03-01

    This paper presents the diagnostic algorithm in twin pregnancy. The most important sonographic parameters in the assessment of twins have been discussed. Moreover, the most significant complications of twin pregnancy as well as diagnostic possibilities and management, have been also presented and defined.

  18. Trends in the obstetric features and management of twin pregnancies.

    LENUS (Irish Health Repository)

    Smith, K E

    2010-03-01

    There are no reports outlining the trends in obstetric features and clinical management of twin pregnancies in an Irish obstetric population. The aim of this study was to investigate these factors for all twin pregnancies delivered during the 19 year period between 1989 and 2007, at Galway University Hospital (GUH). There were 52,199 infants delivered at GUH, of which 1594 infants (3.05% of births) were twins, related to 797 twin pregnancies. The overall incidence of twin pregnancies was 1.52%, increasing from 0.8%-1.0% in the early years of the study to 1.7-1.8% in the latter years of the study (P<0.001). There was a significant increase in incidence of twins born to mothers aged 30-39 years, alongside a significant reduction to mothers aged 20-29 years (P<0.01). The caesarean section rate overall was 41.5% (331\\/797), of which 54% (n=179) were elective, and 46% (n=152) were emergency, representing an emergency caesarean section rate of 19.1% of all twin pregnancies, and of 24.6% after exclusion of elective caesarean sections. The caesarean section rate for twins increased from 30% in 1989 to greater than 50% in the latter years of the study (P<0.01), related largely to a significant increase in elective caesarean sections (P<0.01). The combined vaginal-caesarean delivery rate was remarkably low at 0.75% of all twin pregnancies, and 1% after exclusion of elective caesarean sections. The preterm delivery rates were 4.1% (<32 weeks), and 16.3% (<36 weeks), with an overall perinatal mortality rate of 37 per 1000. These findings highlight the altered demographic and clinical aspects of twin pregnancies in an Irish obstetric population.

  19. Prospective Risk of Stillbirth and Neonatal Complications in Twin Pregnancies : Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Cheong-See, Fiona; Schuit, Ewoud; Arroyo-Manzano, David; Khalil, Asma; Barrett, Jon; Joseph, K. S.; Asztalos, Elizabeth; Hack, Karien; Lewi, Liesbeth; Lim, Arianne; Liem, Sophie; Norman, Jane E.; Morrison, John; Combs, C. Andrew; Garite, Thomas J.; Maurel, Kimberly; Serra, Vicente; Perales, Alfredo; Rode, Line; Worda, Katharina; Nassar, Anwar; Aboulghar, Mona; Rouse, Dwight; Thom, Elizabeth; Breathnach, Fionnuala; Nakayama, Soichiro; Russo, Francesca Maria; Robinson, Julian N.; Dodd, Jodie M.; Newman, Roger B.; Bhattacharya, Sohinee; Tang, Selphee; Mol, Ben Willem J; Zamora, Javier; Thilaganathan, Basky; Thangaratinam, Shakila

    2017-01-01

    Twin pregnancies are at increased risk of stillbirth. Uncomplicated twin pregnancies are commonly delivered earlier to prevent stillbirth; however, there is a risk of neonatal complications associated with being born prior to 39 weeks’ gestation. The optimal gestational age for delivery in twin

  20. Invasive treatment in complicated monochorionic twin pregnancies

    DEFF Research Database (Denmark)

    Sundberg, Karin; Søgaard, Kirsten; Jensen, Lisa Neerup;

    2012-01-01

    Objective. Monochorionic twin pregnancies are associated with increased risk of severe complications. Umbilical cord occlusion (UCO) and fetoscopic selective laser coagulation (FSLC) are used as invasive treatment. The study aim was to document treatment indications and pregnancy outcome where UCO...... and FSLC were used for treating fetal discrepancies and twin-to-twin transfusion syndrome (TTTS). Design. Cohort study of all consecutively treated monochorionic twin pregnancies 2004-2010. Setting. Tertiary care center. Population. One hundred and twenty pregnancies treated by FSLC (55) or UCO (65...

  1. Fetal blood sampling in twin pregnancies. Prenatal diagnosis and management of 19 cases.

    Science.gov (United States)

    Cox, W L; Forestier, F; Capella-Pavlovsky, M; Daffos, F

    1987-01-01

    Twin pregnancies pose particular problems in both prenatal diagnosis and obstetric management. We present 19 twin pregnancies that underwent fetal blood sampling (FBS). The indications were mostly similar to those for singleton pregnancies, with both fetuses being sampled. There was one indication specific to twin pregnancies; disseminated intravascular coagulation in the retained twin after the death-in-utero (DIU) of the other. In 5 cases, only 1 twin was sampled; in 2 because the second twin was female in the diagnosis of an X-linked disorder; in 1 because of technical failure, and in 2 the other twin had predeceased. Eight pregnancies continued after the FBS delivering 2 live, healthy infants, though 5 were delivered before 37 weeks of gestation. In 7 cases there was a discordance in the diagnosis between the twins. In 3 of these cases the affected fetus underwent selective termination by air embolism; in 2 cases the pregnancies were continued and the affected twin not resuscitated; 1 pregnancy is still in progress, and 1 patient had a non-medically supervised termination of both twins in another country. Two patients miscarried within a week of the FBS. Two patients had only 1 living twin at the time of FBS; 1 had a second DIU a month after the FBS and the other a neonatal death at 11 days of age in an infant with severe porencephaly. FBS is technically feasible for similar indications as for singleton pregnancies though discordance in diagnosis raises specific management problems.

  2. Complications arising in twin pregnancy: findings of prenatal ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ah; Cho, Jeong Yeon; Lee, Young Ho; Song, Mi Jin; Min, Jee Yeon; Lee, Hak Jong; Han, Byoung Hee; Lee, Kyung Sang; Cho, Byung Jae; Chun, Yi Kyeong [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2003-03-01

    Multifetal gestations are high-risk pregnancies involving higher perinatal morbidity and mortality, and are subject to unique complications including twin oligohydramnios- polyhydramnios sequence, twin-to-twin transfusion syndrome, acardiac twins, conjoined twins, co-twin demise, and heterotopic pregnancies. The purpose of this study is to describe the prenatal ultrasonographic and pathologic findings of these complications.

  3. Optimal nutrition for improved twin pregnancy outcome.

    Science.gov (United States)

    Goodnight, William; Newman, Roger

    2009-11-01

    Twin pregnancies contribute a disproportionate degree to perinatal morbidity, partly because of increased risks of low birth weight and prematurity. Although the cause of the morbidity is multifactorial, attention to twin-specific maternal nutrition may be beneficial in achieving optimal fetal growth and birth weight. Achievement of body mass index (BMI)-specific weight gain goals, micronutrient and macronutrient supplementation specific to the physiology of twin gestations, and carbohydrate-controlled diets are recommended for optimal twin growth and pregnancy outcomes. The daily recommended caloric intake for normal-BMI women with twins is 40-45 kcal/kg each day, and iron, folate, calcium, magnesium, and zinc supplementation is recommended beyond a usual prenatal vitamin. Daily supplementation of docosahexaenoic acid and vitamin D should also be considered. Multiple gestation-specific prenatal care settings with a focus on nutritional interventions improve birth weight and length of gestation and should be considered for the care of women carrying multiples. Antepartum lactation consultation can also improve the rate of postpartum breastfeeding in twin pregnancies. Twin gestation-specific nutritional interventions seem effective in improving the outcome of these pregnancies and should be emphasized in the antepartum care of multiple gestations. This review examines the available evidence and offers recommendations for twin pregnancy-specific nutritional interventions.

  4. The neonatal outcome in twin versus triplet and quadruplet pregnancies

    Directory of Open Access Journals (Sweden)

    Fatemeh Nasseri

    2009-02-01

    Full Text Available

    • BACKGROUND: To assess the risk of neonatal mortality and morbidity in twin, triplet and quadruplet pregnancies.
    • METHODS: In a retrospective study, the neonatal outcome of all twin, triplet and quadruplet gestations delivered from October 2001 to September 2006 was reviewed. The neonatal outcome of triples and quadruplets was compared with a matched group of twins for gestational age.
    • RESULTS: During a 5-year period, 511 sets of twin pregnancies, 42 sets of triplet and 5 sets of quadruplet pregnancies were studied. The mean of gestational age for twins, triplets and quadruplets were 33.92 ± 3.5 weeks, 30.92 ± 3.8 weeks and 31.60 ± 2.0 weeks, respectively, (P = 0.0001. Triplets and quadruplets weighed less than twins, (P = 0.0001. Neonatal mortality was 13.5% for twins, 26.8% for triplets and 30% for quadruplets. In vitro fertilization, use of ovulation induction agents, and cesarean delivery in the women with triplet and quadruplet were significantly higher than in those with twin pregnancies, (P = 0.0001. The mean age of mothers with triplets and quadruplets was significantly higher than with twins (P = 0.026. There was not a significant difference in respiratory and non-respiratory short outcomes between triplets, quadruplets and twins when matched for gestational age. Apgar score at 1 and 5 minutes was significantly lower in triplets and quadruplets than twins. There was no influence of birth order on neonatal mortality of triplet pregnancy. Neonatal mortality of triplet births was significantly decreased over the 5 years of the study period.
    • CONCLUSIONS: Triplets and quadruplets have a similar neonatal outcome as twins when matched for gestational age. There is no influence of birth on the neonatal mortality of triplet pregnancy. It appears that outcome is mainly dependent on gestational age.
    • KEYWORDS: Neonatal

    • Diabetes and perinatal mortality in twin pregnancies.

      Directory of Open Access Journals (Sweden)

      Zhong-Cheng Luo

      Full Text Available BACKGROUND: Diabetes in pregnancy has been associated with a paradoxically reduced risk of neonatal death in twin pregnancies. Risk "shift" may be a concern in that the reduction in neonatal deaths may be due to an increase in fetal deaths (stillbirths. This study aimed to clarify the impact of diabetes on the risk of perinatal death (neonatal death plus stillbirth in twin pregnancies. METHODS: This was a retrospective cohort study of twin births using the largest available dataset on twin births (the U.S. matched multiple birth data 1995-2000; 19,676 neonates from diabetic pregnancies, 541,481 from non-diabetic pregnancies. Cox proportional hazard models were applied to estimate the adjusted hazard ratios (aHR of perinatal death accounting for twin cluster-level dependence. RESULTS: Comparing diabetic versus non-diabetic twin pregnancies, overall perinatal mortality rate was counterintuitively lower [2.1% versus 3.3%, aHR 0.70 (95% confidence intervals 0.63-0.78]. Individually, both stillbirth and neonatal mortality rates were lower in diabetic pregnancies, but we identified significant differences by gestational age and birth weight. Diabetes was associated with a survival benefit in pregnancies completed before 32 weeks [aHR 0.55 (0.48-0.63] or with birth weight =2500 g [aHR 2.20 (1.55-3.13]. CONCLUSIONS: Diabetes in pregnancy appears to be "protective" against perinatal death in twin pregnancies ending in very preterm or very low birth weight births. Prospective studies are required to clarify whether these patterns of risk are real, or they are artifacts of unmeasured confounders. Additional data correlating these outcomes with the types of diabetes in pregnancy are also needed to distinguish the effects of pre-gestational vs. gestational diabetes.

    • Prevention of preterm delivery in twin pregnancy.

      Science.gov (United States)

      Rode, Line; Tabor, Ann

      2014-02-01

      The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery (i.e. birth before 37 weeks of gestation). Multiple gestations therefore account for 2-3% of all pregnancies but constitute at least 10% of cases of preterm delivery. Complications from preterm birth are not limited to the neonatal period, such as in retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, respiratory disorder and sepsis; they can also constitute sequelae such as abnormal neurophysiological development in early childhood and underachievement in school. Several treatment modalities have been proposed in singleton high-risk pregnancies. The mechanism of initiating labour may, however, be different in singleton and twin gestations. Therefore, it is mandatory to evaluate the proposed treatments in randomised trials of multiple gestations. In this chapter, we describe the results of trials to prevent preterm delivery in twin pregnancies.

    • Cord entanglement in monoamniotic twin pregnancies

      DEFF Research Database (Denmark)

      Lyndrup, J; Schouenborg, Lars Øland

      1987-01-01

      Monoamniotic twin pregnancy involves a heavy risk of fatal umbilical cord entanglement. Two cases are reported. In the first case, both twins were found dead in the 36th week, and the monoamnionicity was recognized at birth. In the second case, the monoamnionicity was discovered during...

    • Twin tubal pregnancy: A large unruptured ectopic pregnancy.

      Science.gov (United States)

      Goswami, Deepti; Agrawal, Nidhi; Arora, Vrinda

      2015-11-01

      Twin ectopic pregnancy is a rare occurrence, with an estimated incidence of 1 in 20 000 spontaneous pregnancies. We describe a case of unilateral twin ectopic pregnancy in which the gravid fallopian tube showed no signs of tubal rupture despite marked tubal distension. A 25-year-old woman presented with clinical features suggestive of large right-sided tubal ectopic pregnancy. Serum β-human chorionic gonadotropin was 10 800 IU/mL. Laparotomy revealed markedly distended right fallopian tube. There was no hemoperitoneum. The tube contained twin gestational sacs. The crown-rump length of the embryos was 2 cm. The ectopic gestation was thus unique, in that despite marked tubal distension, the trophoblastic invasion was not significant to cause tubal rupture. There may be a role for medical management based on individual gestational sac size in selected cases of twin tubal pregnancy in which there is no evidence of hemoperitoneum.

    • Hydropic Placenta as a First Manifestation of Twin-Twin Transfusion in a Monochorionic Diamniotic Twin Pregnancy

      NARCIS (Netherlands)

      de Laat, Monique W. M.; Manten, Gwendoline T. R.; Nikkels, Peter G. J.; Stoutenbeek, Philip

      2009-01-01

      Monochorionic twin pregnancies are at a 10% to 1.5% risk of developing twin-twin transfusion syndrome (TTTS).(1) Monitoring such pregnancies is aimed at evaluating the fetal condition by measuring the amount of amniotic fluid, Doppler parameters, and fetal growth. Twin-twin transfusion syndrome may

    • Hydropic Placenta as a First Manifestation of Twin-Twin Transfusion in a Monochorionic Diamniotic Twin Pregnancy

      NARCIS (Netherlands)

      de Laat, Monique W. M.; Manten, Gwendoline T. R.; Nikkels, Peter G. J.; Stoutenbeek, Philip

      Monochorionic twin pregnancies are at a 10% to 1.5% risk of developing twin-twin transfusion syndrome (TTTS).(1) Monitoring such pregnancies is aimed at evaluating the fetal condition by measuring the amount of amniotic fluid, Doppler parameters, and fetal growth. Twin-twin transfusion syndrome may

    • Hydropic Placenta as a First Manifestation of Twin-Twin Transfusion in a Monochorionic Diamniotic Twin Pregnancy

      NARCIS (Netherlands)

      de Laat, Monique W. M.; Manten, Gwendoline T. R.; Nikkels, Peter G. J.; Stoutenbeek, Philip

      2009-01-01

      Monochorionic twin pregnancies are at a 10% to 1.5% risk of developing twin-twin transfusion syndrome (TTTS).(1) Monitoring such pregnancies is aimed at evaluating the fetal condition by measuring the amount of amniotic fluid, Doppler parameters, and fetal growth. Twin-twin transfusion syndrome may

    • Interstitial twin pregnancy: A unique case presentation.

      Science.gov (United States)

      Garretto, Diana; Lee, Lan Na; Budorick, Nancy E; Figueroa, Reinaldo

      2015-09-01

      Early recognition and timely treatment of an interstitial pregnancy is imperative to avoid the high morbidity and mortality of this type of ectopic pregnancy. We report a case of twin interstitial pregnancy that was initially missed on initial sonogram and was subsequently recognized at our institution by transvaginal sonography. The patient underwent open laparoscopic surgery with cornual wedge resection but suffered infundibulopelvic ligament hemorrhage and subsequently required ipsilateral salpingo-oophorectomy. She did well and was discharged home a day later.

    • A Rare Case of Antepartum Spontaneous Septostomy in a Monochorionic Diamniotic Twin Pregnancy

      Directory of Open Access Journals (Sweden)

      Rati Chadha

      2012-01-01

      Full Text Available Spontaneous septostomy in a monochorionic diamniotic twin pregnancy is a rare phenomenon. We present a case of monochorionic diamniotic twin pregnancy with an intact dividing membrane seen in the 1st half of the pregnancy. At 26 weeks, when she was assessed for preterm contractions, the dividing membrane was not documented, which suggested spontaneous septostomy. There had been no invasive procedures during the pregnancy. She subsequently delivered at 29 weeks, secondary to preterm labor. No dividing membrane was noticed at the time of caesarian section. Spontaneous septostomy can complicate the management of monochorionic diamniotic twins by creating a pseudomonoamniotic environment resulting in cord entanglement, and difficulty in the diagnosis and management of twin-twin transfusion syndrome. We believe that such a case should be managed as monochorionic monoamniotic twin gestation.

    • Prevention of preterm delivery in twin pregnancy

      DEFF Research Database (Denmark)

      Rode, Line; Tabor, Ann

      2014-01-01

      The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery (i.e. birth before 37 weeks of gestation). Multiple gestations therefore account for 2......-3% of all pregnancies but constitute at least 10% of cases of preterm delivery. Complications from preterm birth are not limited to the neonatal period, such as in retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, respiratory disorder and sepsis; they can also constitute......, it is mandatory to evaluate the proposed treatments in randomised trials of multiple gestations. In this chapter, we describe the results of trials to prevent preterm delivery in twin pregnancies....

    • Twin pregnancy in the congenital malformed uterus.

      Science.gov (United States)

      Heinonen, Pentti K

      2016-07-01

      The frequency and outcome of twin pregnancies in women with uterine malformation were studied. The cohort comprised 13 (4.9%) women with twin pregnancy found among 263 women. They had 483 deliveries, 13 of them twins (2.7%; 95% CI 1.6-4.6%). Among 38 patients with unicornuate uterus 5 (6.8%) out of 74 deliveries were twins, 39 women with didelphic uterus 2 (3.2%) out of 62 deliveries and 147 women with septate or subseptate uterus 6 (2.3%) out of 264 deliveries were twins. The mean duration of gestation was 249 days (range 190-268 days), 5 (38%) out of 13 deliveries were premature, 25 out of 26 newborns were alive. Mean durations of gestation and mean weights of newborns did not differ when 7 cases with unicornuate or didelphic uterus were compared to 6 cases with complete or partial uterine septum. A congenital malformed uterus can bear twin pregnancy without severe complications apart from prematurity.

    • Ultrasound estimation of birth weight in twin pregnancy: comparison of biometry algorithms in the STORK multiple pregnancy cohort.

      Science.gov (United States)

      Khalil, A; D'Antonio, F; Dias, T; Cooper, D; Thilaganathan, B

      2014-08-01

      The aims of this study were first, to ascertain the accuracy of formulae for ultrasonographic birth-weight estimation in twin compared with singleton pregnancies and second, to assess the accuracy of sonographic examination in the prediction of birth-weight discordance in twin pregnancies. This was a retrospective cohort study including both singleton and twin pregnancies. Routine biometry was recorded and estimated fetal weight (EFW) calculated using 33 different formulae. Only pregnancies that delivered within 48 h of the ultrasound scan were included (4280 singleton and 586 twin fetuses). Differences between the EFW and actual birth weight (ABW) were assessed by percentage error, accuracy in predictions within ± 10% and ± 15% of error and use of the Bland-Altman method. The accuracy of prediction of the different cut-offs of birth-weight discordance in twin pregnancies was also assessed using the area under the receiver-operating characteristics curve (AUC). The overall mean absolute percentage error was ≤ 10% for 25 formulae in singleton pregnancies compared with three formulae in twin pregnancies. The overall predictions within ± 10% and ± 15% of the ABW were 62.2% and 81.5% in singleton and 49.7% and 68.5% in twin pregnancies, respectively. When t e formulae were categorized according to the biometric parameters included, those based on a combination of head, abdomen and femur measurements showed the lowest mean absolute percentage error, in both singleton and twin pregnancies. The predictive accuracy for 25% birth-weight discordance using the Hadlock 2 formula, as assessed by the AUC, was 0.87. Ultrasound estimation of birth weight is less accurate in twin than in singleton pregnancies. Formulae that include a combination of head, abdomen and femur measurements perform best in both singleton and twin pregnancies. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

    • Transvaginal cervical length measurement at 22- to 26-week pregnancy in prediction of preterm births in twin pregnancies.

      Science.gov (United States)

      El-Gharib, Mohamed Nabih; Albehoty, Sherin Barakat

      2017-03-01

      To investigate the predictive role of transvaginal ultrasonographic measurement of cervical length (CL) at 22-26 weeks of gestation in determining preterm deliveries in twin pregnancies. The study included 150 twin pregnancies. CL was measured by transvaginal ultrasonography at 22-26 weeks. Signs of preterm labor, ruptured membranes, vaginal bleeding, patients with systemic disease, and cervical incompetencies were excluded. The patients had monthly digital cervical examinations but no routine TVCL ultrasound examinations. The primary outcome was spontaneous preterm birth at before 37 weeks of gestation. Ninety-two percent of twin pregnancies delivered by cesarean section and 16% babies had a neonatal intensive care unit requisitioned. Ninety-two patients were delivered in smaller than 37 gestational weeks and the mean CL measurement (CLM) was twin pregnancy, the risk of preterm birth can be evaluated using the ultrasonographic measurement of CL at 22-26 weeks of gestation.

    • Problem in twin pregnancy: Findings of prenatal sonography and autopsy

      Energy Technology Data Exchange (ETDEWEB)

      Kim, Jeong Ah; Cho, Jeong Yeon; Song, Mi Jin; Min, Jee Yeon; Lee, Young Ho; Lee, Hak Jong; Chun, Yi Kyeong; Kim, Yee Jeong; Hong, Sung Ran [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

      2001-12-15

      Multifetal gestations are high risk pregnancies with higher perinatal morbidity and mortality. Multifetal gestations are subject to unique complications including conjoined twins, twin-to-twin transfusion syndrome (TTTS), acardiac twins, twin embization of co-twin demise and heterotopic pregnancies. Prenatal sonographic diagnosis of types and complications of multifetal gestations is important for antenatal care and prediction of fetal outcome. This study was performed to present the prenatal ultrasonographic findings and pathologic findings of the unique complications of twin pregnancy. Acardia is a lethal anomaly occurring in 1% of monozygotic twin. The acardiac twin has a parasitic existence and depends on the donor (pump) twin for its blood supply via placental anastomoses and retrograde perfusion of umbilical cord. This twin reversed arterial perfusion (TRAP) sequence is a most extreme manifestation on the TTTS. Doppler verification reversed flow in umbilical cord of the acardiac twin confirms the diagnosis.

    • A Rare Localization of Ectopic Pregnancy: Intramyometrial Pregnancy in Twin Pregnancy following IVF

      OpenAIRE

      Lahcen Boukhanni; Yassir Ait Benkaddour; Ahlam Bassir; Abdrahim Aboulfalah; Hamid Asmouki; Abderraouf Soummani

      2014-01-01

      Intramyometrial pregnancy is a rare form of ectopic pregnancy. It makes a diagnostic and therapeutic challenge. If misdiagnosed the intramyometrial pregnancy can cause a uterine rupture and become life-threatening condition. We report a case of intramyometrial pregnancy in twin pregnancy following IVF with spontaneous abortion of the first twin At 9 weeks of gestation. The 10 weeks scan showed a normal fetus which was described to be highly localized in the uterus but the diagnosis of intramy...

    • Effect of Betamethasone on Neonatal Outcomes in Twin Pregnancies Delivered by Elective Caesarean Section%倍他米松对双胎择期剖宫产新生儿结局作用探讨

      Institute of Scientific and Technical Information of China (English)

      高岩; 杜晓红; 董江华; 周羽

      2013-01-01

      Objective:To explore the impact of antenatal betamethasone on neonatal morbidity and mortality in twin pregnancies delivered by elective prelabor caesarean section.Methods:The clinical data of 72 cases of twin pregnancies (study group) delivered by elective prelabor caesarean section from January 2011 to February 2012 in Sichuan Provincial Hospital for Women and Children were retrospectively analyzed.156 cases of singleton pregnancies delivered by elective prelabor caesarean section at same period were included as control group.Both singletons and twins caesarean delivery were undertaken electively only after prophylactic antenatal betamethasone administration.The neonatal outcomes were compared between the two groups.Results:There was no difference between the distribution of gestational age and the mean gestational age(P >0.05).The birth weight in study group was lower than that in control group,the difference was statistically significant(P < 0.05).There was no difference between the groups in Apgar scores,neonatal deaths,and morbidity of neonatal diseases such as NRDS(2.78% & 2.56%),PPHN(0.69% & 1.28%),IVH(2.78% & 3.21%),NEC(2.08% & 1.28%).The proportion of NICU and hospital stays in NICU in research group was significantly higher than that in control group (P < 0.05).Conclusions:Antenatal betamethasone for the prevention neonatal morbidity and mortality in twins after elective prelabor caesarean section is as effective as singletons.%目的:探讨倍他米松对双胎妊娠择期剖宫产新生儿结局的影响.方法:对2011年1月至2012年2月在四川省妇幼保健院临产前行择期剖宫产的72例双胎妊娠(研究组)临床资料进行回顾性分析,选择同期156例单胎妊娠作为对照组,两组患者剖宫产前均常规预防性使用倍他米松,比较两组新生儿结局.结果:两组在分娩孕周分布、平均孕周比较,差异无统计学意义(P>0.05);但研究组新生儿体重低于对照

  1. Twin pregnancy in a Fontan-palliated patient.

    Science.gov (United States)

    Nair, Anupama; Radhakrishnan, Sitaraman; Iyer, Krishna S

    2016-08-01

    The Fontan connection, originally described in 1971, is used to provide palliation for patients with many forms of CHDs that cannot support a biventricular circulation. An increasing number of females who have undergone these connections in childhood are now surviving into adulthood and some are becoming pregnant. We report a case of a 29-year-old woman who presented with a twin pregnancy at 33 weeks of gestation. She had significant deterioration of her cardiovascular status before the twin babies were delivered by emergency caesarean section owing to associated obstetric complications. This report also highlights the various maternal and fetal complications occurring in pregnancy of Fontan-palliated patients and suggests the need for meticulous pre-conception counselling and strict perinatal care.

  2. [Gestational diabetes insipidus during a twin pregnancy].

    Science.gov (United States)

    De Mesmay, M; Rigouzzo, A; Bui, T; Louvet, N; Constant, I

    2013-02-01

    Gestational diabetes insipidus is an uncommon clinical disease whose prevalence is approximately two to three pregnancies per 100,000. It may be isolated or associated with preeclampsia. We report a case of gestational diabetes insipidus in a twin pregnancy, originally isolated during two months, and secondarily complicated by HELLP-syndrome. We recall the specific pathophysiology of polyuric-polydipsic syndrome during pregnancy and summarize its various causes. Finally, we discuss the indications, in case of isolated gestational diabetes insipidus, of treatment by dDAVP.

  3. Successful Singleton and Twin Pregnancies With the Nuss Bars in Place.

    Science.gov (United States)

    Jaroszewski, Dawn E; Ewais, MennatAllah M; Gotway, Michael B; McMahon, Lisa E; Notrica, David M

    2015-11-01

    Pectus excavatum (PE) occurs less commonly in women, and the implications on a pregnancy after repair during the period when support bars are in place are unknown. We present 2 cases: 1 with a successful twin gestation and another with a successful singleton gestation. These women carried the pregnancies to term and delivered their infants with the Nuss bars in place.

  4. Acardiac Parabiotic Fetus: A Rare Complication of Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Sood S

    2015-10-01

    Full Text Available Acardiac parabiotic fetus is sequelae of complication of monochorionic monoamniotic twin pregnancy also known as Twin Reversed Arterial Perfusion Sequence (TRAP. It is rare affecting 1 in 35,000 births and 1 % of monozygotic twins. Acardiac parabiotic twin commonly known as parasite occurs rarely and may lead to high output cardiac failure, hydrops or premature delivery in the pump fetus. In this report, we present a 23 years old primigravida with twin pregnancy, with twin reversed arterial perfusion sequence with one of the twins being acardiac anceps and the other normal pump fetus. This association is relatively uncommon and therefore rarely documented.

  5. Herceptin (trastuzumab) therapy in a twin pregnancy with associated oligohydramnios.

    Science.gov (United States)

    Beale, Jennifer M A; Tuohy, Jeremy; McDowell, Simon J

    2009-07-01

    Herceptin (trastuzumab) is an adjuvant chemotherapy agent used in treatment of certain breast cancers. Limited information is available on the use of herceptin in pregnancy. This case is a twin pregnancy exposed to herceptin until 23 weeks' gestation. One twin had chronic renal failure develop, whereas the other twin did not.

  6. CLINICAL STUDY OF LABOUR IN TWIN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Amudha

    2015-07-01

    Full Text Available OBJECTIVES: The objective of the present study is to analyse the incidence of preterm labour, intrapartum complications, incidence of operative delivery both vaginal and cesarean and indications for such interventions. METHODOLOGY: A total of 150 cases of twin pregnancy were analyzed between the period of September 2012 to February 2014. These cases were stud ied with respect to period of gestation at the onset of labour, fetal presentations at the onset of labour, route and mode of delivery, indications in cases of cesarean delivery, intrapartum complications and delivery interval between twins. OBSERVATIONS A ND RESULTS: In the present study there was increased incidence of preterm labour (52.6%, fetal malpresentations (43.3%, operative vaginal delivery (29.5%, cesarean delivery (17.3%. CONCLUSION: In this study it is observed that above mentioned labour ev ents and complications double up in the event of a twin pregnancy. Regular antenatal visits, planned delivery and anticipation and identification of complications will help for better pregnancy outcome.

  7. Pregnancy outcome after fetal reduction in women with a dichorionic twin pregnancy

    NARCIS (Netherlands)

    van de Mheen, L.; Everwijn, S. M. P.; Knapen, M. F. C. M.; Haak, M. C.; Engels, M. A. J.; Manten, G. T. R.; Zondervan, H. A.; Wirjosoekarto, S. A. M.; van Vugt, J. M. G.; Erwich, J. J. H. M.; Bilardo, C. M.; van Pampus, M. G.; de Groot, C. J. M.; Mol, B. W. J.; Pajkrt, E.

    2015-01-01

    STUDY QUESTION: What are the pregnancy outcomes for women with a twin pregnancy that is reduced to a singleton pregnancy? summary answer: Fetal reduction of a twin pregnancy significantly improves gestational age at birth and neonatal birthweight, however at an increased risk of pregnancy loss and p

  8. Pregnancy outcome after fetal reduction in women with a dichorionic twin pregnancy

    NARCIS (Netherlands)

    Mheen, L. van de; Everwijn, S.M.; Knapen, M.F.; Haak, M.C.; Engels, M.A.J.; Manten, G.T.; Zondervan, H.A.; Wirjosoekarto, S.A.; Vugt, J.M.G. van; Erwich, J.J.; Bilardo, C.M.; Pampus, M.G. van; Groot, C.J. de; Mol, B.W.; Pajkrt, E.

    2015-01-01

    STUDY QUESTION: What are the pregnancy outcomes for women with a twin pregnancy that is reduced to a singleton pregnancy? SUMMARY ANSWER: Fetal reduction of a twin pregnancy significantly improves gestational age at birth and neonatal birthweight, however at an increased risk of pregnancy loss and p

  9. Dichorionic Diamniotic Twin Pregnancy Discordant for Bladder Exstrophy

    OpenAIRE

    William Tu; Jane Chueh; William Kennedy

    2009-01-01

    A 38 year-old woman presented with a dichorionic diamniotic twin pregnancy at gestational age of 32 weeks concerning for an abdominal wall mass in one of the twins. Initial ultrasound evaluation was suspicious for an omphalocele, but the affected twin was found to have bladder exstrophy at birth. This illustrates the difficulties of accurate prenatal diagnosis of bladder exstrophy in a twin pregnancy at a late gestation.

  10. Dichorionic Diamniotic Twin Pregnancy Discordant for Bladder Exstrophy

    Directory of Open Access Journals (Sweden)

    William Tu

    2009-01-01

    Full Text Available A 38 year-old woman presented with a dichorionic diamniotic twin pregnancy at gestational age of 32 weeks concerning for an abdominal wall mass in one of the twins. Initial ultrasound evaluation was suspicious for an omphalocele, but the affected twin was found to have bladder exstrophy at birth. This illustrates the difficulties of accurate prenatal diagnosis of bladder exstrophy in a twin pregnancy at a late gestation.

  11. Incidence and mode of delivery of twin pregnancies in Uyo, Nigeria

    Directory of Open Access Journals (Sweden)

    Aniekan M Abasiattai

    2010-01-01

    Full Text Available Background: Twin pregnancy continues to be a focus of interest the world over due to its increasing incidence and also the high maternal and perinatal mortality and morbidity associated with it. Objective: To determine the incidence and mode of delivery of twin pregnancies at the University of Uyo Teaching Hospital, Uyo. Methodology: A 5-year retrospective review of twin deliveries at the University of Uyo Teaching Hospital. Results: There were 6,344 deliveries out of which 164 were twin deliveries resulting in an incidence of 2.6%. The modal age group of the patients was 20-29 years (66.5%, majority (71.3% of the patients were multiparous, 79.3% booked and had regular antenatal care in the hospital while 49.4% of the patients delivered at term. Eighty-four patients (51.2% were delivered by caesarean section and malpresentation of the first twin (18.2% and hypertensive disorders of pregnancy (10.4% were the most common indications. The perinatal mortality rate was 207/1000 and there was one maternal death which was from eclampsia. Conclusion: The incidence of twin pregnancy and its attendant perinatal mortality is high in our center. In addition, caesarean section is the most common mode of delivery with malpresentation of the first twin and hypertensive disorders of pregnancy as the most common indications. We advocate widespread public enlightenment on the increased risk associated with twin pregnancy. Community leaders should ensure that women with twin pregnancy should book early and obtain antenatal care in specialized units.

  12. [Spontaneous hepatic hematoma in twin pregnancy].

    Science.gov (United States)

    Quesnel, Carlos; Weber, Alejandro; Mendoza, Dalila; Garteiz, Denzil

    2012-02-01

    The hepatic hematoma or rupture appear in 1 of every 100,000 pregnancies. The most common causes of hepatic hematoma in pregnancy are severe preeclampsia and HELLP syndrome; some predisposing factors are seizures, vomiting, labor, preexistent hepatic disease and trauma. A 33 year old primigravid with a normal 33 week twin pregnancy presented abdominal pain and hypovolemic shock due to spontaneous subcapsular hepatic hematoma; laparoscopy was performed to evaluate the possibility of rupture, which was not found, later emergency cesarean section was carried out followed by hepatic hematoma drainage and abdominal packaging by laparoscopy. After surgery the flow through drainage was too high additionally hemodynamic instability and consumption coagulopathy. Abdominal panangiography was performed without identifying bleeding areas. Intesive care was given to the patient evolving satisfactorily, was discharged 19 days after the event. Seven months later she had laparoscopic cholecystectomy due to acute litiasic colecistitis. We found 5 cases in literatura about hepatic hematoma during pregnancy no related to hypertensive disorders of pregnancy; these were related to hepatoma, amebian hepatic abscess, falciform cell anemia, cocaine consumption and molar pregnancy. Hepatics hematomas have high morbidity and mortality so is significant early diagnosis and multidisciplinary approach.

  13. NOTE: Increasing cardiac output and decreasing oxygenation sequence in pump twins of acardiac twin pregnancies

    Science.gov (United States)

    van Gemert, Martin J. C.; Umur, Asli; van den Wijngaard, Jeroen P. H. M.; Van Bavel, Ed; Vandenbussche, Frank P. H. A.; Nikkels, Peter G. J.

    2005-02-01

    An acardiac twin pregnancy is a rare but serious complication of monochorionic twinning and consists of an acardiac twin and a pump twin. The acardiac twin is a severely malformed fetus that lacks most organs, particularly a heart, but grows during pregnancy because it is perfused by the developmentally normal pump twin via a set of arterioarterial and venovenous placental anastomoses. Pump twins die intrauterine or neonatally in about 50% of the cases. Because the effects of an acardiac mass on the pump twin's development are incompletely known, methods for outcome prognosis are currently not available. We sought to derive simple relations for the pump twin's excess cardiac output and decreased oxygenation and to use available clinical cases for a preliminary test of the model. As a method, we used a theoretical flow model to represent the fetoplacental circulation of an acardiac twin pregnancy and estimated blood deoxygenation and reoxygenation following perfusion of the two bodies and placentas, respectively. The results show the pump twin's excess cardiac output and decrease of venous oxygen saturation to depend on the ratio of pump twin to acardiac twin umbilical blood flow, whose ratio can be measured by ultrasonography. The clinical cases show a decreasing umbilical flow ratio with gestation. In conclusion, prospective serial study is necessary to test whether measurement of umbilical flow ratios allows monitoring the pump twin's pathophysiologic development, possibly resulting in a guideline for prognosis of pump twin survival.

  14. Increasing cardiac output and decreasing oxygenation sequence in pump twins of acardiac twin pregnancies

    Energy Technology Data Exchange (ETDEWEB)

    Gemert, Martin J C van [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Umur, Asli [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Wijngaard, Jeroen P H M van den [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); VanBavel, Ed [Department of Medical Physics, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Vandenbussche, Frank P H A [Department of Obstetrics, Leiden University Medical Center, Leiden (Netherlands); Nikkels, Peter G J [Department of Pathology, University Medical Center, Utrecht (Netherlands)

    2005-02-07

    An acardiac twin pregnancy is a rare but serious complication of monochorionic twinning and consists of an acardiac twin and a pump twin. The acardiac twin is a severely malformed fetus that lacks most organs, particularly a heart, but grows during pregnancy because it is perfused by the developmentally normal pump twin via a set of arterioarterial and venovenous placental anastomoses. Pump twins die intrauterine or neonatally in about 50% of the cases. Because the effects of an acardiac mass on the pump twin's development are incompletely known, methods for outcome prognosis are currently not available. We sought to derive simple relations for the pump twin's excess cardiac output and decreased oxygenation and to use available clinical cases for a preliminary test of the model. As a method, we used a theoretical flow model to represent the fetoplacental circulation of an acardiac twin pregnancy and estimated blood deoxygenation and reoxygenation following perfusion of the two bodies and placentas, respectively. The results show the pump twin's excess cardiac output and decrease of venous oxygen saturation to depend on the ratio of pump twin to acardiac twin umbilical blood flow, whose ratio can be measured by ultrasonography. The clinical cases show a decreasing umbilical flow ratio with gestation. In conclusion, prospective serial study is necessary to test whether measurement of umbilical flow ratios allows monitoring the pump twin's pathophysiologic development, possibly resulting in a guideline for prognosis of pump twin survival. (note)

  15. STUDY OF OBSTETRIC COMPLICATIONS & OUTCOME OF TWIN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Swati

    2014-10-01

    Full Text Available : INTRODUCTION: Twin pregnancy is a rare phenomenon and significantly related to increased maternal & fetal morbidity and mortality as compared to singleton pregnancy. It is important that every physician must know the complications related to twin pregnancy and how to manage these complications. DESIGN: Prospective observational study AIMS AND OBJECTIVE: (1 To study incidence of various obstetric complications in twin pregnancy (2 To study outcome of twin pregnancy in terms of average duration of gestation, mode of delivery & neonatal outcome. METHODS: 59 Patients with sonographically confirmed twin pregnancy attending ante-natal care outpatient department (ANC OPD & labor room at a tertiary care hospital in our Unit in specified period of 18 months as mentioned above were enrolled in this study and followed till delivery and thereafter in the neonatal period. RESULTS: In this study twin pregnancies were slightly more in multigravida. The rate of preterm delivery was 77.9%.PIH & Anaemia was more common in primigravida. Monochorionic twins had more complications than dichorionic twins. NICU admission rate in this study was 23.6%, perinatal mortality rate was 16.9% and neonatal mortality rate was 12.2%. CONCLUSION: Twinning in pregnancy is a high risk factor which can cause various maternal as well fetal complications. Prompt ANC care and timely intervention is required to avoid these complications.

  16. Do assisted-reproduction twin pregnancies require additional antenatal care?

    Science.gov (United States)

    Jauniaux, E; Ben-Ami, I; Maymon, R

    2013-02-01

    Iatrogenic twinning has become the main side-effect assisted reproduction treatment. We have evaluated the evidence for additional care that assisted-reproduction twins may require compared with spontaneous twins. Misacarriages are increased in women with tubal problems and after specific treatments. Assisted-reproduction twin pregnancies complicated by a vanishing twin after 8 weeks have an increased risk of preterm delivery and of low and very low birthweight compared with singleton assisted-reproduction pregnancies. Monozygotic twin pregnancies occur at a higher rate after assisted reproduction treatment and are associated with a higher risk of perinatal complications. The incidence of placenta praevia and vasa praevia is increased in assisted-reproduction twin pregnancies. Large cohort studies do not indicate a higher rate of fetal congenital malformations in assisted-reproduction twins. Overall, assisted-reproduction twins in healthy women assisted-reproduction twins is only increased in women with a pre-existing medical condition such as hypertensive disorders and diabetes and most of these risks can be avoided with single-embryo transfer. Following the birth of the first IVF baby, rumours started to spread in both the medical literature and the media about the long-term health effects for children born following assisted reproduction treatment. However, after more than 30 years, the most common complications associated with IVF treatment remain indirect and technical such as the failure of treatment and ovarian hyperstimulation. Iatrogenic twinning has become the main side-effect of assisted reproduction treatment and the increasing number of twin pregnancies, in particular in older women, has generated numerous debates on the need for additional healthcare provision. In this review, we have evaluated the evidence for additional care that assisted-conception twin pregnancies may require compared with spontaneous twin pregnancies. Twin pregnancies are

  17. A Rare Localization of Ectopic Pregnancy: Intramyometrial Pregnancy in Twin Pregnancy following IVF

    Directory of Open Access Journals (Sweden)

    Lahcen Boukhanni

    2014-01-01

    Full Text Available Intramyometrial pregnancy is a rare form of ectopic pregnancy. It makes a diagnostic and therapeutic challenge. If misdiagnosed the intramyometrial pregnancy can cause a uterine rupture and become life-threatening condition. We report a case of intramyometrial pregnancy in twin pregnancy following IVF with spontaneous abortion of the first twin At 9 weeks of gestation. The 10 weeks scan showed a normal fetus which was described to be highly localized in the uterus but the diagnosis of intramyometrial pregnancy was not suspected. The patient was admitted at 14 weeks of gestation with pelvic pain, hemorrhage, and shock. She was operated and the diagnosis of ruptured intramyometrial pregnancy was done and managed conservatively. This case illustrates the diagnostic difficulties of intramyometrial pregnancy. We discuss pathophysiology, diagnosis, and treatment of this exceptional form of ectopic pregnancy.

  18. Spontaneous Live Twin Tubal Ectopic Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    R Benn

    2016-02-01

    Full Text Available We report the case of a 29-year old G3P1+1 woman with a spontaneously conceived live twin tubal ectopic pregnancy. Her history was significant for infertility for 11 years after an induced abortion. Pelvic ultrasound scan showed live twin ectopic pregnancy and a partial salpingectomy was done.

  19. Cytokines and the Risk of Preterm Delivery in Twin Pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Klein, Katharina; Larsen, Helle

    2012-01-01

    To estimate the association between cytokine levels in twin pregnancies and risk of spontaneous preterm delivery, including the effect of progesterone treatment.......To estimate the association between cytokine levels in twin pregnancies and risk of spontaneous preterm delivery, including the effect of progesterone treatment....

  20. [Intrauterine fetal transfusion in twin pregnancy with Rh isoimmunization].

    Science.gov (United States)

    Vasileva, Iu; Poissonier, M E

    1989-01-01

    Two women with twin pregnancy and with Rhesus isoimmunization were described. The disease of these women was so grave that intrauterine transfusions were made in both fetuses (from all 86 pregnancies treated with transfusions). Twins of one of the women were born alive, but the other twins died in utero. Difficulties and problems of this rarely encountered combination of two independent one from the other pathologies are discussed.

  1. Carbohydrate metabolism in women with a twin pregnancy.

    Science.gov (United States)

    Spellacy, W N; Buhi, W C; Birk, S A

    1980-06-01

    Carbohydrate metabolism was evaluated in 24 women with a twin pregnancy and 24 women with a singleton pregnancy. The groups were of similar age, parity, weight, and gestational age. In each woman an intravenous glucose tolerance test was done using a 25-g glucose load in the last half of gestation. Both blood glucose and plasma insulin levels were measured and statistically compared. The plasma human placental lactogen levels were significantly higher in the women with the twin gestation (7.3 +/- 0.7 versus 4.7 +/- 0.3 microgram/ml). Although the glucose disappearance rates (K) were not different, there was a significantly lower fasting as well as 5- and 15-minute blood glucose value in the twin pregnancy group. There was also a significantly lower 15-minute insulin level in the twin group. The importance of these findings to the clinical management of twin pregnancies and to the understanding of the metabolic changes in pregnancy is discussed.

  2. Presenting Twins Are Exposed to Higher Levels of Inflammatory Mediators than Nonpresenting Twins as Early as the Midtrimester of Pregnancy.

    Directory of Open Access Journals (Sweden)

    Seung Mi Lee

    Full Text Available Presenting twins are less likely to develop respiratory complications than non-presenting twins. The precise reason for this difference is not well understood, although it is known that the presence of inflammation reduces the risk of respiratory morbidity at birth. To further investigate this association, we compared the concentrations of inflammatory biomarkers in mid-trimester amniotic fluid (AF of asymptomatic twin pairs.The study population consisted of women with twin pregnancies who underwent mid-trimester amniocentesis (15-20 weeks for routine clinical indications and delivered at term. AF was analyzed for pro-inflammatory cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, IL-15, IFN-γ, TNF-α, matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, MMP-12, and chemokines (Complement Factor D/Adipsin, Serpin E1/PAI-1, Adiponectin/Acrp30, CRP, CCL2/MCP-1, Leptin, Resistin using Luminex Performance Assay multiplex kits. Data were analyzed using Wilcoxon signed rank test.A total of 82 twin pairs were enrolled. Mid-trimester AF concentrations of IL-8, MMP-8, CRP, MCP-1, leptin, and resistin were significantly higher in the presenting twin compared with the non-presenting twin (p<0.05 for each. Differences in AF concentrations of IL-8, MMP-8, and CRP persisted after adjustment for the fetal growth restriction at the time of birth and chorionicity.These data suggest that, as early as the mid-trimester, the presenting fetus in an otherwise uncomplicated twin pregnancy is exposed to higher levels of pro-inflammatory mediators (especially IL-8, MMP-8, and CRP than its non-presenting co-twin. Whether this pro-inflammatory milieu reduces the risk of neonatal respiratory morbidity at birth or has other functional implications needs to be further evaluated.

  3. Haemodynamic resistance model of monochorionic twin pregnancies complicated by acardiac twinning

    Energy Technology Data Exchange (ETDEWEB)

    Umur, Asli [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam(Netherlands); Gemert, Martin J C van [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Wijngaard, Jeroen P H M van den [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Ross, Michael G [Department of Obstetrics and Gynecology, Harbor University of California-Los Angeles Medical Center, Torrence, CA 9050 (United States); Nikkels, Peter G J [Department of Pathology, University Medical Center, Utrecht (Netherlands)

    2004-07-21

    An acardiac twin is a severely malformed monochorionic twin fetus that lacks most organs, particularly a heart. It grows during pregnancy, because it is perfused by its developmentally normal co-twin (called the pump twin) via a set of placental arterioarterial and venovenous anastomoses. The pump twin dies intrauterine or neonatally in about 50% of the cases due to congestive heart failure, polyhydramnios and prematurity. Because the pathophysiology of this pregnancy is currently incompletely understood, we modified our previous haemodynamic model of monochorionic twins connected by placental vascular anastomoses to include the analysis of acardiac twin pregnancies. We incorporated the fetoplacental circulation as a resistance circuit and used the fetal umbilical flow that perfuses the body to define fetal growth, rather than the placental flow as done previously. Using this modified model, we predicted that the pump twin has excess blood volume and increased mean arterial blood pressure compared to those in the acardiac twin. Placental perfusion of the acardiac twin is significantly reduced compared to normal, as a consequence of an increased venous pressure, possibly implying reduced acardiac placental growth. In conclusion, the haemodynamic analysis may contribute to an increased knowledge of the pathophysiologic consequences of an acardiac body mass for the pump twin. (note)

  4. Maternal and perinatal complications in triplet compared with twin pregnancy

    NARCIS (Netherlands)

    J.G. Santema (Job); P. Bourdrez (Petra); H.C.S. Wallenburg (Henk)

    1995-01-01

    textabstractObjective: To compare maternal and perinatal complications in triplet and twin pregnancies. Study design: Case-controlled study in the setting of a University Hospital. Each pregnancy of a consecutive series of 40 triplet pregnancies of 20 weeks or more was matched for parity and materna

  5. Evidence for No Significant Impact of Müllerian Anomalies on Reproductive Outcomes of Twin Pregnancy in Korean Women.

    Science.gov (United States)

    Shim, Sohyun; Hur, Yoon-Mi; Kim, Da Hee; Seong, Seok Ju; Kim, Mi-La; Shin, Joong Sik

    2016-04-01

    The present article aimed to evaluate the impact of congenital Müllerian anomalies (MA) on twin pregnancy after 24 gestational weeks in Korean women. All records of twin pregnancies in a large maternity hospital in Korea between January 2005 and July 2013 were analyzed. Patients with monochorionic monoamniotic (MCMA) twins, non-Korean patients, patients with twins delivered prior to 24 gestational weeks, and patients with miscarriage of one fetus or intrauterine fetal death (IUFD) before 24 gestational weeks were excluded from data analysis. In total, 1,422 women with twin pregnancy were eligible for data analysis, including 17 (1.2%) who had a known congenital MA (septate uterus, bicornuate uterus, arcuate uterus, and unicornuate uterus). Except for the mode of conception, baseline demographics were similar between women with MA and those without MA. No significant differences were found in pregnancy outcomes of gestational age at delivery (p = .86), birth weight of smaller and larger twins (p = .54 and p = .65), and number of twins with birth weight <5th percentile for gestational age (p = .43).The rates of obstetrical complications such as pre-eclampsia, gestational diabetes mellitus (GDM), placenta previa, cerclage, IUFD, and postpartum hemorrhage were not significantly different between the two groups either. We concluded that the presence of congenital MA may not increase obstetrical risks in outcomes of pregnancy of twins delivered after 24 gestational weeks.

  6. Observed Rate of Down Syndrome in Twin Pregnancies.

    Science.gov (United States)

    Sparks, Teresa N; Norton, Mary E; Flessel, Monica; Goldman, Sara; Currier, Robert J

    2016-11-01

    To evaluate the observed incidence of Down syndrome in twins compared with that expected based on maternal age-matched singletons, which is the current clinical approach. This was a retrospective review of California Prenatal Screening Program participants with expected delivery dates between July 1995 and December 2012. Cases confirmed prenatally or postnatally with a genetic imbalance leading to phenotypic Down syndrome (trisomy 21, mosaic trisomy 21, or translocations) were included. Pregnancies conceived with ovum donation and women older than 45 years were excluded. We compared the observed Down syndrome incidence per pregnancy for twins with expected incidence by extrapolating from singleton data and expected zygosity as is the current clinical approach. This extrapolation assumes that monozygotic pregnancies have equivalent Down syndrome risk per pregnancy relative to maternal age-matched singletons and dizygotic pregnancies have twice the risk of at least one affected fetus. Zygosity for affected cases was presumed to be monozygotic with Down syndrome concordance and dizygotic with Down syndrome discordance. Counts were compared using cumulative Poisson distributions. Of 77,279 twin pregnancies, 182 (0.2%) had at least one fetus with Down syndrome confirmed by karyotype. The ratio of observed-to-expected Down syndrome incidence per pregnancy was 33.6%, 75.2%, and 70.0% for monozygotic, dizygotic, and all twins, respectively (PDown syndrome incidence was seen for women aged 25 to 45 years with monozygotic pregnancies and overall for women aged 25 to 45 years with dizygotic pregnancies. The observed incidence of Down syndrome in twin pregnancies is lower than expected, most notably for monozygotic pregnancies and with increasing maternal age. Risk-based counseling can strongly affect women's choices regarding testing and management during pregnancy, so an understanding of the true Down syndrome risk in twin gestations is crucial.

  7. Prospective risk of stillbirth and neonatal complications in twin pregnancies

    DEFF Research Database (Denmark)

    Cheong-See, Fiona; Schuit, Ewoud; Arroyo-Manzano, David

    2016-01-01

    OBJECTIVE: To determine the risks of stillbirth and neonatal complications by gestational age in uncomplicated monochorionic and dichorionic twin pregnancies. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, and Cochrane databases (until December 2015). REVIEW METHODS: ...

  8. Consequences of vanishing twins in IVF/ICSI pregnancies

    DEFF Research Database (Denmark)

    Pinborg, Anja Bisgaard; Lidegaard, Ojvind; la Cour Freiesleben, Nina

    2005-01-01

    Spontaneous reductions are a possible cause of the increased morbidity in IVF singletons. The aim of this study was to assess incidence rates of spontaneous reductions in IVF/ICSI twin pregnancies and to compare short- and long-term morbidity in survivors of a vanishing co-twin with singletons...

  9. Consequences of vanishing twins in IVF/ICSI pregnancies

    DEFF Research Database (Denmark)

    Pinborg, Anja Bisgaard; Lidegaard, Ojvind; la Cour Freiesleben, Nina;

    2005-01-01

    Spontaneous reductions are a possible cause of the increased morbidity in IVF singletons. The aim of this study was to assess incidence rates of spontaneous reductions in IVF/ICSI twin pregnancies and to compare short- and long-term morbidity in survivors of a vanishing co-twin with singletons...

  10. Twin pregnancy in a liver transplant recipient with HIV infection.

    Science.gov (United States)

    Van Schalkwyk, McI; Westbrook, R H; O'Beirne, J; Wright, A; Gonzalez, A; Johnson, M A; Kinloch-de Loës, S

    2016-10-05

    We are not aware of a report detailing the complex obstetrical and medical management of twin pregnancy in the context of HIV infection and early post-liver transplantation period. Here we describe the successful outcome of a twin pregnancy in a 28-year-old HIV-positive female receiving antiretroviral therapy and immunosuppressive therapy who was the recipient of a liver transplant for previous drug-induced liver failure.

  11. Assessing Weight Gain by the 2009 Institute of Medicine Guidelines and Perinatal Outcomes in Twin Pregnancy.

    Science.gov (United States)

    Ozcan, Tulin; Bacak, Stephen J; Zozzaro-Smith, Paula; Li, Dongmei; Sagcan, Seyhan; Seligman, Neil; Glantz, Christopher J

    2016-07-23

    Objective The objective is to estimate the impact of maternal weight gain outside the 2009 Institute of Medicine recommendations on perinatal outcomes in twin pregnancies. Study Design Twin pregnancies with two live births between January 1, 2004 and December 31, 2014 delivered after 23 weeks Finger Lakes Region Perinatal Data System (FLRPDS) and Central New York Region Perinatal Data System were included. Women were classified into three groups using pre-pregnancy body mass index (BMI). Perinatal outcomes in women with low or excessive weekly maternal weight gain were assessed using normal weekly weight gain as the referent in each BMI group. Results Low weight gain increased the risk of preterm delivery, birth weight less than the 10th percentile for one or both twins and decreased risk of macrosomia across all BMI groups. There was a decreased risk of hypertensive disorders in women with normal pre-pregnancy weight and an increased risk of gestational diabetes with low weight gain in obese women. Excessive weight gain increased the risk of hypertensive disorders and macrosomia across all BMI groups and decreased the risk of birth weight less than 10th percentile one twin in normal pre-pregnancy BMI group. Conclusion Among twin pregnancies, low weight gain is associated with low birth weight and preterm delivery in all BMI groups and increased risk of gestational diabetes in obese women. Our study did not reveal any benefit from excessive weekly weight gain with potential harm of an increase in risk of hypertensive disorders of pregnancy. Normal weight gain per 2009 IOM guidelines should be encouraged to improve pregnancy outcome in all pre-pregnancy BMI groups.

  12. Can prematurity risk in twin pregnancies after in vitro fertilization be predicted? A retrospective study

    Directory of Open Access Journals (Sweden)

    Barad David

    2009-01-01

    Full Text Available Abstract Background Assisted reproduction (ART contributes to world-wide increases of twin pregnancies, in turn raising prematurity risks. Whether characteristics of ART cycles, resulting in twin gestations, can predict prematurity risks was the subject of this study. Methods One-hundred-and-six women, ages 20 to 39 years, with consecutive dichorionic-diamniotic (DC/DA twin gestations were retrospectively investigated. All pregnancies investigated followed fresh ART cycles, with use of autologous gamets, and were delivered at a university-based high-risk, maternal-fetal medicine unit. Only premature deliveries (i.e., <37.0 weeks gestational age, with viable neonate(s of ≥ 500 grams, were considered for analysis. Results After 1.8 +/- 1.2 ART cycles, 11.0 +/- 5.4 oocytes were retrieved and 2.4 +/- 0.9 embryos transferred in 106 women aged 31.6 +/- 4.2 years. Indications for ART treatment were male factor in 51.9%, female infertility in 27.4% and combined infertility in 20.8%. Though maternal age significantly influenced prematurity risk (p < 0.05, paternal age, maternal body mass index, indications for fertility treatment, number of previous ART attempts, oocytes retrieved or embryos transferred, as well as stimulation protocols and previous ART pregnancies, were not associated with gestational duration in twin pregnancies. Summary Except for female age, baseline and ART cycle characteristics do not allow for prediction of prematurity risk in dichorionic twin gestations after assisted reproduction.

  13. A comparison of the contractile properties of myometrium from singleton and twin pregnancies.

    Directory of Open Access Journals (Sweden)

    Peter Turton

    Full Text Available OBJECTIVE: Over half of twin pregnancies in US and UK deliver prematurely but the reasons for this are unclear. The contractility of myometrium from twin pregnancies has not been directly investigated. The objective of this research was to determine if there are differences in the contractile activity and response to oxytocin, between myometrium from singleton and twin pregnancies, across a range of gestational ages. Furthermore, we wished to determine if contractile activity correlates with increasing level of stretch, using neonatal birth weights as a marker of uterine stretch. METHODS: This was an in vitro, laboratory based study of myometrial contractility in women pregnant with one or two babies, using biopsies obtained from non-labouring women undergoing Caesarean section. Spontaneous, oxytocin-stimulated and depolarization induced contractile activity was compared. RESULTS: Direct measurements of myometrial contractility under controlled conditions show that the frequency of contractions and responses to oxytocin are significantly increased in twins compared to singletons. The duration of contraction however was significantly reduced. We find that contractile activity correlates with increasing levels of stretch, using neonatal birth weights as a surrogate for uterine stretch, with response to oxytocin being significantly positively correlated with birth weight. CONCLUSIONS: We have found significant differences in contractile properties between myometrium from singleton and twin pregnancies and that increasing uterine stretch can alter the contractile properties of myometrium. We discuss the implication of these findings to preterm delivery and future studies.

  14. Delayed Interval Delivery of a Second Twin after the Preterm Labor of the First One in Twin Pregnancies: Delayed Delivery in Twin Pregnancies

    Directory of Open Access Journals (Sweden)

    Yunus Aydin

    2012-01-01

    Full Text Available A diamnionic dichorionic twin pregnant women (due to in vitro fertilization admitted to emergency department at the 21st week of gestation because of regular contractions. By gynecological examination, we observed 8 cm dilated cervix with 80% effacement. Amniotic membrane was also bulging through the cervix. After evaluation delivery of the presenting fetus occurred quickly. The baby’s weight was 610 gr and no heart activity was detected. Placenta of the first fetus expulsed immediately. We decided to retain the second fetus to allow the improvement in the outcome. McDonald cerclage was performed and the patient treated with tocolytics and antibiotics, and she was continuously monitored up to the 28th week of pregnancy. After she was discharged in the 28th week, she was controlled weekly in obstetrics clinic. At the 36th gestational week which was 101 days after the cerclage procedure, 3639 g male fetus was delivered with cesarean section and had an uneventful neonatal course. Delayed-interval delivery is useful and acceptable therapeutic option for the management of the remaining fetus in twin pregnancies even after the expulsion of the placenta. Antibiotic and tocolytic administration with cervical cerclage application can be associated with longer interdelivery interval.

  15. Twin pregnancy with both complete hydatiform mole and coexistent alive fetus:case report

    Institute of Scientific and Technical Information of China (English)

    Achour Radhouane; Ben Aissa Imen; NEJI Khaled

    2015-01-01

    Twin pregnancy consisting of a complete hydatidiform mole coexisting with a live fetus is a rare condition with an incidence of 1 in 22 000 to 1 in 1 00 000 pregnancies. Clinical information is limited and management is difficult due to the risk of pregnancy complications such as fetal death, vaginal bleeding, preeclampsia, hyperthyroidism, and the risk of persistent gestational trophoblastic disease. Thus, the report described about the change of size and implantation site of the molar mass coexisting with a live fetus is rare especially about sonographic findings such as echo patterns. Recently we experienced a case of complete hydatidiform mole with a healthy infant delivered at term.

  16. Twin pregnancy with both complete hydatiform mole and coexistent alive fetus: Case report

    Directory of Open Access Journals (Sweden)

    Achour Radhouane

    2015-12-01

    Full Text Available Twin pregnancy consisting of a complete hydatidiform mole coexisting with a live fetus is a rare condition with an incidence of 1 in 22000 to 1 in 100000 pregnancies. Clinical information is limited and management is difficult due to the risk of pregnancy complications such as fetal death, vaginal bleeding, preeclampsia, hyperthyroidism, and the risk of persistent gestational trophoblastic disease. Thus, the report described about the change of size and implantation site of the molar mass coexisting with a live fetus is rare especially about sonographic findings such as echo patterns. Recently we experienced a case of complete hydatidiform mole with a healthy infant delivered at term.

  17. FIRST-TRIMESTER PRENATAL-DIAGNOSIS IN TWIN PREGNANCIES

    NARCIS (Netherlands)

    CHRISTIAENS, GCML; Oosterwijk, JC; STIGTER, RH; DEUTZTERLOUW, PP; KNEPPERS, ALJ; BAKKER, E

    Two twin pregnancies at risk for a sex-linked disorder are described. Both pregnancies were dichorionic. Transabdominal sampling was chosen for prenatal diagnosis. Molecular genetic techniques raised suspicion with regard to the accuracy of the samples in one case. Second-trimester amniocentesis

  18. FIRST-TRIMESTER PRENATAL-DIAGNOSIS IN TWIN PREGNANCIES

    NARCIS (Netherlands)

    CHRISTIAENS, GCML; Oosterwijk, JC; STIGTER, RH; DEUTZTERLOUW, PP; KNEPPERS, ALJ; BAKKER, E

    1994-01-01

    Two twin pregnancies at risk for a sex-linked disorder are described. Both pregnancies were dichorionic. Transabdominal sampling was chosen for prenatal diagnosis. Molecular genetic techniques raised suspicion with regard to the accuracy of the samples in one case. Second-trimester amniocentesis con

  19. Coffee and smoking as risk factors of twin pregnancies

    DEFF Research Database (Denmark)

    Morales-Suárez-Varela, Maria M; Bech, Bodil Hammer; Christensen, Kaare

    2007-01-01

    Twinning rates have changed substantially over time for reasons that are only partly known. In this study we studied smoking, coffee and alcohol intake, and their possible interaction with obesity as potential determinants of twinning rates using data from the Danish National Birth Cohort between...... their prepregnancy weight and height, coffee and alcohol intake, smoking habits, and potential confounding factors at early stages of pregnancy. We identified smoking (> 10 cigarettes/day) as a possible determinant of twinning, particularly for dizygotic twinning rates (same sex) and furthermore corroborated...... that obesity and the mother's age are strong correlates of twinning. Others have found coffee intake to increase twinning rates but that is not seen in these data....

  20. Photoperiod length and the estrus synchronization protocol used before AI affect the twin pregnancy rate in dairy cattle.

    Science.gov (United States)

    Andreu-Vázquez, C; Garcia-Ispierto, I; López-Gatius, F

    2012-10-01

    This study addresses potential management risk factors affecting the incidence of twin pregnancies in high-producing dairy cows. Special attention was paid to the estrus synchronization protocol used before the AI resulting in pregnancy. Possible factors affecting the twin pregnancy rate were analyzed through binary logistic regression procedures on 2015 pregnant cows from July 2010 to July 2011. Twin pregnancy was recorded in 361 of the 2015 pregnancy diagnoses made (17.9%). Twin pregnancy rates differed among herds (P twin pregnancy was reduced by factors of 0.65 or 0.71 when AI was performed during the warm season or an increasing photoperiod, respectively and increased by a factor of 1.11 for each unit increase in lactation number; by factors of 4.57 or 6.33 in cows that received a progesterone-releasing intravaginal device (PRID) plus 500 or 750 IU of equine chorionic gonadotropin (eCG) 28 days before the pregnancy AI, respectively; by a factor of 2.39 in cows with an ovarian cyst diagnosed in the 14 days prior to AI and treated with prostaglandins (PG); by factors of 1.94 or 3.91 in cows that received two PG doses during the 14 days prior to AI or cows that following failed PRID treatment had received PG started over the 28 days prior to AI, respectively; and by a factor of 2.58 in cows that had previously delivered twins compared to cows delivering singletons. Our results indicate that cow factors, such as lactation number and previous twining, as well as environmental factors, such as photoperiod and season and management related to synchronization protocols affect significantly the incidence of twin pregnancies.

  1. Is Cesarean Delivery Preferable in Twin Pregnancies at >=36 Weeks Gestation?

    Science.gov (United States)

    Dong, Yu; Luo, Zhong-Cheng; Yang, Zu-Jing; Chen, Lu; Guo, Yu-Na; Branch, Ware; Zhang, Jun; Huang, Hong

    2016-01-01

    Background The optimal mode of delivery in twin pregnancies remains controversial. A recent randomized trial did not find any benefit of planned cesarean vs. vaginal delivery at 32–38 weeks gestation, but the trial was not powered to detect a moderate effect. We aimed to evaluate the impact of cesarean delivery on perinatal mortality and severe neonatal morbidity in twin pregnancies at ≥32 weeks through a large database exploration approach with the power to detect moderate risk differences. Methods In a retrospective birth cohort study using the U.S. matched multiple births, 1995–2000 (the available largest multiple birth dataset), we compared perinatal outcomes in twins (n = 181,810 pregnancies) delivered at 32–41 weeks gestation without congenital anomalies. The primary outcome was a composite of perinatal death and severe neonatal morbidity. Cox regression was used to estimate the adjusted hazard ratio (aHR) controlling for the propensity to cesarean delivery, fetal characteristics (sex, birth weight, birth weight discordance, same-sex twin or not) and twin-cluster level dependence. Prospective risks were calculated using the fetuses-at-risk denominators. Results The overall rates of the primary outcome were slightly lower in intended cesarean (6.20%) vs. vaginal (6.45%) deliveries. The aHRs of the primary outcome were in favor of vaginal delivery at 32 (aHR = 1.06, p = 0.03) or 33 (aHR = 1.22, pcesarean delivery at 36 (aHR = 0.94, p = 0.004), 37, 38 and 39+ weeks (aHR: 0.72 to 0.78, all pcesarean vs. vaginal deliveries at 36+ weeks of gestation remained when the analyses were restricted to different-sex (dichorionic) twins (aHR = 0.84, 95% CI 0.80–0.88). Conclusion Cesarean delivery may be beneficial for perinatal outcomes overall in twin pregnancies at ≥36 weeks gestation. PMID:27227678

  2. Fetal behavior in normal dichorionic twin pregnancy

    NARCIS (Netherlands)

    Mulder, E. J. H.; Derks, J. B.; de Laat, M. W. M.; Visser, G. H. A.

    2012-01-01

    Objectives: A prospective study was performed to compare fetal behavioral development in healthy dichorionic twins and singletons, and identify twin intra-pair associations (synchrony) of fetal movements and rest-activity cycles using different criteria to define synchrony. Subjects and methods: Twe

  3. A short review of twin pregnancy and how oxytocin receptor expression may differ in multiple pregnancy.

    Science.gov (United States)

    Turton, Peter; Neilson, James P; Quenby, Siobhan; Burdyga, Theodor; Wray, Susan

    2009-05-01

    During a multiple pregnancy, the mother and her fetuses are exposed to a variety of risks during both pregnancy and labour. The most notable of these risks is that of pre-term labour and its associated sequelae. Whilst much research has been directed towards understanding the mechanisms of uterine contractility, very little research has focussed on how contractility in multiple pregnancy differs from contractility in the singleton pregnancy. The aim of this paper is to review the changing prevalence and risks of a twin pregnancy, as well as reviewing what is known about myometrium from multiple pregnancies. The paper ends by discussing how oxytocin receptor expression may differ in twin pregnancy, based on the evidence of animal models, as well as presenting our own evidence of how oxytocin affects myometrium from twin pregnancies. We highlight the lack of the basic information needed to characterize human myometrium in twin pregnancies. Of particular note is the lack of supporting data for the hypothesis that stretch is responsible for earlier activation of the uterus in multiple pregnancy. New hypotheses based on increased experimental work are called for. Such information may throw light on specific mechanisms leading to the increased incidence of pre-term delivery in twins.

  4. Successful twin pregnancy in a patient with parkin-associated autosomal recessive juvenile parkinsonism

    Directory of Open Access Journals (Sweden)

    Takakuwa Koichi

    2011-06-01

    Full Text Available Abstract Background Pregnancy in patients with Parkinson disease is a rare occurrence. To the best of our knowledge, the effect of pregnancy as well as treatment in genetically confirmed autosomal recessive juvenile parkinsonism (ARJP has never been reported. Here, we report the first case of pregnancy in a patient with ARJP associated with a parkin gene mutation, ARJP/PARK2. Case presentation A 27-year-old woman with ARJP/PARK2 was diagnosed as having a spontaneous dichorionic/diamniotic twin pregnancy. Exacerbation of motor disability was noted between ovulation and menstruation before pregnancy as well as during late pregnancy, suggesting that her parkinsonism might have been influenced by fluctuations in the levels of endogenous sex hormones. During the organogenesis period, she was only treated with levodopa/carbidopa, although she continued to receive inpatient hospital care for assistance in the activities of daily living. After the organogenesis period, she was administered sufficient amounts of antiparkinsonian drugs. She delivered healthy male twins, and psychomotor development of both the babies was normal at the age of 2 years. Conclusion Pregnancy may worsen the symptoms of ARJP/PARK2, although appropriate treatments with antiparkinsonian drugs and adequate assistance in the activities of daily living might enable successful pregnancy and birth of healthy children.

  5. Classification of discordant fetal growth may contribute to risk stratification in monochorionic twin pregnancies

    NARCIS (Netherlands)

    van Gemert, MJC; Vandenbussche, FPHA; Schaap, AHP; Zondervan, HA; Nikkels, PGJ; van Wijngaarden, WJ; van Zalen-Sprock, RM; Sollie-Szarynska, KM; Stoutenbeek, PH

    2000-01-01

    Objectives To determine whether classification of discordant growth between fetal twins allows risk stratification in monochorionic twin pregnancies. Methods In 12 twin-to-twin transfusion syndrome (TTTS) pregnancies and 12 cases that were suspected of developing the syndrome, fetal growth was deter

  6. Gestational Weight Gain and Peripartum Cardiomyopathy in a Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Hiroko Matsumiya

    2015-01-01

    Full Text Available Preeclamptic twin pregnancy with larger gestational weight gain (GWG is suggested to have a higher risk of peripartum cardiomyopathy (PPCM. This was true in a 5-year experience at a single center. A primiparous woman with twins and prepregnancy weight of 51.0 kg exhibited hypertension at gestational week (GW 32−6/7 and GWG of 18.3 kg (6.0 kg and 2.9 kg during the last four weeks and one week of gestation, resp. concomitant with generalized edema, gave birth at GW 34−4/7, developed proteinuria, cough, and dyspnea postpartum, and was diagnosed with preeclampsia and PPCM showing left ventricular ejection fraction of 34% and plasma BNP level of 1530 pg/mL. This was the only case of PPCM among 101 (12 with preeclampsia and 3266 women with twin and singleton pregnancies, respectively. Thus, PPCM occurred significantly more often in women with preeclamptic twin pregnancies than in women with singleton pregnancies (8.3% [1/12] versus 0.0% [0/3266], P=0.0355. This patient showed the greatest weight gain of 6.0 kg during the last four weeks of gestation and the greatest weight loss of 19.2 kg during one month postpartum among 90 women with twin deliveries at GW ≥ 32.

  7. Oliver Sacks: Our Correspondence About Twins/Twin Research: Vanishing Twins Syndrome; Discordant Sex in MZ Twins; Pregnancy Outcomes in IVF and ICSI Conceived Twins/Print and Media: Superfetated Twins; Twins Discordant for Smoking; Twins in Fashion; Yale University Twin Hockey Players; Conjoined Twin-Visiting Professor.

    Science.gov (United States)

    Segal, Nancy L

    2017-08-01

    The late neurologist and author, Oliver Sacks, published an insightful 1986 review of Marjorie Wallace's book, The Silent Twins, in the New York Times. Taking exception to his assertion about Sir Francis Galton, I wrote a letter to the Times' editor. The letter was unpublished, but it brought a wonderful response from Sacks himself that is reproduced and examined. Next, brief reviews of twin research concerning the vanishing twin syndrome (VTS), discordant sex in a monozygotic (MZ) twin pair, and multiple pregnancy outcomes from assisted reproductive technology (ART) are presented. This section is followed by popular coverage of superfetated twins, smoking-discordant co-twins, twins in fashion, Yale University twin hockey players, and a visiting professor who was a conjoined twin.

  8. Progestogens to prevent preterm birth in twin pregnancies

    DEFF Research Database (Denmark)

    Schuit, Ewoud; Stock, Sarah; Groenwold, Rolf H H;

    2012-01-01

    Preterm birth is the principal factor contributing to adverse outcomes in multiple pregnancies. Randomized controlled trials of progestogens to prevent preterm birth in twin pregnancies have shown no clear benefits. However, individual studies have not had sufficient power to evaluate potential b...... benefits in women at particular high risk of early delivery (for example, women with a previous preterm birth or short cervix) or to determine adverse effects for rare outcomes such as intrauterine death....

  9. Modelling the influence of amnionicity on the severity of twin-twin transfusion syndrome in monochorionic twin pregnancies

    Energy Technology Data Exchange (ETDEWEB)

    Wijngaard, Jeroen P H M van den [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Umur, Asli [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Ross, Michael G [Department of Obstetrics and Gynecology, Harbor University of California-Los Angeles Medical Center, Torrance, CA 90502 (United States); Gemert, Martin J C van [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands)

    2004-03-21

    Clinical treatment for diamniotic-monochorionic twin-twin transfusion syndrome (TTTS) may include conversion of diamniotic pregnancies to a monoamniotic-monochorionic state by disrupting the amnion septum. We sought to test the underlying hypothesis, i.e. that a monoamniotic state reduces the severity of TTTS. With use of our previously developed mathematical model of two equal fetoplacental circulatory units connected by various sizes and types of placental anastomoses, we compared the haemodynamic and amniotic fluid dynamics of monoamniotic and diamniotic twins that develop TTTS. We used three anastomotic patterns that produce severe, moderate or mild forms of TTTS, respectively, in our diamniotic-monochorionic twin model. Monoamnionicity was modelled by adding the two amniotic fluid volumes and using the volume-averaged amniotic fluid osmolality. The results were as follows: for severe TTTS, small differences develop between diamniotic and monoamniotic donor twins in fetal urine production, swallowed volume, blood volume, blood pressures, net fetofetal transfusion, and blood and amniotic fluid osmolality. However, the circulatory imbalance between the monoamniotic twins deteriorates similar to that of diamniotic twins. The pathophysiological differences tend to disappear for milder TTTS. In conclusion, our model suggests that the uncommon finding of TTTS in monoamniotic twins is not due to the presence of a single amniotic sac. Rather, clinically significant differences in anastomotic patterns and the delayed or lack of identification of manifestations in monoamniotic twins account for the reduced rate of TTTS diagnosis. Based on these results we expect the clinical disruption of the amnion septum in diamniotic-monochorionic TTTS pregnancies to have only minimal benefits. (note)

  10. Congenital varicella syndrome in a monochorionic diamniotic twin pregnancy

    Directory of Open Access Journals (Sweden)

    Vania A Villota

    2014-01-01

    Full Text Available Congenital varicella syndrome encompasses a broad spectrum of malformations present in children of mothers who developed chickenpox during the first 20 weeks of gestation. We report a case of a monochorionic diamniotic twin pregnancy, with maternal exposure to chickenpox during the thirteenth week of gestation, which produced one symptomatic and one healthy child.

  11. Fetal Behavior and Heart Rate in Twin Pregnancy : A Review

    NARCIS (Netherlands)

    Tendais, Iva; Visser, Gerard H. A.; Figueiredo, Barbara; Montenegro, Nuno; Mulder, Eduard J. H.

    2013-01-01

    Fetal movements and fetal heart rate (FHR) are well-established markers of fetal well-being and maturation of the fetal central nervous system. The purpose of this paper is to review and discuss the available knowledge on fetal movements and heart rate patterns in twin pregnancies. There is some evi

  12. Abdominal cerclage in twin pregnancy after radical surgical conization

    NARCIS (Netherlands)

    Kyvernitakis, I.; Lotgering, F.K.; Arabin, B.

    2014-01-01

    Radical and repeated cone biopsies are associated with a high risk of spontaneous preterm birth. A 30-year-old gravida 1 presented with a spontaneous dichorionic twin pregnancy. She had a history of two radical surgical conizations. By speculum examination, no cervical tissue was detected. A history

  13. Outcome of twin pregnancies conceived after assisted reproductive techniques

    Directory of Open Access Journals (Sweden)

    A Baxi

    2008-01-01

    Full Text Available Context : There is a continuous controversy regarding the obstetric perinatal outcome of twin pregnancies conceived after assisted reproductive techniques (ART. There is an ongoing discussion whether theses parameters may show poorer results as compared to spontaneous conception. Aims: To evaluate the outcome of multifetal pregnancies and to compare maternal and neonatal complications between spontaneously conceived and assisted reproductive therapy. Settings and Design : Prospective case-control study. Materials and Methods :In this prospective case-control study of 2-year duration, obstetric and perinatal outcomes were compared in 36 ART twin pregnancies (Group A with 138 twins who conceived naturally (Group B. The outcomes were analyzed and used for a comparison between spontaneous and assisted multifetal pregnancies. Statistical Analysis : The continuous variables were analyzed by Student′s t -test and categorical variables were analyzed with Fisher′s exact test. Results : Pregnancy-related complications like pregnancy-induced hypertension, antepartum hemorrhage, were similar in both groups. Incidence of cesarean section, preterm delivery, and hospital stay was significantly more in Group A vs. Group B, P < 0.001. The newborns in the assisted group had more complications than the spontaneous group; most notable were respiratory distress syndrome, newborn intensive care admission, sepsis, and longer hospital stay (4.8 days vs. 1.6 days, P < 0.001. Conclusions : Increased rates of cesarean section and preterm delivery are the main reasons for increased obstetric risk in pregnancies conceived through ART. Preterm birth and neonatal prematurity-related complications were the main cause for longer stay in hospital in ART-conceived twins.

  14. Optimal timing for term delivery of twin pregnancies: a population-based study.

    Science.gov (United States)

    Vilchez, Gustavo A; Dai, Jing; Hoyos, Luis R; Chelliah, Anushka; Bahado-Singh, Ray; Sokol, Robert J

    2015-04-01

    The objective of this study was to examine the risk of adverse neonatal outcomes after twin delivery according to gestational age. The U.S. Natality Database from 2007 to 2010 was reviewed. Inclusion criteria were twin deliveries and gestational age of 37 to 42 weeks. Exclusion criteria were congenital anomalies and missing/incomplete data. Cases were subdivided by gestational age into early term, term, and late term. Singleton pregnancies matched by delivery time and location were selected as controls. Outcome variables included were low Apgar score, assisted ventilation, neonatal intensive care unit admission, surfactant/antibiotic use, seizures, and birth injury. Logistic regression analysis was used to calculate adjusted odds ratios according to gestational age and plurality, using singleton term as reference. A total of 220,169 twin and 270,540 singleton deliveries were identified. The risk of adverse neonatal outcomes for twins was higher than for singletons. For twins, the distribution of the risks of the composite of adverse neonatal outcomes was linear, being the lowest at early term and the highest at late term, whereas the distribution for singletons was u-shaped being lowest at term compared with early and late term. Twins are at higher risk of suboptimal neonatal outcomes than singletons, but do better when delivered at early term rather than term or late term. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Pregnancy prognosis associated with an isolated single umbilical artery in twin pregnancy.

    Science.gov (United States)

    Cade, Thomas J; Da Silva Costa, Fabricio; Reidy, Karen; Doyle, Lex W; Mitchell, Sarah E; Palma-Dias, Ricardo; Umstad, Mark P

    2014-12-01

    To determine the prognosis of an isolated single umbilical artery (SUA) in a twin pregnancy, we selected twin pregnancies with a second trimester ultrasound diagnosing a SUA in at least one fetus at our tertiary hospital. This was confirmed by placental histopathology or by expert review of ultrasound images. Cases were identified by searching the hospital ultrasound database over a period of 7.5 years. Higher order multiples or coexistent aneuploidy or major anomalies were excluded. Each case of an isolated SUA was assigned three consecutive twin pregnancy controls paired for chorionicity and maternal age. Primary outcomes were preterm birth <34 weeks, small for gestational age (SGA) or perinatal death. Other outcomes included antenatal growth restriction, mode of delivery, and admission to neonatal intensive care or special care nursery. Nine pregnancies (18 fetuses) were identified for analysis as cases. Isolated SUA was associated with preterm birth <34 weeks (odds ratio = 12.2; 95% CI = 2.0-75.2; p = .005) but not for SGA. There was also no difference in SGA between the affected twin and its normal co-twin. Perinatal death was increased but after controlling for gestational age and clustering this finding was no longer significant. We conclude that isolated SUA in twins adds a degree of risk to an already high-risk pregnancy but does not increase the need for surveillance for growth restriction.

  16. Spontaneous Rupture of Uterine Vein in Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Emek Doger

    2013-01-01

    Full Text Available Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester. Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear. Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs.

  17. The importance of plasma volume expansion and nutrition in twin pregnancy.

    Science.gov (United States)

    Campbell, D M; MacGillivray, I

    1984-01-01

    Physiological adaptation including expansion in plasma volume is exaggerated in women with twin pregnancies. In singleton pregnancy and multiparous twin pregnancies there is an association between plasma volume expansion and birth weight, but this is not so in primigravid twin pregnancies. Women with twin pregnancies have a similar dietary intake to singleton pregnancies, but it is not known whether there are differences with parity or zygosity. Absorption and utilisation of nutrients may be increased to meet demands for extra fetal growth. Nutrient supply and plasma volume expansion will be further discussed and their association with birth weight presented.

  18. Infant mortality in twin pregnancies following in-utero demise of the co-twin

    Institute of Scientific and Technical Information of China (English)

    Boubakari Ibrahimou; Hamisu M Salihu; Muktar H Aliyu; Gary English; Getachew Dagne

    2015-01-01

    Objective:To assess whether conversion from twin to singleton pregnancy following the demise of a co-twin influences survival.Methods:This retrospective study compared the risk for neonatal, post-neonatal and infant death for converted co-twins versus unconverted co-twins using the US matched multiple file dataset for the period 1995-2000. We also examined the same risks for converted versus same-quantile co-twins, hazard ratios (HR) and 95% confidence intervals (CI) were computed using Cox Proportional Hazards models.Results:The risk for neonatal (HR=0.18, 95%CI: 0.09-0.34 andHR=0.69, 95%CI: 0.50- 0.96) and infant death (HR=0.22, 95%CI: 0.12-0.42 andHR=0.57, 95%CI: 0.42-0.77) were significantly lower for converted twins than for unconverted twins and same-quantile twins, respectively. For black compared to white, the risk for post-neonatal death increased by 89% (HR=1.89, 95%CI= 1.03, 3.48), and 79% (HR=1.79, 95%CI=1.53, 2.09) for convertedvs. unconverted and convertedvs. same-quantile, respectively. For converted black, the risk for neonatal death decreased by 17% (HR=0.83, 95%CI=0.73-0.93) as compared to unconverted.Conclusions: Risks for all mortality types were lower among converted co-twins than their unconverted or same-quantile counterparts. The lower neonatal and higher post-neonatal mortality among black require future research.

  19. Induction of twin pregnancy and the risk of caesarean delivery: a cohort study.

    Science.gov (United States)

    Jonsson, Maria

    2015-06-16

    Complications are common in twin pregnancies and induction of labour is often indicated. Most methods for induction are used but data on risks related to induction methods are sparse. The aim of this study was to investigate the association between induction of labour and caesarean delivery in twin pregnancies, and to assess the influence of induction method. Cohort study of twin pregnancies ≥ 34 weeks, planned for vaginal delivery, from two University Hospitals in Sweden. Data were collected from medical records during the periods 1994 (Örebro) and 2004 (Uppsala) to 2013. During the study period there were 78,180 live born births and 1,282 were twin births. Women with previous caesarean section were excluded. Induction methods were categorized into amniotomy, oxytocin and cervical ripening (intra cervical Foley catheter or prostaglandin). Adjusted odds ratios (AOR) with 95 % confidence interval (CI) for caesarean section were calculated by logistic regression and were adjusted for parity, maternal age, gestational length, complications to the pregnancy, infant birth weight and year of birth. Spontaneous labour onsets were used as the reference group. The main outcome measure was caesarean section. In 462 twin pregnancies, 220 (48 %) had induction of labour and 242 (52 %) a spontaneous labour onset. Amniotomy was performed in 149 (68 %) of these inductions, oxytocin was administered in 11 (5 %) and cervical ripening was used in 60 (27 %). The rate of caesarean sections was 21 % in induced and 12 % in spontaneous labours (p 0.01). The absolute risk of caesarean section following induction was: 15 % with amniotomy; 36 % with oxytocin and 37 % with Foley/prostaglandin. Induction of labour increased the risk of caesarean section by 90 % compared with spontaneous labour onset (AOR 1.9, 95 % CI 1.1-3.5) and, when cervical ripening was used, the risk increased more than two fold (AOR 2.5, 95 % CI 1.2-5.3). Induction of labour in twin pregnancies increases the risk of

  20. Recommendations for fetal echocardiography in twin pregnancy in 2016

    Directory of Open Access Journals (Sweden)

    Leszczyńska Katarzyna

    2016-01-01

    Full Text Available Progress in the fields of fetal cardiology and fetal surgery have been seen not only in singleton pregnancies but also in multiple pregnancies. Proper interpretation of prenatal echocardiography is critical to clinical decision making, family counseling and perinatal management for obstetricians, maternal fetal medicine specialists, neonatologists and pediatric cardiologists. Fetal echocardiography is one of the most challenging and time-consuming prenatal examinations to perform, especially in multiple gestations. Performing just the basic fetal exam in twin gestations may take an hour or more. Thus, it is not practical to perform this exam in all cases of multiple gestations. Therefore our review and recommendations are related to fetal echocardiography in twin gestation.

  1. Maternal postpartum complications according to delivery mode in twin pregnancies

    Directory of Open Access Journals (Sweden)

    Sonia Leme Stach

    2014-07-01

    Full Text Available OBJECTIVE:We aimed to examine maternal postpartum complications of twin deliveries according to mode of delivery and investigate the associated risk factors.METHODS:This was a retrospective cohort review of twin pregnancies with delivery after 26 weeks at a tertiary teaching hospital (1993-2008. The rates of maternal postpartum complications were compared among vaginal, elective cesarean and emergency cesarean deliveries. Significant predictors of complications were investigated with stepwise regression analysis and relative risks were calculated.RESULTS:A total of 90 complications were observed in 56/817 (6.9% deliveries: 7/131 (5.3% vaginal, 10/251 (4.0% elective cesarean and 39/435 (9.0% emergency cesarean deliveries. Significant predictors included high-risk pregnancy, gestational age at birth and delivery mode. The occurrence of complications was significantly increased in emergency compared to elective cesarean deliveries (RR = 2.34.CONCLUSIONS:Maternal postpartum complications in twin pregnancies are higher in emergency compared to elective cesarean deliveries and are also related to preexisting complications and earlier gestational age at delivery.

  2. Study of obstetric and fetal outcome of twin pregnancy in a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Gurpreet Kaur Nandmer

    2015-12-01

    Conclusions: Twin pregnancies are high risk pregnancies with more maternal and fetal complications. The use of antenatal care services, identification and anticipation of complications, intrapartum management and good NICU facilities will help to improve maternal and neonatal outcome in twin pregnancies. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1789-1792

  3. Obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART compared with spontaneous pregnancy

    Directory of Open Access Journals (Sweden)

    Leila Pourali

    2016-05-01

    Full Text Available Introduction: Regarding to the recent advances in assisted reproductive techniques (ART, twin and multiple pregnancies have increased during past years. Objective: This study was performed to compare obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART with spontaneous pregnancy. Materials and Methods: In this cross-sectional study which was performed in Ghaem Hospital, Mashhad University of Medical Sciences, 107 dichorionic twin pregnancy were enrolled in two groups: spontaneous group (n=96 and ART group (n=31. Basic criteria and obstetrics and neonatal outcomes information including demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, and intrauterine growth retardation (IUGR, postpartum hemorrhage, neonatal outcomes (weight, first and fifth minuteP PApgar score, Neonatal Intensive Care Unit (NICU admission, mortality, respiratory distress, and icterus were recorded using a questionnaire. Results: Preterm labor, gestational diabetes, and preeclampsia were significantly higher in ART group compared to spontaneous pregnancy group. However, other factors such as anemia, IUGR, postpartum hemorrhage, and intrauterine fetal death (IUFD were not significantly different between groups. There were no significant differences between groups in terms of neonatal outcomes (weight, 1PstP and 5PthP min Apgar score <7, NICU hospitalization, mortality, respiratory distress, and icterus. Conclusion: With regard of significantly higher poor outcomes such as preeclampsia, gestational diabetes and preterm labor in ART group, the couples should be aware of these potential risks before choosing ART.

  4. 2ND TRIMESTER AMNIOCENTESIS IN TWIN PREGNANCIES - MATERNAL HEMOGLOBIN AS A DYE MARKER TO DIFFERENTIATE DIAMNIOTIC TWINS

    NARCIS (Netherlands)

    BEEKHUIS, [No Value; DEBRUIJN, HWA; VANLITH, JMM; MANTINGH, A

    1992-01-01

    Objective To review the use of a membrane-free haemolysate prepared from maternal blood to distinguish the amniotic sacs at amniocentesis in twin gestation. Setting University Hospital, Groningen. Method Haemoglobin solution prepared from maternal blood. Subjects 63 twin pregnancies having amniocent

  5. Spontaneous intra-abdominal bleeding in twin pregnancy: Case report

    Directory of Open Access Journals (Sweden)

    Berisavac Milica

    2008-01-01

    Full Text Available INTRODUCTION Spontaneous rupture of utero-ovarian vessels is a rare cause of haemoperitoneum in pregnancy, leading to significant maternal and foetal morbidity and mortality. Aetiopathogenesis of this condition is still unclear. Establishing clinical diagnosis of this condition is difficult, but very important. Clinical symptoms are nonspecific, and the diagnosis is usually made at laparotomy. CASE OUTLINE We report a case of spontaneous haematoperitoneum in the third trimester of twin pregnancy. Differential diagnosis included uterine rupture and placental abruption. Due to the deteriorated condition of the patient, it was decided to perform laparotomy which established the diagnosis of ruptured venous varices on the posterior uterine wall. Delivery was performed by caesarean section. The postoperative period was uneventful. CONCLUSION The clinical presentation of spontaneous rupture of utero-ovarian blood vessels is not specific and clinical examination and ultrasonographic scanning may be insufficient for diagnosis. Once the diagnosis of spontaneous haematoperitoneum in pregnancy is established, emergency laparotomy is indicated. Following caesarean delivery, it is necessary to establish surgical haemostasis. There are some authors who suggest leaving the pregnancy intact in cases when the fetus is not viable, although one must have in mind the possibility of recurrent bleeding. The safety of this procedure requires further investigation. It is necessary to have in mind the possibility of blood vessel rupture in all cases of abdominal pain and hypotension of unknown origin during pregnancy.

  6. Dizygotic monochorionic twin pregnancy conceived following intracytoplasmic sperm injection treatment and complicated by twin-twin transfusion syndrome and blood chimerism

    DEFF Research Database (Denmark)

    Ekelund, C K; Skibsted, L; Søgaard, K

    2008-01-01

    We report a case of a dizygotic monochorionic twin pregnancy preceded by intracytoplasmic sperm injection treatment including assisted hatching. On ultrasound examination at 25 weeks' gestation the twins, which had been assumed to be monochorionic, were found to be of different sexes. Karyotyping...

  7. Prenatal diagnosis of lethal osteogenesis imperfecta in twin pregnancy.

    Science.gov (United States)

    Morin, L R; Herlicoviez, M; Loisel, J C; Jacob, B; Feuilly, C; Stanescu, V

    1991-06-01

    Lethal osteogenesis imperfecta was diagnosed at 27 weeks amenorrea in one fetus of a bichorial twin pregnancy. Sonographic findings included: short-limb dwarfism, hypotrophy and hypoechoic bones. The affected fetus was so translucent that only the normal fetus could be seen on plain in utero radiography. The affected fetus died immediately after birth. Postmortem radiography and histology were typical of lethal osteogenesis imperfecta of type IIA. Aids to the etiological diagnosis of in utero dwarfism are presented. Sonographic features correlated with neonatal death are described.

  8. Severe intrahepatic cholestasis of pregnancy is a risk factor for preeclampsia in singleton and twin pregnancies.

    Science.gov (United States)

    Raz, Yael; Lavie, Anat; Vered, Yaffa; Goldiner, Ilana; Skornick-Rapaport, Avital; Landsberg Asher, Ysca; Maslovitz, Sharon; Levin, Ishai; Lessing, Joseph B; Kuperminc, Michael J; Rimon, Eli

    2015-09-01

    Intrahepatic cholestasis of pregnancy (ICP) is known to be associated with fetal complications. It recently was suggested to be associated possibly with preeclampsia (PET) as well. The objective of this study was to investigate that possibility. The study group included 78 women (54 singleton and 24 twin pregnancies) who had been diagnosed with ICP based on clinical presentation, elevated liver enzymes, and elevated total bile acids (>10 μmol/L). Disease severity was based on total bile acids levels as being severe (>40 μmol/L), moderate (20-40 μmol/L), or mild (10-20 μmol/L). The course of disease was reviewed carefully in each case. The control groups were comprised of apparently healthy women with singleton (n = 200) and twin (n = 100) pregnancies that were drawn randomly from a computerized registry of all the deliveries in our institution during the study period. The total incidence of PET was significantly higher for the patients with ICP who had singleton and twin pregnancies compared with the control groups (singletons: 7.4% vs 1.5%; P pregnancies compared with control subjects. Severe ICP, but not mild ICP, was a major risk factor for PET among women with either singleton or twin pregnancies. The timing of the initial presentation of ICP had no effect on PET incidence rates. Preeclampsia occurred usually 2-4 weeks after the diagnosis of ICP, and proteinuria preceded elevated blood pressure in all cases. Moreover, the total bile acid levels among 33 women who were diagnosed as having PET, but not ICP, were within normal range. ICP increases the incidence of PET; severe disease was a major risk factor for preeclampsia. Therefore, we strongly suggest including routine evaluation for preeclampsia in the treatment of women with moderate and severe ICP. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. The influence of maternal body mass index on fetal weight estimation in twin pregnancy.

    LENUS (Irish Health Repository)

    Ryan, Helen M

    2013-11-08

    Sonographic estimation of fetal weight (EFW) is important in the management of high-risk pregnancies. The possibility that increased maternal body mass index (BMI) adversely affects EFW assessments in twin pregnancies is controversial. The aim of this study was to investigate the effect of maternal BMI on the accuracy of EFW assessments in twin gestations prospectively recruited for the ESPRiT (Evaluation of Sonographic Predictors of Restricted growth in Twins) study.

  10. Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial.

    Science.gov (United States)

    Nicolaides, Kypros H; Syngelaki, Argyro; Poon, Liona C; de Paco Matallana, Catalina; Plasencia, Walter; Molina, Francisca S; Picciarelli, Gemma; Tul, Natasa; Celik, Ebru; Lau, Tze Kin; Conturso, Roberto

    2016-01-01

    Preterm birth is the leading cause of neonatal death and handicap in survivors. Although twins are found in 1.5% of pregnancies they account for about 25% of preterm births. Randomized controlled trials in singleton pregnancies reported that the prophylactic use of progestogens, cervical cerclage and cervical pessary reduce significantly the rate of early preterm birth. In twin pregnancies, progestogens and cervical cerclage have been shown to be ineffective in reducing preterm birth. The objective of this study was to test the hypothesis that the insertion of a cervical pessary in twin pregnancies would reduce the rate of spontaneous early preterm birth. This was a multicenter, randomized controlled trial in unselected twin pregnancies of cervical pessary placement from 20(+0)-24(+6) weeks' gestation until elective removal or delivery vs. expectant management. Primary outcome was spontaneous birth control groups in rates of spontaneous birth birth. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Case of twin pregnancy complicated by idiopathic thrombocytopenic purpura treated with intravenous immunoglobulin: Review of the literature.

    Science.gov (United States)

    Zhao, W X; Yang, X F; Lin, J H

    2017-01-01

    Idiopathic thrombocytopenic purpura (ITP) is an acquired thrombocytopenia without other clear cause of thrombocytopenia. It is not common in a singleton pregnancy and less common in twin pregnancy. We report a 33-year-old ITP pluripara whose first pregnancy was uneventful. She carried twin pregnancy, complicated by recurrent very low platelets, and gave birth to preterm twins. This patient received multiple courses of intravenous immunoglobulin (IVIG) and showed a significant platelet count improvement with IVIG therapy.

  12. Arabin cervical pessary to prevent preterm birth in twin pregnancies with short cervix.

    Science.gov (United States)

    Di Tommaso, Mariarosaria; Seravalli, Viola; Arduino, Silvana; Bossotti, Carlotta; Sisti, Giovanni; Todros, Tullia

    2016-08-01

    A retrospective study was conducted to evaluate the effect of Arabin cervical pessary in twin pregnancies with cervical length (CL)  <25 mm between 21 and 31 weeks. Forty patients receiving pessary were matched with 40 controls without pessary. They were matched for gestational age (GA) at admission and CL. GA at delivery, delivery before 36, 34 and 32 weeks, latency between detection of short cervix and delivery, and duration of hospital admission were compared between groups. Women with the pessary delivered at higher GA compared to controls (35 vs. 33 weeks, p = 0.02). Cervical pessary significantly reduced the incidence of delivery  <36 and  < 34 weeks (p < 0.05), but not before 32 weeks. Interval between detection of short cervix and delivery was longer in the pessary group and duration of hospital admission was shorter (p = 0.03) compared to women without pessary.

  13. MRI findings in multifetal pregnancies complicated by twin reversed arterial perfusion sequence (TRAP)

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Carolina V.A.; Kline-Fath, Beth M.; Linam, Leann E.; Calvo Garcia, Maria A.; Rubio, Eva I. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Lim, Foong-Yen [Cincinnati Children' s Hospital Medical Center, Division of Pediatric Surgery, Cincinnati, OH (United States)

    2011-06-15

    Twin reversed arterial perfusion sequence (TRAP) is a rare complication in multifetal monochorionic pregnancies in which a normal ''pump'' twin provides circulation to an abnormal acardiac co-twin, resulting in high-output cardiac dysfunction in the pump twin. To define fetal MRI findings of TRAP sequence. Fetal MR images were retrospectively reviewed in 35 pregnancies complicated by TRAP sequence. Abnormalities of the pump twin, acardiac twin, umbilical cord, placenta and amniotic fluid were reviewed. Acardiac twins were classified as: acephalus (51%), anceps (40%), amorphus (9%), acormus (0%). Common findings in acardiac twins include subcutaneous edema (77%), absent cardiac structures (86%), absent or abnormal thoracic cavity (100%), abnormal abdominal organs (100%), superior limbs absent (46%) or abnormal (51%), and inferior limbs present but abnormal (83%). There were pump twin findings of cardiac dysfunction in 43% and intracranial ischemic changes in 3%. Umbilical cord anomalies were present in 97%. Acardiac twins present with a predictable pattern of malformation with poorly developed superior structures, more normally formed inferior structures and absent or rudimentary heart. Although usually absent, abnormal heart structures can be seen and do not exclude TRAP sequence. Pump twins are commonly normal with exception of findings of cardiac dysfunction and possible brain ischemia. (orig.)

  14. Stolen twin: fascination and curiosity/twin research reports: evolution of sleep length; dental treatment of craniopagus twins; cryopreserved double embryo transfer; gender options in multiple pregnancy/current events: appendectomy in one twin; autistic twin marathon runners; 3D facial recognition; twin biathletes.

    Science.gov (United States)

    Segal, Nancy L

    2014-02-01

    The story of her allegedly stolen twin brother in Armenia is recounted by a 'singleton twin' living in the United States. The behavioral consequences and societal implications of this loss are considered. This case is followed by twin research reports on the evolution of sleep length, dental treatment of craniopagus conjoined twins, cryopreserved double embryo transfer (DET), and gender options in multiple pregnancy. Current events include the diagnosis of appendectomy in one identical twin, the accomplishments of autistic twin marathon runners, the power of three-dimensional (3D) facial recognition, and the goals of twin biathletes heading to the 2014 Sochi Olympics in Russia.

  15. Serum mineral levels at pregnancy and postpartum in single and twin pregnant sheep.

    Science.gov (United States)

    Yildiz, Atilla; Balikci, Engin; Gurdogan, Fuat

    2005-12-01

    This study was performed to investigate calcium (Ca), inorganic phosphorus (P), potassium (K), magnesium (Mg), and chlorine (Cl) levels in blood serum at d 60, 100, and 150 of gestation and at d 45 after parturition and to find out the significance of differences for macromineral levels during these stages of single or twin gestation in Akkaraman sheep. Blood samples of 30 apparently healthy pregnant Akkaraman sheep (15 single pregnancies, 15 twin pregnancies) were used. The samples were analyzed using a biochemical analyzer for Ca, P, Na, K, and Mg concentrations and using the Schales method for Cl levels. A statistically significant decrease (p pregnancy for Ca levels and for serum inorganic P levels in both groups. Twin pregnant sheep were found to have lower (p 0.05, p pregnancy. There were significant increases (p < 0.01) in serum Cl levels on d 100 in single and twin pregnant sheep.

  16. Double trouble: the importance of reporting chorionicity and amnionicity in twin pregnancy ultrasound reports.

    Science.gov (United States)

    Constantine, Sarah; Wilkinson, Chris

    2015-02-01

    An obstetric ultrasound report in a twin pregnancy that does not unambiguously determine chorionicity and amnionicity in the first trimester is substandard. This article will assist radiologists to understand the importance of reporting the chorionicity and amnionicity in all twin obstetric scans.

  17. Comparison of perinatal outcome in twin pregnancy with and without cervical cerclage

    Directory of Open Access Journals (Sweden)

    Mitesh Suresh Chavan

    2016-11-01

    Conclusions: In spite of close vigilance, preterm birth in twin gestation is common and unpredictable. It is difficult to predict those who may require cervical cerclage although all multiple pregnancies are at high risk. Cerclage should be considered an option for patients with twin pregnancies in the second trimester to prolong the duration of gestation as close to term as possible. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3924-3930

  18. Both babies with sirenomelia' in twin pregnancy: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Soham Chowdhury

    2015-06-01

    Full Text Available Sirenomelia, also called as and lsquo;Mermaid syndrome', is a rare congenital malformation of uncertain aetiology. It is characterised by fusion of the lower limbs and commonly associated with severe urogenital and gastrointestinal malformation. We report a case of twin pregnancy with both babies had sirenomelia. No previous case of and lsquo;both babies with sirenomelia' in twin pregnancy has been reported till date. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 908-910

  19. Maternal and perinatal outcomes of twin pregnancy in 23 low- and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Joshua P Vogel

    Full Text Available BACKGROUND: Twin pregnancies in low- and middle-income countries (LMICs pose a high risk to mothers and newborns due to inherent biological risks and scarcity of health resources. We conducted a secondary analysis of the WHO Global Survey dataset to analyze maternal and perinatal outcomes in twin pregnancies and factors associated with perinatal morbidity and mortality in twins. METHODS: We examined maternal and neonatal characteristics in twin deliveries in 23 LMICs and conducted multi-level logistic regression to determine the association between twins and adverse maternal and perinatal outcomes. RESULTS: 279,425 mothers gave birth to 276,187 (98.8% singletons and 6,476 (1.2% twins. Odds of severe adverse maternal outcomes (death, blood transfusion, ICU admission or hysterectomy (AOR 1.85, 95% CI 1.60-2.14 and perinatal mortality (AOR 2.46, 95% CI 1.40-4.35 in twin pregnancies were higher, however early neonatal death (AOR 2.50, 95% CI 0.95-6.62 and stillbirth (AOR 1.22, 95% CI 0.58-2.57 did not reach significance. Amongst twins alone, maternal age 15%, born second, preterm birth and low birthweight were associated with perinatal mortality. Marriage and caesarean section were protective. CONCLUSIONS: Twin pregnancy is a significant risk factor for maternal and perinatal morbidity and mortality in low-resource settings; maternal risk and access to safe caesarean section may determine safest mode of delivery in LMICs. Improving obstetric care in twin pregnancies, particularly timely access to safe caesarean section, is required to reduce risk to mother and baby.

  20. Complete Hydatidiform Mole Presenting as a Placenta Accreta in a Twin Pregnancy with a Coexisting Normal Fetus: Case Report

    Directory of Open Access Journals (Sweden)

    Marijo Aguilera

    2012-01-01

    Full Text Available A twin pregnancy with a complete hydatidiform mole and a coexisting normal fetus (CHMF is a rare clinical scenario, and it carries many associated pregnancy and postnatal risks. Limited numbers of case studies exist reporting an outcome of live birth, and only three prior cases report the presentation of a hydatidiform mole as a placenta previa. We report a case of CHMF with the molar component presenting antenatally as a placenta previa, which ultimately resulted in placenta accreta at the time of delivery. A live male infant was delivered at 34 weeks’ gestation via planned cesarean section, and a hysterectomy was performed following unsuccessful removal of the molar component. We additionally utilized previously described methods of placing internal iliac balloons and ureteral stents prior to delivery. In such a high-risk pregnancy with a known molar previa component, these surgical preparation measures may be of benefit.

  1. Validity of lamellar body count as a fetal lung maturity assessment in twin pregnancy.

    Science.gov (United States)

    Tsuda, Hiroyuki; Kotani, Tomomi; Sumigama, Seiji; Kawabata, Ichiro; Takahashi, Yuichiro; Iwagaki, Shigenori; Kigoshi, Kaori; Kikkawa, Fumitaka

    2012-08-01

    Fetal lung maturity assessment in twin pregnancy has been discussed, but is still controversial. The purpose of this study is to predict the occurrence of respiratory distress syndrome (RDS) using lamellar body count (LBC) and analyze the validity of LBC for fetal lung maturity assessment in twin pregnancy. Three-hundred two amniotic fluid samples were obtained at cesarean section from 29 to 38 weeks of gestation. Samples were analyzed immediately with no centrifugation and the number of lamellar bodies was counted using a platelet channel on the Sysmex SF-3000. There were 18 neonates (6.0%) suffering from RDS. An LBC cut-off value of 2.95×10⁴/μL resulted in 91.5% sensitivity and 83.3% specificity for predicting RDS. This cut-off value for predicting RDS was the same as that in singleton pregnancy. Moreover, the median LBC value in RDS cases was significantly lower than in non-RDS cases (1.50±1.1×10⁴/μL vs. 10.6±7.5×10⁴/μL; ptwin pregnancy and also the largest study on fetal lung maturity assessment in twin pregnancy. An LBC value of >2.95×10⁴/μL means reassuring findings for RDS even in twin pregnancy. We believe the data in this study provide valuable, new information for the management of twin pregnancies.

  2. Reducing twin pregnancy rates after IVF--elective single embryo transfer (eSET).

    LENUS (Irish Health Repository)

    Milne, P

    2010-01-01

    Multiple pregnancy is a major complication of IVF and is associated with increased maternal, fetal and neonatal morbidity. Elective single embryo transfer (eSET) during IVF, rather than the more standard transfer of two embryos (double embryo transfer or DET), has been shown to significantly reduce the multiple pregnancy rate associated with IVF, while maintaining acceptable pregnancy rates. Couples undergoing IVF in 2008 who met good prognostic criteria had eSET performed. Pregnancy and twinning rates were compared with those for similar couples in 2007 who had DET. Couples unsuccessful with a fresh cycle of treatment had subsequent frozen embryo transfer cycles with DET. The cumulative pregnancy rate was similar for each group. However there were no multiple pregnancies in the eSET group, compared to 4 twins of 5 pregnancies in the DET group. 96% of eligible couples agreed to eSET. ESET is successful in and acceptable to good prognosis Irish couples undergoing IVF.

  3. Confined blood chimerism in a monochorionic dizygotic sex discordant twin pregnancy conceived after induced ovulation.

    Science.gov (United States)

    Mayeur Le Bras, Anne; Petit, François; Benachi, Alexandra; Bedel, Bettina; Oucherif, Salima; Martinovic, Jelena; Armanet, Narjes; Tosca, Lucie; Gautier, Valérie; Parisot, Frédéric; Labrune, Philippe; Tachdjian, Gérard; Brisset, Sophie

    2016-04-01

    Monochorionic twins are generally considered as a monozygotic twin pregnancy. However, several cases of monochorial dizygotic twin pregnancies have been reported. We report on a rare case of monochorionic dizygotic twin pregnancy conceived after induced ovulation in a 32-year-old woman. The diagnosis was made on morphological ultrasound examination at 18+4 weeks of gestation, showing two fetuses with discordant sex. The amniocentesis was declined by the patient. The monochorionic status was confirmed after a histopathalogical study of the placenta. At delivery, both a phenotypically normal boy and a phenotypically normal girl without sexual abnormality were observed. This analysis also revealed the presence of vascular anastomoses between both fetal circulations. Postnatal cytogenetic analyses indicated the presence of a chimerism in peripheral blood lymphocytes. This chimerism was not observed in cells obtained from a buccal swab. Molecular determination of zygosity confirmed the existence of the confined peripheral blood chimerism with the presence of four parental alleles. We report on a case of monochorionic dizygotic twin pregnancy. This observation underlies the need to carefully assess twin pregnancies, especially when obtained after assisted reproductive technology. © 2016 Wiley Periodicals, Inc.

  4. Art for twins: Yorùbá artists and their statues/twin research studies: twins' education and conceptions; diurnal preference; inherited eye diseases; ultrasound counseling when twins are conjoined/popular twin reports: twin sisters (the film); rare pregnancy; diet test; French twins reared apart and reunited.

    Science.gov (United States)

    Segal, Nancy L

    2014-06-01

    The Yorùbá of Nigeria are well known for their high twinning rate and the statues they create to commemorate deceased twins. An impressive collection of this artwork was displayed at the University of California's Fowler Museum in Los Angeles between October 13, 2013 and March 2, 2014. An overview of this exhibit is provided. Next, twin research on maternal education and conception, diurnal preference, inherited eye diseases, and ultrasound counseling for couples with conjoined twins are briefly summarized. This article concludes with a discussion of media-based items related to twins. The topics include an award-winning twin film, a rare pregnancy, a diet test, and the separation and chance reunion of monozygotic female twins.

  5. Successful treatment of Rh alloimmunization in a twin pregnancy: case report

    Directory of Open Access Journals (Sweden)

    Rahimi Sharbaf F

    2008-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} Background: The prevalence of Rh alloimmunization has decreased following the use of anti-D immunoglobulin. With serial amniocentesis, Doppler sonography of the middle cerebral artery and treatment of anemia with intrauterine blood transfusion, perinatal mortality has declined. However, Rh alloimmunization in twin pregnancies poses a diagnostic and therapeutic challenge."n"n Case report: We are reporting, for the first time in Iran, the successful treatment of severe Rh alloimmunization in a dichorionic- diamnionic twin pregnancy leading to the live births of both neonates. Before treatment, the fetal hemoglobin levels were 3.1g/dL and 3.9g/dL, with ascites in both fetuses. The fetuses were treated with several IUTs."n"n Results: After treatment, the neonates were delivered, weighing 2200 and 2300g, with good Apgar scores, at a gestational age of 34 weeks. "n"n Conclusion: 10% of population in Iran is Rh-negative, although Prophylaxis for Rh alloimmunization is universal, as other part of the world it cannot irrigated. For the best management of these cases, we need a well-equipped referral center."n"n Keywords: Twin, pregnancy, Rh alloimmunization, intrauterine blood transfusion, Doppler, middle cerebral

  6. Transient early preeclampsia in twin pregnancy with a triploid fetus : a case report

    NARCIS (Netherlands)

    van der Houwen, C.; Schukken, T.; van Pampus, M.

    2009-01-01

    INTRODUCTION: Triploid pregnancies have an increased risk of early preeclampsia. Twin pregnancies consisting of one healthy fetus and one complete or partial molar, with or without a triploid fetus, are rare and management is complex. CASE PRESENTATION: A 33-year-old Caucasian woman presented with a

  7. Transient early preeclampsia in twin pregnancy with a triploid fetus : a case report

    NARCIS (Netherlands)

    van der Houwen, C.; Schukken, T.; van Pampus, M.

    2009-01-01

    INTRODUCTION: Triploid pregnancies have an increased risk of early preeclampsia. Twin pregnancies consisting of one healthy fetus and one complete or partial molar, with or without a triploid fetus, are rare and management is complex. CASE PRESENTATION: A 33-year-old Caucasian woman presented with a

  8. Dichorionic triamniotic triplet pregnancy complicated by twin anemia polycythemia sequence: the place of fetal therapy.

    Science.gov (United States)

    Griersmith, Thérèse H; Fung, Alison M; Walker, Susan P

    2014-12-01

    Monochorionic twins as part of a high order multiple pregnancy can be an unintended consequence of the increasingly common practice of blastocyst transfer for couples requiring in vitro fertilisation (IVF) for infertility. Dichorionic triamniotic (DCTA) triplets is the most common presentation, and these pregnancies are particularly high risk because of the additional risks associated with monochorionicity. Surveillance for twin-to-twin transfusion syndrome, including twin anemia polycythemia sequence, may be more difficult, and any intervention to treat the monochorionic pair needs to balance the proposed benefits against the risks posed to the unaffected singleton. Counseling of families with DCTA triplets is therefore complex. Here, we report a case of DCTA triplets, where the pregnancy was complicated by threatened preterm labour, and twin anemia polycythemia sequence (TAPS) was later diagnosed at 28 weeks. The TAPS was managed with a single intraperitoneal transfusion, enabling safe prolongation of the pregnancy for over 2 weeks until recurrence of TAPS and preterm labour supervened. Postnatal TAPS was confirmed, and all three infants were later discharged home at term corrected age, and were normal at follow-up. This case highlights that in utero therapy has an important role in multiple pregnancies of mixed chorionicity, and can achieve safe prolongation of pregnancy at critical gestations.

  9. Twin pregnancy in a patient of chronic myeloid leukemia on imatinib therapy.

    Science.gov (United States)

    Meera, V; Jijina, Farah; Shrikande, Mitu; Madkaikar, Manisha; Ghosh, K

    2008-10-01

    Imatinib is a tyrosine kinase inhibitor and is now used regularly in chronic myeloid leukaemia therapy in chronic phase with great success. This drug due its very nature of action is suspected to be teratogenic hence the patients are counseled not to get pregnant while on this drug. However in world literature few normal pregnancies have been reported in patients on Imatinib therapy, though no twin pregnancy has been reported on this medication. We report here the birth of normal mono-ovular mono-chorionic twin while the patient is on imatinib during conception and early pregnancy for chronic myeloid leukaemia.

  10. Twin Legacies: Victor and Vincent McKusick/Twin Studies: Twinning Rates I; Twinning Rates II; MZ Twin Discordance for Russell-Silver Syndrome; Twins' Language Skills/Headlines: Babies Born to Identical Twin Couples; Identity Exchange; Death of Princess Ashraf (Twin); Yahoo CEO Delivers Identical Twins.

    Science.gov (United States)

    Segal, Nancy L

    2016-04-01

    The lives of the illustrious monozygotic (MZ) twins, Victor A. and Vincent L. McKusick, are described. Victor earned the distinction as the 'Father of Medical Genetics', while Vincent was a legendary Chief Justice of the Maine Supreme Court. This dual biographical account is followed by two timely reports of twinning rates, a study of MZ twin discordance for Russell-Silver Syndrome (RSS) and a study of twins' language skills. Twin stories in the news include babies born to identical twin couples, a case of switched identity, the death of Princess Ashraf (Twin) and a new mother of twins who is also Yahoo's CEO.

  11. Neonatal status of twins

    Directory of Open Access Journals (Sweden)

    Božinović Dragica

    2012-01-01

    Full Text Available Multiple pregnancy is a pregnancy where more than one fetus develops simultaneously in the womb, as a result of the ovulation and fertilization of more than one egg. It is relatively rare in humans and represents the rest of the phylogenetic stages. The most common are twins and they indicate the development of two fetuses in the womb. The frequency of twin pregnancies is about 1%. Multiple pregnancies belong to a group of high-risk pregnancies because of the many complications that occur during the pregnancy: higher number of premature deliveries, bleeding, early neonatal complications and higher perinatal morbidity and mortality. Such pregnancies and infants require greater supervision and monitoring. The aim of this study was to determine the percentage of baby twins born at the maternity ward of the General Hospital in Prokuplje and their morbidity and mortality. Data on the total number of deliveries, number of twins, parity and maternal age, gestational age, body weight of twins, method of delivery, Apgar score and perinatal mortality were collected and statistically analyzed by means of retrospective analysis of operative birth and neonatal protocol for 6 years (2005 of 2010. Out of 4527 mothers who gave birth 43 were pairs of twins, or 0.95% of women gave birth to twins. These babies are more likely born by Caesarean section, but delivered with slightly lower birth weight.

  12. Effective treatment of cervical incompetence in a monochorionic monoamniotic twin pregnancy with a rescue cervical cerclage and pessary--a case report and review of literature.

    Science.gov (United States)

    Kosińska-Kaczyńska, Katarzyna; Szymusik, Iwona; Bomba-Opoń, Dorota; Brawura-Biskupski-Samaha, Robert; Wegrzyn, Piotr; Wielgoś, Mirosław

    2012-12-01

    A monochorionic monoamniotic (MCMA) twin pregnancy is the rarest form of twin gestation, accounting for around 1:10000 to 1:20000 of all deliveries regardless of the region of the world. All multiple gestations have a higher risk of preterm delivery due to either preterm uterine contractions or asymptomatic cervical shortening (cervical incompetence). A case of a 28-year-old primigravida in MCMA twin pregnancy with cervical incompetence diagnosed at 22 weeks of gestation is presented. After obtaining cervical swabs, negative laboratory infection parameters and confirming concordant gestational age on ultrasound scan with no structural abnormalities of both fetuses, the patient was qualified for an emergency cervical cerclage according to Wurm-Hefner method. Five days after the procedure, a cervical pessary was additionally inserted. She was administered antibiotics and steroids. The wellbeing of both fetuses was strictly monitored by means of cardiotocography tracing and ultrasound examinations, on which they were both eutrophic, with no abnormalities in Doppler blood flow patterns. Spontaneous premature rupture of membranes took place at 32 weeks of gestation, a cesarean section was performed and two female fetuses of 1740 g and 1760 g were delivered. They both required antibiotics because of congenital pneumonia, but no respiratory support was necessary The twins were discharged from the hospital 22 days after birth in good general condition. This case of a rescue cervical cerclage and pessary used simultaneously can be an example of an effective method of cervical incompetence treatment in twin pregnancies.

  13. Outcome following selective fetal reduction in monochorionic and dichorionic twin pregnancies discordant for structural, chromosomal and genetic disorders.

    Science.gov (United States)

    Nobili, Elena; Paramasivam, Gowrishankar; Kumar, Sailesh

    2013-04-01

    To investigate the indications for offering selective fetal reduction in monochorionic (MC) and dichorionic (DC) twins and to correlate obstetric outcome with the antenatal procedure. All cases of MC and DC twins discordant for structural anomalies and for chromosomal/genetic abnormalities were included. Selective reductions performed for twin-to-twin transfusion syndrome or growth restriction were excluded. For DC twins, feticide was achieved using intracardiac injection of potassium chloride (KCl). For MC twins, bipolar cord occlusion (BCO), interstitial laser or radiofrequency ablation (RFA) was used. There were 121 twin pregnancies discordant for structural and chromosomal abnormalities. Only 88 (56 were MC twins and 32 were DC twins) had selective reduction. For both MC and DC twins, the leading indication for selective reduction was structural anomalies with CNS malformations the most common. For all MC fetal reduction techniques, the overall pregnancy loss rate (twins were >87% and 100% for DC twins. Selective reduction in MC pregnancies carries an increased procedure-related and preterm delivery rate compared with DC pregnancies. The main indication for selective reduction was structural malformations, with a predominance of CNS anomalies. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  14. Twin pregnancy and partial hydatidiform mole following in vitro fertilization and embryos transfer: a novel case of placental mosaicism

    Institute of Scientific and Technical Information of China (English)

    SUN Cheng-juan; ZHAO You-ping; YU Song; FAN Ling; WU Qing-qing; LI Guang-hui; ZHANG Wei-yuan

    2012-01-01

    Twin pregnancy with mosaic partial hydatidiform mole (PHM) and survival of two healthy fetuses following in vitro fertilization and embryos transfer (IVF-ET) is a rare situation and is considered a challenge for management.A 32-year-old Chinese woman conceived twin pregnancy following IVF-ET.At 22 weeks' gestation,an additional intrauterine echogenic mass with features of PHM were shown by successive ultrasound examinations.At 35 weeks'gestation,two live male infants and two placentas were delivered by caesarean section (CS).Histologic examination of the abnormal placenta confirmed mosaic PHM.Genetic study showed the abnormal placental mosaicism (expressed in molar-69XXY and normal vili-46XY),co-existing with a hypospadia new-born (46XY) in one amniotic sac.However,the other one was normal.Serial serum β-hCG levels showed a declining trend and serum 3-human chorionic gonadotropin (hCG) were undetectable at 6 months after delivery.The case demonstrated that it is possible to prolonged gestation by PHM under close surveillance during the entire pregnancy.

  15. Twin pregnancy and partial hydatidiform mole following in vitro fertilization and embryos transfer: a novel case of placental mosaicism.

    Science.gov (United States)

    Sun, Cheng-juan; Zhao, You-ping; Yu, Song; Fan, Ling; Wu, Qing-qing; Li, Guang-hui; Zhang, Wei-yuan

    2012-12-01

    Twin pregnancy with mosaic partial hydatidiform mole (PHM) and survival of two healthy fetuses following in vitro fertilization and embryos transfer (IVF-ET) is a rare situation and is considered a challenge for management. A 32-year-old Chinese woman conceived twin pregnancy following IVF-ET. At 22 weeks' gestation, an additional intrauterine echogenic mass with features of PHM were shown by successive ultrasound examinations. At 35 weeks' gestation, two live male infants and two placentas were delivered by caesarean section (CS). Histologic examination of the abnormal placenta confirmed mosaic PHM. Genetic study showed the abnormal placental mosaicism (expressed in molar-69XXY and normal vili-46XY), co-existing with a hypospadia new-born (46XY) in one amniotic sac. However, the other one was normal. Serial serum β-hCG levels showed a declining trend and serum β-human chorionic gonadotropin (hCG) were undetectable at 6 months after delivery. The case demonstrated that it is possible to prolonged gestation by PHM under close surveillance during the entire pregnancy.

  16. Loop electrosurgical excision of the cervix and risk for spontaneous preterm delivery in twin pregnancies

    DEFF Research Database (Denmark)

    Noehr, Bugge; Jensen, Allan; Frederiksen, Kirsten;

    2009-01-01

    OBJECTIVE: To investigate the association between three cervical procedures (biopsy with no treatment, ablation, and loop electrosurgical excision procedure [LEEP]) and subsequent spontaneous preterm delivery in twin pregnancies using population-based data from various nationwide registries...... spontaneously preterm (32.7%). Preterm delivery was defined as gestational age between 21 weeks and 37 weeks. Logistic regression analyses were used to evaluate the association between cervical procedures and preterm delivery. RESULTS: Twin pregnancies subsequent to LEEP had a significantly increased risk...... preterm groups. We found no increase in risk of preterm delivery subsequent to biopsy without treatment or ablation. CONCLUSION: Our study showed an overall significant increase in risk of preterm delivery in twin pregnancies subsequent to LEEP treatment, even after adjustment for several potential risk...

  17. Perinatal outcome after first-trimester risk assessment in monochorionic and dichorionic twin pregnancies

    DEFF Research Database (Denmark)

    Kristiansen, Mona Kjærbøl; Joensen, BS; Ekelund, CK

    2015-01-01

    .8% for DC, MCDA and MCMA twins, respectively (P death of one fetus after week 22 was higher in MCDA twins than DC twins 1.7% versus 0.6% (P neonatal death. CONCLUSIONS: The risk of spontaneous loss of both fetuses......) pregnancies and 15.7% monochorionic (MC) pregnancies (15% diamniotic [MCDA] and 0.7% monoamniotic [MCMA]). METHODS: A cohort study based on data collected from the Danish Fetal Medicine Database from July 2008 to July 2011. MAIN OUTCOME MEASURES: Fetal loss rate before week 22, intrauterine death rate from...... week 22 to birth, and neonatal mortality. RESULTS: Significantly more DC than MC pregnancies resulted in at least one live born infant-98.2% versus 92.3% in MCDA (P

  18. Acardiac twin pregnancy: successful intrauterine ablative treatment with alcohol at 14 weeks of gestation.

    Science.gov (United States)

    Guven, M A; Koc, O; Bodur, H; Erkanli, S; Bagis, T; Usal, D

    2016-01-01

    Twin reversed arterial perfusion (TRAP) sequence is a serious condition of monochorionic twin pregnancy, occurring in approximately one in 35,000 cases. First trimester treatment of TRAP sequence is controversial with higher incidence of procedure related complications. Present case demonstrates a TRAP sequence that was managed by intrauterine treatment with one-ml 100% pure alcohol injection into the abdominal part of the umbilical artery and obliteration of the acardiac twin at 14 weeks of gestation. Antenatal follow-up was uneventful and elective cesarean section was performed at 39 weeks' gestation. Postnatal outcome of the pump twin was excellent at 30 months after birth. Early second trimester elective ablation by alcohol injection can be an inexpensive, alternative, and reasonable minimal invasive treatment option to prevent fetal loss of pump twin before mid and late second trimester in perinatology centers where intrafetal cord occlusive methods are not available.

  19. Effectiveness of progestogens to improve perinatal outcome in twin pregnancies : an individual participant data meta-analysis

    NARCIS (Netherlands)

    Schuit, E; Stock, S; Rode, L; Rouse, D J; Lim, A C; Norman, J E; Nassar, A H; Serra, V; Combs, C A; Vayssiere, C; Aboulghar, M M; Wood, S; Çetingöz, E; Briery, C M; Fonseca, E B; Worda, K; Tabor, A; Thom, E A; Caritis, S N; Awwad, J; Usta, I M; Perales, A; Meseguer, J; Maurel, K; Garite, T; Aboulghar, M A; Amin, Y M; Ross, S; Cam, C; Karateke, A; Morrison, J C; Magann, E F; Nicolaides, K H; Zuithoff, N P A; Groenwold, R H H; Moons, K G M; Kwee, A; Mol, B W J

    2015-01-01

    BACKGROUND: In twin pregnancies, the rates of adverse perinatal outcome and subsequent long-term morbidity are substantial, and mainly result from preterm birth (PTB). OBJECTIVES: To assess the effectiveness of progestogen treatment in the prevention of neonatal morbidity or PTB in twin pregnancies

  20. Successful outcome in a patient with glioma of brain with twin pregnancy

    Directory of Open Access Journals (Sweden)

    Anjali Rani

    2014-06-01

    Full Text Available We present a case of glioma in pregnant female with twin pregnancy. Gliomas during pregnancy are rare. Gliomas during pregnancy pose a risk to maternal and fetal life. The benefit-to-risk ratio should be carefully evaluated and discussed prior to get marriage and pregnancy. In present case, patient had non-specific symptom like seizure and no any focal neurological deficit, Caesarean Section (CS was done at term with multidisciplinary group, including a neurosurgeon, obstetrician, anesthesiologist and neonatologist. She has been followed up to the present date and remains in good health. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 827-830

  1. Isolated pregnancy-induced anti-thrombin deficiency in a woman with twin pregnancy.

    Science.gov (United States)

    Kawabata, Kosuke; Morikawa, Mamoru; Yamada, Takahiro; Minakami, Hisanori

    2016-06-01

    A woman with twin pregnancy had a gradual decline in anti-thrombin (AT) activity from 72% at gestational week (GW) 29(-3/7) , to 53% at GW31(-2/7) , and to 41% at GW32(-2/7) , at which time hypertension (148/90 mmHg) and proteinuria (protein-to-creatinine ratio [P/Cr], 0.79 mg/mg) developed in the presence of normal platelet count (159 × 10(9) /L) and serum aspartate aminotransferase/lactate dehydrogenase (22/164 IU/L). AT product was given three times to maintain AT activity >50% and blood pressure was maintained below 155/95 mmHg with no treatment, but generalized edema with a weekly weight gain of 4.9 kg and increased proteinuria (to P/Cr, 7.6 mg/mg) required cesarean section at GW33(-3/7) . This case highlights the occurrence of pregnancy-induced AT deficiency alone in the absence of any other abnormality, including hypertension, proteinuria, or thrombocytopenia. Measurement of AT activity was considered helpful for determination of the appropriate time for delivery in this patient.

  2. Prediction of spontaneous preterm delivery in asymptomatic twin pregnancies using cervical length and granulocyte elastase.

    Science.gov (United States)

    Tanaka, Kei; Yamada, Kenji; Matsushima, Miho; Izawa, Tomoko; Furukawa, Seishi; Kobayashi, Yoichi; Iwashita, Mitsutoshi

    2017-04-01

    The purpose of this study was to evaluate sonographic cervical length (CL) and granulocyte elastase (GE) in cervical secretion as predictors of preterm delivery in asymptomatic twin pregnancies. This study prospectively enrolled asymptomatic twin pregnancies with CL preterm labor, and the cervical secretion was obtained for GE testing on admission. The results of CL measurement and GE testing were reviewed, and the relationship between each variables and preterm delivery prior to 34 weeks of gestation was assessed. Overall, we included 54 women with twin pregnancies, of which 12 (22.2%) had preterm deliveries prior to 34 weeks of gestation. A CL of preterm delivery with an odds ratio of 4.88 (95% confidence limit, 1.15-20.73). GE was not an independent predictive marker for preterm delivery. We also performed a subgroup analysis on the combination of CL and GE for predicting preterm delivery. Among the patients with GE(-), CL preterm delivery with an odds ratio of 10.89 (95% confidence limit, 1.40-77.10). CL was not associated with preterm delivery among those with GE(+). Those with negative GE and shorter CL demonstrated the shortest duration of pregnancy after admission. The combination of sonographic CL and GE of cervical secretion is useful to predict the risk of preterm delivery in asymptomatic twin pregnancies. Copyright © 2017. Published by Elsevier B.V.

  3. Ductus venosus Doppler at 11 to 13 weeks of gestation in the prediction of outcome in twin pregnancies.

    Science.gov (United States)

    Maiz, Nerea; Staboulidou, Ismini; Leal, Antonio M; Minekawa, Ryoko; Nicolaides, Kypros H

    2009-04-01

    To examine the independent contribution of abnormal flow in the ductus venosus at 11 to 13 weeks of gestation in the prediction of adverse pregnancy outcome in relation to chorionicity. This was a prospective study in 516 dichorionic and 179 monochorionic twin pregnancies in which the fetal ductus venosus flow was assessed at 11 0/7 to 13 6/7 weeks of gestation. The prevalence of reversed a-wave in the fetal ductus venosus was compared between monochorionic and dichorionic pregnancies and between those with and without pregnancy complications. Comparisons between each of the pregnancy outcomes and the normal outcome group and between monochorionic and dichorionic pregnancies were made using the Mann-Whitney U-test for continuous variables and the chi2 test and Fisher exact test for categorical variables. The prevalence of reversed a-wave in at least one of the fetuses was significantly higher in monochorionic than in dichorionic pregnancies (18.4% compared with 8.3%, P<.001) and in pregnancies complicated by miscarriage (28.6%, P=.005), fetal aneuploidy (70.0%, P<.001), and twin-twin transfusion syndrome (38.5%, P<.001) compared with the pregnancies with two healthy live births (7.7%). Pregnancy outcome was normal in 33 of the 43 (76.7%) dichorionic and in 14 of the 33 (42.4%) monochorionic twins with reversed a-wave in at least one of the fetuses. In twins, reversed a-wave in the ductus venosus at 11 to 13 weeks of gestation is associated with increased risk for aneuploidies, miscarriage, and development of severe twin-twin transfusion syndrome. However, in about 75% of dichorionic twins and 40% of monochorionic twins with reversed a-wave, the pregnancy outcome is normal. II.

  4. Twin births

    DEFF Research Database (Denmark)

    Hoffmann, Elise; Oldenburg, Anna; Rode, Line;

    2012-01-01

    To assess morbidity and mortality in twin pregnancy deliveries, according to chorionicity and mode of delivery.......To assess morbidity and mortality in twin pregnancy deliveries, according to chorionicity and mode of delivery....

  5. Infant mortality in twin pregnancies following in-utero demise of the co-twin

    Directory of Open Access Journals (Sweden)

    Boubakari Ibrahimou

    2015-09-01

    Conclusions: Risks for all mortality types were lower among converted co-twins than their unconverted or same-quantile counterparts. The lower neonatal and higher post-neonatal mortality among black require future research.

  6. First trimester β-hCG and estradiol levels in singleton and twin pregnancies after assisted reproduction.

    Science.gov (United States)

    Póvoa, Ana; Xavier, Pedro; Matias, Alexandra; Blicksttein, Isaac

    2017-07-28

    To compare levels of β-hCG and estradiol collected during the first trimester in singleton and twin pregnancies following assisted reproduction technologies (ART). We prospectively evaluated 50 singleton and 47 dichorionic twin pregnancies that eventually ended in live births. Patients were recruited from a single ART center with standard treatment protocols followed by fresh embryo transfers. Hormone measurements were performed within a narrow gestational age range and analyzed in a single laboratory thus minimizing inter- and intra-assay variability. We measured serum β-hCG at 13 days after embryo transfer as well as samples of β-hCG and estradiol at 8-9 weeks+6 days. No significant differences existed between singletons and twins in respect to demographic and cycle characteristics. β-hCG and estradiol were all significantly higher in twins (PhCG and estradiol in twins, pointing to the potential role of these placental hormones in early support of a twin pregnancy.

  7. Twin pregnancies in the Niger Delta of Nigeria: a four-year review

    Directory of Open Access Journals (Sweden)

    Ibrahim I

    2012-05-01

    Full Text Available Isa Ibrahim,1 Abisoye Oyeyemi,2 Abhulimen Obilahi21Department of Obstetrics, 2Epidemiology Division, Department of Public Health, Ministry of Health, Bayelsa State, NigeriaBackground: The female is programmed to nurture one fetus and to take care of one neonate at a time; hence, twin pregnancy is associated with an increased risk of preterm deliveries, perinatal morbidity, and mortality and maternal complications. This study aimed to determine the twinning rate, and maternal and fetal outcomes of all twin pregnancies managed at the Niger Delta University Teaching Hospital Okolobiri.Methods: The study is a 4-year descriptive retrospective evaluation of twin pregnancies managed at the Niger Delta University Teaching Hospital Okolobiri. Records of all pregnancies, booked and unbooked, managed from January 1, 2007 to December 31, 2010 were reviewed. Details of delivery and maternal and fetal outcomes were obtained using a pro forma designed for the study. Epi Info version 3.5.3 was used for statistical analysis. The Chi-square test was used to test for associations between variables. The level of significance was set at P ≤ 0.05.Results: A total of 1341 deliveries including 41 cases of twin deliveries were recorded during the study period, giving an incidence of 30.6/1000. Twenty-nine (70.7% of the patients were unbooked. The mean gestational age was 33.3 ± 2.6 weeks, and the mean fetal weight was 2.34 ± 0.54 kg. There were 13 perinatal deaths, with a perinatal mortality rate of 158.5/1000. There was no association between booking status and perinatal mortality rate (χ2 = 0.017, P = 1.000. Prematurity was the chief cause of perinatal death (65.4%. Maternal morbidities included anemia, wound infection, and genital sepsis. There were no maternal deaths.Conclusion: The twinning rate was high. There was a high perinatal mortality rate, with prematurity accounting for most of the mortality. There is a need for improved incubation/neonatal care for

  8. Genetic amniocentesis in twin pregnancies: results of a multicenter study of 529 cases

    NARCIS (Netherlands)

    Pruggmayer, M.R.K.; M.G. Jahoda (M.); Van der Pol, J.G.; Baumann, P.; Holzgreve, W.; Karkut, G.; Lettau, R.; Eiben, B.; Osmers, R.; Gola, H.W.; Duda, V.; Polak, P.; Körner, H.; Schulte‐Valentin, M.; Schütte, H.

    1992-01-01

    textabstractTo evaluate the risk of abortion after genetic amniocentesis in twin pregnancies, a retrospective study of 15 centers was performed. The spontaneous abortion rate up to 20 completed weeks of gestation was 2.3%; the abortion rate up to 28 completed weeks, as defined by WHO, was 3.7%. The

  9. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    van de Mheen, L; Schuit, E; Liem, S M S; Lim, A C; Bekedam, D J; Goossens, S M T A; Franssen, M T M; Porath, M M; Oudijk, M A; Bloemenkamp, K W M; Duvekot, J J; Woiski, M D; de Graaf, I; Sikkema, J M; Scheepers, H C J; van Eijk, J; de Groot, C J M; van Pampus, M G; Mol, B W J

    2015-01-01

    OBJECTIVE: To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. METHODS: This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable as

  10. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    Van de Mheen, L.; Schuit, E.; Liem, S. M. S.; Lim, A. C.; Bekedam, D. J.; Goossens, S. M. T. A.; Franssen, M. T. M.; Porath, M. M.; Oudijk, M. A.; Bloemenkamp, K. W. M.; Duvekot, J. J.; Woiski, M. D.; De Graaf, I.; Sikkema, J. M.; Scheepers, H. C. J.; Van Eijk, J.; De Groot, C. J. M.; Van Pampus, M. G.; Mol, B. W. J.

    2015-01-01

    Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable asso

  11. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    Mheen, L. van de; Schuit, E.; Liem, S.M.; Lim, A.C.; Bekedam, D.J.; Goossens, S.M.; Franssen, M.T.; Porath, M.M.; Oudijk, M.A.; Bloemenkamp, K.W.; Duvekot, J.J.; Woiski, M.D.; Graaf, I. de; Sikkema, J.M.; Scheepers, H.C.; Eijk, J. van; Groot, C.J. de; Pampus, M.G. van; Mol, B.W.

    2015-01-01

    OBJECTIVE: To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. METHODS: This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable

  12. Cesarean section in twin pregnancies in two Danish counties with different cesarean section rates

    DEFF Research Database (Denmark)

    Henriksen, T B; Sperling, Lene; Hedegaard, M

    1994-01-01

    OBJECTIVE: Based on a comparison of the clinical indications for cesarean section (CS) in two Danish counties and a review of the literature regarding this issue the aim of this study was to discuss possible explanations for variations in CS rates in twin pregnancies. The comparison of indications...

  13. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    Van de Mheen, L.; Schuit, E.; Liem, S. M. S.; Lim, A. C.; Bekedam, D. J.; Goossens, S. M. T. A.; Franssen, M. T. M.; Porath, M. M.; Oudijk, M. A.; Bloemenkamp, K. W. M.; Duvekot, J. J.; Woiski, M. D.; De Graaf, I.; Sikkema, J. M.; Scheepers, H. C. J.; Van Eijk, J.; De Groot, C. J. M.; Van Pampus, M. G.; Mol, B. W. J.

    2015-01-01

    Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable

  14. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    van de Mheen, L; Schuit, E; Liem, S M S; Lim, A C; Bekedam, D J; Goossens, S M T A; Franssen, M T M; Porath, M M; Oudijk, M A; Bloemenkamp, K W M; Duvekot, J J; Woiski, M D; de Graaf, I; Sikkema, J M; Scheepers, H C J; van Eijk, J; de Groot, C J M; van Pampus, M G; Mol, B W J

    OBJECTIVE: To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. METHODS: This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable

  15. Gestational diabetes insipidus, HELLP syndrome and eclampsia in a twin pregnancy: a case report.

    Science.gov (United States)

    Woelk, J L; Dombroski, R A; Brezina, P R

    2010-02-01

    We report a case of eclampsia in a twin pregnancy complicated by HELLP syndrome and diabetes insipidus. This confluence of disease processes suggests that a modification of common magnesium sulfate treatment protocols may be appropriate in a certain subset of patients.

  16. Genetic amniocentesis in twin pregnancies: results of a multicenter study of 529 cases

    NARCIS (Netherlands)

    Pruggmayer, M.R.K.; M.G. Jahoda (M.); Van der Pol, J.G.; Baumann, P.; Holzgreve, W.; Karkut, G.; Lettau, R.; Eiben, B.; Osmers, R.; Gola, H.W.; Duda, V.; Polak, P.; Körner, H.; Schulte‐Valentin, M.; Schütte, H.

    1992-01-01

    textabstractTo evaluate the risk of abortion after genetic amniocentesis in twin pregnancies, a retrospective study of 15 centers was performed. The spontaneous abortion rate up to 20 completed weeks of gestation was 2.3%; the abortion rate up to 28 completed weeks, as defined by WHO, was 3.7%. The

  17. Acute Abdomen in the 17th Week of Twin Pregnancy due to Ovarian Torsion – A Late Complication of IVF

    Science.gov (United States)

    Habek, D.; Bauman, R.; Rukavina Kralj, L.; Hafner, T.; Turudic, T.; Vujisic, S.

    2016-01-01

    Background: A 32-year-old woman with tubal factor infertility due to bilateral laparoscopic salpingectomy conceived twins with in vitro fertilization (IVF). She developed moderate ovarian hyperstimulation syndrome which was treated with anticoagulant therapy. The subsequent course of the twin pregnancy was normal until the 17th week of gestation when she presented to hospital because of a sharp pain in the right lower abdomen which ceased after admission. Case: Except for a single incident of vomiting, patient had no other subjective symptoms. The clinical examination showed tenderness of the lower right abdominal segment on palpation. The surgeon and the urologist found no signs of an acute surgical or urologic condition, and laboratory findings were within normal reference ranges for pregnant women. Two days after admission the pain reappeared; it was now much stronger and colic-like. The pain was initially located supraumbilically but subsequently spread diffusely across the lower abdomen. Abdominal guarding was present and laboratory findings showed an increase in inflammatory parameters. An enlarged and edematous right ovary was found on transvaginal ultrasound. Conclusion: Exploratory laparotomy via a vertical midline abdominal transection revealed a torqued necrotic right ovary with elements of inflammation and inflammatory adhesions involving the entire pelvis. The patient underwent right-sided ovariectomy and adhesiolysis. Recovered was normal and the patient was delivered of healthy twins in the 37th week of gestation. PMID:28017976

  18. Twin pregnancy possibly associated with high semen quality

    DEFF Research Database (Denmark)

    Asklund, Camilla; Jensen, Tina Kold; Jørgensen, Niels

    2007-01-01

    a questionnaire. RESULTS: After adjustment, fathers of DZ and MZ twins had 3.6 (95% CI 1.7; 5.4) and 4.6 (95% CI 2.0; 7.2) percentage points higher percentage of sperm cells with normal morphologic features and percentages of motile sperm cells were 11.5 (95% CI 7.2; 15.9) and 12.5 (95% CI 6.3; 18.6) percentage...... points higher than the reference group (P sperm concentration than the reference group. CONCLUSIONS: Fathers of DZ twins had a better semen quality than the reference group, which supports...

  19. Timing of birth for women with a twin pregnancy at term: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Haslam Ross R

    2010-10-01

    Full Text Available Abstract Background There is a well recognized risk of complications for both women and infants of a twin pregnancy, increasing beyond 37 weeks gestation. Preterm birth prior to 37 weeks gestation is a recognized complication of a twin pregnancy, however, up to 50% of twins will be born after this time. The aims of this randomised trial are to assess whether elective birth at 37 weeks gestation compared with standard care in women with a twin pregnancy affects the risk of perinatal death, and serious infant complications. Methods/Design Design: Multicentred randomised trial. Inclusion Criteria: women with a twin pregnancy at 366 weeks or more without contraindication to continuation of pregnancy. Trial Entry & Randomisation: Following written informed consent, eligible women will be randomised from 36+6 weeks gestation. The randomisation schedule uses balanced variable blocks, with stratification for centre of birth and planned mode of birth. Women will be randomised to either elective birth or standard care. Treatment Schedules: Women allocated to the elective birth group will be planned for elective birth from 37 weeks gestation. Where the plan is for vaginal birth, this will involve induction of labour. Where the plan is for caesarean birth, this will involve elective caesarean section. For women allocated to standard care, birth will be planned for 38 weeks gestation or later. Where the plan is for vaginal birth, this will involve either awaiting the spontaneous onset of labour, or induction of labour if required. Where the plan is for caesarean birth, this will involve elective caesarean section (after 38 and as close to 39 weeks as possible. Primary Study Outcome: A composite of perinatal mortality or serious neonatal morbidity. Sample Size: 460 women with a twin pregnancy to show a reduction in the composite outcome from 16.3% to 6.7% with adjustment for the clustering of twin infants within mothers (p = 0.05, 80% power. Discussion This

  20. Transient osteoporosis of pregnancy of the bilateral hips in twin gestation: a case series.

    Science.gov (United States)

    Reese, Maria E; Fitzgerald, Colleen; Hynes, Christina

    2015-01-01

    Transient osteoporosis of pregnancy has been described as a rare, self-limiting disease of unclear etiology that presents as severe pain, which typically affects pregnant women in their third trimester. We describe 3 cases of primigravid pregnant women with twin gestation who reported unilateral hip pain and who were diagnosed with transient osteoporosis of pregnancy of the hip by magnetic resonance imaging. These women were advised to undergo limited weight bearing and activity modification to minimize the risk of fracture. Each patient was able to proceed through her pregnancy, delivery, and postpartum course without complication, with symptom resolution, and return to unrestricted activity.

  1. Conservative treatment for interstitial monochorionic twin pregnancy: case report and review of the published work.

    Science.gov (United States)

    Berretta, Roberto; Merisio, Carla; Dall'Asta, Andrea; Verrotti, Carla; Rolla, Martino; Bruni, Stefano; Bacchi Modena, Alberto

    2014-03-01

    Interstitial pregnancy is considered one of the most hazardous types of ectopic pregnancies, with a mortality rate of 2-2.5%. We describe a case of a viable monochorionic twin pregnancy in a 35-year-old woman successfully treated with systemic methotrexate associated with bilateral uterine arteries' embolization. β-hCG was undetectable 67 days after the first administration of methotrexate and the ultrasonography performed on day 67 showed the remnant of the gestational sac in the right uterine horn, a thin endometrium and a normal myometrial vascularization. Conservative treatment allowed us to avoid surgical treatment and to preserve the patient's fertility.

  2. Unilateral twin tubal ectopic pregnancy in a patient following tubal surgery

    Directory of Open Access Journals (Sweden)

    Nahid Ghanbarzadeh

    2015-01-01

    Full Text Available We report a spontaneous unilateral live tubal twin pregnancy in a patient with a history of previous ectopic pregnancy (EP and tubal surgery. Transvaginal ultrasound showed one pregnancy sac containing two fetal poles with cardiac activity, which appeared to be sited within the right adnexum. The right tubal EP was removed by salpingectomy. Ultrasound findings of suspected adnexal mass and free liquid in the Douglas pouch along with an increased a beta-human chorionic gonadotrophin levels, especially in association of risk factors, can help the early diagnosis of EP and reduce the related mortality and morbidity.

  3. [Twin pregnancy with complete mole and coexisting fetus: Reach fetal viability is possible].

    Science.gov (United States)

    Arsène, E; Clouqueur, E; Stichelbout, M; Devisme, L; Vaast, P; Subtil, D

    2015-11-01

    Twin pregnancies combining complete hydatidiform mole and coexistent fetus are a rare situation (incidence in 1/20,000 in 1/100,000 pregnancies) and a challenge for diagnosis. Their complications can be important - bleeding, preeclampsia, miscarriage - and their management remains complex and controversial. In case of continuing the pregnancy, nearly 40% of women have lives babies. Three quarters of fetal loss occur before 24weeks gestation. We report here three new cases; only one of these cases had a favorable outcome.

  4. A re-assessment of biochemical marker distributions in T21 affected and unaffected twin pregnancies in the first trimester

    DEFF Research Database (Denmark)

    Madsen, Helen Nordahl; Tørring, Niels

    unaffected and 47 trisomy 21 affected twin pregnancies were included in the study. Chorionicity specific medians were generated for PAPP-A and free β-hCG from gestational age 8 to 14 weeks. Multiple of the median for each of the markers were calculated. Detection rates (DR) and false-positive rates (FPR....... Allowing for gestation and chorionicity, twin pregnancies affected with trisomy 21 had higher levels of free β-hCG and lower levels of PAPP-A. Adding biochemistry into the risk assessment increased the DR for fetal trisomy 21 in dizygotic twin pregnancies from 78% to 90%, and decreased the FPR from 8......INTRODUCTION Serum biochemical marker concentrations in twin pregnancies reflect the presence of two fetuses rather than one. In general, the concentrations are approximately double those found in singleton pregnancies. The objective was to estimate the difference between levels of the two...

  5. [Anti-D isoimmunization severe in a twin pregnancy. Case report].

    Science.gov (United States)

    Calomarde Rees, María Consuelo; Iglesias Sánchez, Carlos; Martín Boado, Elena; Vegas, Gabriel; Omeñaca, Félix; González González, Antonio

    2012-03-01

    Perinatal hemolytic disease occurs secondary to a hemolytic phenomenon of immune origin resulting in fetal or neonatal anemia. A 38-year-old pregnant woman was referred to the Department of high risk Obstetrics, Hospital Universitario La Paz Madrid because of presenting a dichorionic diamniotic twin pregnancy spontaneously, pre-pregnancy diabetes poorly controlled and severe alloinmunization anti-D. Her first pregnancy ended in a normal delivery at term; in the period of 4 years, she has three newborn with 36, 34 and 40 weeks respectively, who die with a week of life. After that, two intrauterine fetal death occur at 26 weeks of gestation. The patient who is RhD negative, suffers anti-D inmunization with a antibody titration of 1/1024 with 14 weeks of gestation. Twelve plasmapheresis, eight doses of anti-D inmunoglobulins and intrauterine transfusions has been the treatment received. A severe anemia is found during the ultrasound control of the middLe cerebral artery peak systolic velocity in both twins since the 16th week. It remains stable thanks to the treatment. Finally at the 28th week of gestation, pregnancy is terminated with a cesarean section. The twins are born alive and premature, but with good general state. The measurement of the middle cerebral artery peak systolic velocity predicts moderate-severe fetal anemia cases, which are the most important in the clinical management because of the need of active treatment or finish the pregnancy.

  6. A unique case of successful twin pregnancy reaching term in a patient with uterus bicornis unicollis

    Directory of Open Access Journals (Sweden)

    Simran Ahluwalia

    2014-08-01

    Full Text Available Abnormal fusion of the Mullerian ducts or failure of absorption of the septum causes varying degrees of congenital uterine malformation. Twin gestation in a case of bicornuate uterus is rare. We are reporting this case because of its rare presentation, where a case of undiagnosed twins managed to reach full-term after spontaneous conception. We report here a 30 year old gravida four para one with no live issues who presented at term in labour. Per Abdomen examination suggested a twin gestation which was confirmed by ultrasonography. Both the twins were delivered by an emergency caesarean section. Intraoperatively the uterus was found to be bicornuate uterus (bicornis unicollis with both the babies in two different horns. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1104-1106

  7. The effect of maternal anemia on maternal and neonatal outcomes in twin pregnancies.

    Science.gov (United States)

    Kosto, Amit; Okby, Rania; Levy, Maya; Sergienko, Ruslan; Sheiner, Eyal

    2016-01-01

    The objective of this study is to investigate the effect of second trimester anemia on maternal and perinatal outcomes in twin pregnancies. A retrospective population-based study was conducted, comparing maternal and neonatal outcomes in women carrying twins, with second trimester anemia (defined as hemoglobin anemia (defined as hemoglobin > or equal to 10 g/dl). Deliveries occurred in a tertiary medical center in 2013. During the study period, there were 307 twin deliveries. Hemoglobin levels were available for 247 (80.4%) twins; 66 (26.7%) of these had anemia (anemia had a higher parity (p=0.03), and needed more blood transfusions than those with hemoglobin level > or equal to 10 g/dl (OR = 1.6; 95% CI 1.11-2.43, p anemia in women carrying twins is associated with a high parity and increases the risk for blood transfusions. However, in our population, maternal anemia in twin gestations does not increase the risk for adverse perinatal outcome.

  8. Crown-rump length discordance in the first trimester: a predictor of adverse outcome in twin pregnancies?

    DEFF Research Database (Denmark)

    Johansen, Mathias; Oldenburg, A.; Rosthøj, Susanne;

    2014-01-01

    OBJECTIVES: To evaluate the usefulness of first-trimester crown-rump length (CRL) discordance in predicting adverse outcome in twin pregnancies. METHODS: This retrospective study included a large cohort retrieved from local ultrasound databases at 14 obstetric departments in Denmark, comprising all...... twin pregnancies with two live fetuses scanned between 11 and 14 weeks' gestation during the period 1 January 2004 to 31 December 2006. The association between CRL discordance ≥ 10 % and adverse outcome was evaluated. RESULTS: Among 1993 twin pregnancies, 1733 were dichorionic (156 (9%) discordant......; 1577 (91%) concordant) and 260 were monochorionic (32 (12%) discordant; 228 (88%) concordant). In dichorionic twin pregnancies we found an association between CRL discordance ≥ 10% and preterm delivery before 34 weeks' gestation (P=0.007), birth weight discordance (P=0.001) and mean birth weight (P=0...

  9. Diagnosis of umbilical cord entanglement in a monochorionic diamniotic twin pregnancy with spontaneous septostomy of the dividing membranes using dual-gate Doppler imaging.

    Science.gov (United States)

    Ito, Ayumu; Nakata, Masahiko; Oji, Ayako; Takano, Mayumi; Umemura, Nahomi; Nagasaki, Sumito; Maemura, Toshimitsu; Morita, Mineto

    2017-05-08

    Umbilical cord entanglement is the leading cause of fetal mortality in monoamniotic twin pregnancies and a pseudo monoamniotic environment. Published methods for detecting this complication include color Doppler and pulsed Doppler sonography; however, no method provides an absolute diagnosis. In this case, we report the diagnosis of umbilical cord entanglement using dual-gate Doppler imaging. A 35-year-old woman was referred to our hospital at 28 weeks of gestation for prenatal management because of diagnosis of a monochorionic diamniotic twin pregnancy with spontaneous septostomy of the dividing membranes. Each fetus displayed normal fetal growth without obvious discordance and anatomical abnormalities. However, the dividing membrane was not detected, and an entangled cord was suspected. Dual-gate Doppler examination was carried out. Two regions of interest were considered at different areas of the umbilical arteries, and when each Doppler image showed two different heart rates at the same time, we considered this to be evidence of umbilical cord entanglement. Cesarean section was performed at 32 weeks of gestation and twins were delivered. The delivered umbilical cords had sixfold entanglement. In this case, dual-gate Doppler seems to have been more accurate than conventional single-gate Doppler for the diagnosis of cord entanglement because we confirmed two different heart rates at the same time with dual-gate Doppler.

  10. Prenatal Diagnosis of Cantrell's Pentalogy Associated with Agenesis of Left Limb in a Twin Pregnancy

    Science.gov (United States)

    Cakiroglu, Yigit; Doger, Emek; Babaoglu, Kadir; Caliskan, Eray; Yucesoy, Gulseren

    2014-01-01

    Pentalogy of Cantrell is a rare malformation described in the literature. We report a case of pentalogy of Cantrell associated with left limb deficiency in a twin pregnancy. The fetus with multiple anomalies revealed kyphosis, ectopia cordis, and a large defect with protruding liver and bowel loops at 12 weeks and 3 days of gestational age on ultrasound scan. The other fetus was ultrasonographically normal. We diagnosed a case of pentalogy of Cantrell in a twin pregnancy after exclusion of limb body wall complex, body stalk anomaly, and amniotic band syndrome and after delivery of the fetuses. Macroscopic examinations were ectopia cordis, extrusion of the abdominal organs without membranes surrounding, and agenesis of the left limb. PMID:24782934

  11. A reassessment of biochemical marker distributions in trisomy 21-affected and unaffected twin pregnancies in the first trimester.

    Science.gov (United States)

    Madsen, H N; Ball, S; Wright, D; Tørring, N; Petersen, O B; Nicolaides, K H; Spencer, K

    2011-01-01

    To estimate the difference between levels of the two biochemical markers pregnancy-associated plasma protein-A (PAPP-A) and maternal serum free β-human chorionic gonadotropin (free β-hCG) in twin pregnancies relative to singleton pregnancies and establish an improved screening procedure for chromosomal abnormalities such as trisomy 21 in twin pregnancies. 4843 unaffected and 47 trisomy 21-affected twin pregnancies were included in the study. Chorionicity-specific medians were generated for PAPP-A and free β-hCG from gestational ages 8 to 14 weeks. Multiple of the median values for each of the biochemical markers were calculated. Detection rates and false-positive rates were estimated for screening tests incorporating nuchal translucency and maternal age, with and without biochemistry. Medians for the two biochemical markers for monochorionic and dichorionic twins in unaffected pregnancies show a gestational age-specific increase relative to singleton medians. Allowing for gestation and chorionicity, twin pregnancies affected with trisomy 21 had higher levels of free β-hCG and lower levels of PAPP-A. Adding biochemistry into the risk assessment using a fixed risk cut-off of 1 in 100 increased the detection rate for fetal trisomy 21 in dizygotic twin pregnancies from 78 to 90%, and decreased the false-positive rate from 8.0 to 5.9%. Generation of chorionicity-specific medians for the biochemical markers and their use in risk assessment can improve the performance of first-trimester screening for chromosomal abnormalities in twins to a level comparable with that in singleton pregnancies.

  12. Successful Non-fluoroscopic Radiofrequency Ablation of Incessant Atrial Tachycardia in a High Risk Twin Pregnancy.

    Science.gov (United States)

    Zuberi, Zia; Silberbauer, John; Murgatroyd, Francis

    2014-01-01

    We describe a patient presenting with incessant ectopic atrial tachycardia during a high risk twin pregnancy. Tachycardia was resistant to escalating doses of beta-blockade with digoxin. Because of increasing left ventricular dysfunction early in the third trimester, catheter ablation was performed successfully at 30 weeks gestation. Electro-anatomic mapping permitted the entire procedure to be conducted without the use of ionizing radiation. The pregnancy proceeded to successful delivery near term and after three years the patient remains recurrence free with normal left ventricular function, off all medication.

  13. A case of a surviving co-twin diagnosed with porencephaly and renal hypoplasia after a single intrauterine fetal death at 21 weeks of gestation in a monochorionic monoamniotic twin pregnancy.

    Science.gov (United States)

    Machino, Hidenori; Iriyama, Takayuki; Nakayama, Toshio; Komatsu, Atsushi; Nagamatsu, Takeshi; Osuga, Yutaka; Fujii, Tomoyuki

    2017-01-01

    Monochorionic monoamniotic (MM) twin pregnancy carries a high risk of intrauterine fetal death (IUFD). Single IUFD in an MM twin pregnancy prior to 22 weeks of gestation has been reported to be strongly correlated with double twin demise. To our knowledge, there are no case reports on the natural course of a surviving co-twin in an MM twin pregnancy resulting in live birth after a single IUFD prior to 22 weeks of gestation. Here, we report a case of a surviving co-twin, after a single IUFD at 21 weeks of gestation in a MM twin pregnancy, with an antenatal diagnosis of renal hypoplasia and severe neurological damage leading to porencephaly, and live birth at 36 weeks of gestation.

  14. Coincidence of Incomplete Pentalogy of Cantrell and Meningomyelocele in a Dizygotic Twin Pregnancy

    Science.gov (United States)

    Timur, Hakan; Tokmak, Aytekin; Bayram, Hatice; Şükran Çakar, Esra; Danışman, Nuri

    2015-01-01

    Pentalogy of Cantrell is an extremely rare and lethal syndrome. Ectopia cordis is frequently found in fetuses with POC but not required for incomplete forms. Likewise, meningomyelocele is a relatively uncommon neural tube defect affecting central nervous system and associated with neurological problems. Herein, we presented a woman with dizygotic twin pregnancy having coincidence of incomplete POC and MMC in each individual fetus, which has never been reported previously. PMID:26421202

  15. Coincidence of Incomplete Pentalogy of Cantrell and Meningomyelocele in a Dizygotic Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Hakan Timur

    2015-01-01

    Full Text Available Pentalogy of Cantrell is an extremely rare and lethal syndrome. Ectopia cordis is frequently found in fetuses with POC but not required for incomplete forms. Likewise, meningomyelocele is a relatively uncommon neural tube defect affecting central nervous system and associated with neurological problems. Herein, we presented a woman with dizygotic twin pregnancy having coincidence of incomplete POC and MMC in each individual fetus, which has never been reported previously.

  16. Goldenhar syndrome with right circumflex aortic arch, severe coarctation and vascular ring in a twin pregnancy

    Directory of Open Access Journals (Sweden)

    Elaheh Malakan Rad

    2014-01-01

    Full Text Available Goldenhar syndrome (GS or oculo-auriculo-vertebral dysplasia (OAVD, involves a wide variety of organ systems. Cardiovascular anomalies are among the frequent malformations. The purpose of this report is to introduce a male case of a dizygotic twin pregnancy with GS and right circumflex aortic arch (RCAA, severe coarctation, hypoplastic aortic arch, aberrant right subclavian artery, vascular ring, bilateral renal artery stenosis, and mild Dandy-Walker syndrome. The embryology of RCAA and coarctation is revisited.

  17. Goldenhar syndrome with right circumflex aortic arch, severe coarctation and vascular ring in a twin pregnancy

    OpenAIRE

    Elaheh Malakan Rad

    2014-01-01

    Goldenhar syndrome (GS) or oculo-auriculo-vertebral dysplasia (OAVD), involves a wide variety of organ systems. Cardiovascular anomalies are among the frequent malformations. The purpose of this report is to introduce a male case of a dizygotic twin pregnancy with GS and right circumflex aortic arch (RCAA), severe coarctation, hypoplastic aortic arch, aberrant right subclavian artery, vascular ring, bilateral renal artery stenosis, and mild Dandy-Walker syndrome. The embryology of RCAA and co...

  18. Goldenhar syndrome with right circumflex aortic arch, severe coarctation and vascular ring in a twin pregnancy.

    Science.gov (United States)

    Rad, Elaheh Malakan

    2014-09-01

    Goldenhar syndrome (GS) or oculo-auriculo-vertebral dysplasia (OAVD), involves a wide variety of organ systems. Cardiovascular anomalies are among the frequent malformations. The purpose of this report is to introduce a male case of a dizygotic twin pregnancy with GS and right circumflex aortic arch (RCAA), severe coarctation, hypoplastic aortic arch, aberrant right subclavian artery, vascular ring, bilateral renal artery stenosis, and mild Dandy-Walker syndrome. The embryology of RCAA and coarctation is revisited.

  19. Goldenhar syndrome with right circumflex aortic arch, severe coarctation and vascular ring in a twin pregnancy

    Science.gov (United States)

    Rad, Elaheh Malakan

    2014-01-01

    Goldenhar syndrome (GS) or oculo-auriculo-vertebral dysplasia (OAVD), involves a wide variety of organ systems. Cardiovascular anomalies are among the frequent malformations. The purpose of this report is to introduce a male case of a dizygotic twin pregnancy with GS and right circumflex aortic arch (RCAA), severe coarctation, hypoplastic aortic arch, aberrant right subclavian artery, vascular ring, bilateral renal artery stenosis, and mild Dandy-Walker syndrome. The embryology of RCAA and coarctation is revisited. PMID:25298700

  20. 双胎妊娠的超声监测%Ultrasound Surveillance in Twin Pregnancy

    Institute of Scientific and Technical Information of China (English)

    景柏华; 陈倩

    2014-01-01

    双胎妊娠属于高危妊娠范畴,无论对母亲或者胎儿,都会增加围生期相关疾病的发病率和死亡率。近年来随着双胎妊娠的发生率逐年提高,所带来的一系列临床问题引起越来越多产科医生的重视。因此加强产前监测,对异常胎儿早期诊断、早期处理,可改善妊娠结局、降低母儿相关并发症。产前超声检查可确定双胎类型、胎盘位置、羊膜情况,并有助于胎儿生长发育监测及诊断胎儿畸形和并发症等。合理规范地应用产前超声检查可监测胎儿宫内情况,为临床处理提供依据。%As high risk pregnancy,twin pregnancy increases the morbidity and mortality of maternal-fetal complications. Recently,more and more obstetricians paid attention to the problems caused by the increased incidence of twin pregnancy. Therefore,antenatal surveillance can help to reduce the maternal-fetal complications and improve mother and child outcome through early diagnosis of abnormal fetals. Ultrasound contributes to determination of chorionicity ,amnionicity and placentas, assessment of fetal growth and screening for anomalies in twin pregnancy. Rational prenatal ultrasonography is reliable method for the diagnosis and assessment of twins and provide evidence for clinical treatment.

  1. Asthma affects time to pregnancy and fertility: a register-based twin study.

    Science.gov (United States)

    Gade, Elisabeth J; Thomsen, Simon F; Lindenberg, Svend; Kyvik, Kirsten O; Lieberoth, Sofie; Backer, Vibeke

    2014-04-01

    Coexistence of infertility and asthma has been observed clinically. Therefore, we investigated the association between asthma and delayed pregnancy in a nationwide population-based cohort of twins. A cohort of 15 250 twins living in Denmark (aged 12-41 years) participated in a questionnaire study including questions about the presence of asthma and fertility. Differences in time to pregnancy and pregnancy outcome were analysed in subjects with asthma, allergy and in healthy individuals using multiple regression analysis. Asthma was associated with an increased time to pregnancy, the percentage of asthmatics with a time to pregnancy >1 year was 27% versus 21.6% for non-asthmatics (OR (95% CI) 1.31 (1.1-1.6); p=0.009). The association remained significant after adjustment for age, age at menarche, body mass index and socioeconomic status (OR (95% CI) 1.25 (1.0-1.6); p=0.05), and was more pronounced in those >30 years of age (32.2% versus 24.9%, OR (95% CI) 1.44 (1.1-1.9); p=0.04). Untreated asthmatics had a significant increased risk of prolonged time to pregnancy compared to healthy individuals (OR (95% CI) 1.79 (1.20-2.66); p=0.004), while asthmatics receiving any kind of treatment for asthma tended to have a shorter time to pregnancy than untreated asthmatics (OR 1.40; p=0.134). Asthma prolongs time to pregnancy. The negative effect of asthma on fertility increases with age and with disease intensity, indicating that a systemic disease characterised by systemic inflammation also can involve reproductive processes.

  2. A re-assessment of biochemical marker distributions in T21 affected and unaffected twin pregnancies in the first trimester

    DEFF Research Database (Denmark)

    Madsen, Helen Nordahl; Ball, Susan; Wright, Dave

    2011-01-01

    increased the detection rate for fetal trisomy 21 in dizygotic twin pregnancies from 78 to 90%, and decreased the false-positive rate from 8.0 to 5.9%. CONCLUSION: Generation of chorionicity-specific medians for the biochemical markers and their use in risk assessment can improve the performance of first...... of the biochemical markers were calculated. Detection rates and false-positive rates were estimated for screening tests incorporating nuchal translucency and maternal age, with and without biochemistry. RESULTS: Medians for the two biochemical markers for monochorionic and dichorionic twins in unaffected pregnancies......OBJECTIVE: To estimate the difference between levels of the two biochemical markers pregnancy-associated plasma protein-A (PAPP-A) and maternal serum free β-human chorionic gonadotropin (free β-hCG) in twin pregnancies relative to singleton pregnancies and establish an improved screening procedure...

  3. Twin pregnancy: the impact of the Higgins Nutrition Intervention Program on maternal and neonatal outcomes.

    LENUS (Irish Health Repository)

    Dubois, S

    1991-06-01

    Perinatal outcomes were compared between 354 twins treated with the Higgins Nutrition Intervention Program and 686 untreated twins. After differing distributions of key confounding variables were adjusted for, the twins in the intervention group weighed an average of 80 g more (P less than 0.06) than the nonintervention twins; their low-birth-weight rate was 25% lower (P less than 0.05) and their very-low-birth-weight rate was almost 50% lower (P less than 0.05). Although the rate of preterm delivery was 30% lower in the intervention group (P less than 0.05), the rates of intrauterine growth retardation were similar in the two groups. Fetal mortality was slightly higher (14 vs 12 per 1000, NS), but early neonatal mortality was fivefold lower (3 vs 19 per 1000, P less than 0.06) in the intervention group. Maternal morbidity was significantly lower (P less than 0.05) in the intervention group. There was a trend towards lower infant morbidity in the intervention group. These results suggest that nutritional intervention can significantly improve twin-pregnancy outcome.

  4. Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

    Science.gov (United States)

    Yuan, Ting; Wang, Wei; Li, Xue-Lan; Li, Chun-Fang; Li, Chao; Gou, Wen-Li; Han, Zhen

    2016-01-01

    Abstract The aim of our study was to compare the clinical characteristics of fetal and neonatal outcomes in twin pregnancies between women with preeclampsia (PE) and those with normotension in a Chinese population. There were 143 preeclamptic women and 367 normotensive women with twin pregnancies included in this retrospective case–control study. The baseline characteristics and perinatal outcomes were collected and compared between the groups. Multiple logistic regression and linear regression were used to assess the correlations between PE and the outcomes. Significant increases were observed in the frequencies of preterm delivery (OR = 2.75, P < 0.001), iatrogenic preterm birth (OR = 3.52, P < 0.001), and IUGR (OR = 2.94, P = 0.001) in the PE group, and the PE group had more than a 2-fold risk of adverse neonatal outcomes. Preeclamptic twin neonates had lower birth weights (β = −147.34, P = 0.005; β = −169.47, P = 0.001). The comparison on the discordance of intertwin weight was not significantly different. Twin pregnancies with PE are associated with worse perinatal outcomes. The adverse outcomes of preeclamptic twin pregnancies may be associated with lower birth weights rather than the discordance of the intertwin weight, which requires further confirmation. The results may provide helpful references for better clinical assessments, evaluations of prognosis, and a deeper understanding of preeclamptic twin pregnancies. PMID:27787375

  5. First trimester risk assessment for trisomy 21 in twin pregnancies combining nuchal translucency and first trimester biochemical markers.

    Science.gov (United States)

    Prats, Pilar; Rodríguez, Ignacio; Comas, Carmina; Puerto, Bienvenido

    2012-10-01

    The aim is to describe the performance of first-trimester combined risk assessment in twin pregnancies. Maternal serum free beta-human chorionic gonadotrophin and pregnancy-associated plasma protein A (PAPP-A) were determined at 8 to 12 weeks and fetal nuchal translucency (NT) was measured at 11 to 13+6 weeks. The individual risk was estimated for each fetus using the combined test in dichorionic twins. In monochorionic twins, the mean risk assessment of the two fetuses was used. An invasive diagnostic procedure was offered when the risk was ≥ 1 : 270 in either one of the fetuses. From February 2007 to June 2011, 447 twin pregnancies were enrolled in this study. There were 402 (89.9%) dichorionic and 45 (10.1%) monochorionic twins. In dichorionic twins, mean crown-rump length (CRL) was 63.9 mm; median NT multiples of the median (MoM) was 0.97; median Β-hCG was MoM 1.74; median PAPP-A was 1.72. In monochorionic twins, mean CRL was 61.9 mm; median NT MoM was 0. 98; median Β-hCG MoM was 1.44; and median PAPP-A was 1.51. Two pregnancies with Down syndrome were detected by first trimester screening, both in dichorionic twins. The false positive rate was 5.7% (95% confidence interval 4.1-7.3) and 4.4% (95% confidence interval 0.1-8.8%) in dichorionic and monochorionic twins, respectively. The combined test in twins appears to be a good method for Down syndrome screening with a high detection rate and an acceptable false-positive rate. © 2012 John Wiley & Sons, Ltd.

  6. Prospective risk of fetal death in uncomplicated monochorionic twins.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-03-01

    A retrospective cohort study was carried out in a university teaching hospital to determine the prospective risk of unexpected fetal death in uncomplicated monochorionic diamniotic (MCDA) twin pregnancies after viability. All MCDA twins delivered at or after 24 weeks\\' gestation from July 1999 to July 2007 were included. Pregnancies with twin-twin transfusion syndrome, growth restriction, structural abnormalities, or twin reversed arterial perfusion sequence were excluded. Of the 144 MCDA twin pregnancies included in our analysis, the risk of intrauterine death was 4.9%. The prospective risk of unexpected intrauterine death was 1 in 43 after 32 weeks\\' gestation and 1 in 37 after 34 weeks\\' gestation. Our results demonstrate that despite close surveillance, the unexpected intrauterine death rate in uncomplicated MCDA twin pregnancies is high. This rate seems to increase after 34 weeks\\' gestation, suggesting that a policy of elective preterm delivery warrants evaluation.

  7. Pregnancy outcomes of twin pregnancies complicated with growth discordance%双胎妊娠胎儿发育不均衡的妊娠结局

    Institute of Scientific and Technical Information of China (English)

    赫英东; 李雨利; 陈倩

    2014-01-01

    目的 探讨双胎妊娠胎儿发育不均衡的临床特点及预后.方法 回顾性分析2000年1月1日至2012年7月31日在北京大学第一医院产科分娩的576例双胎妊娠孕妇(除外双胎输血综合征病例)资料.根据胎儿腹围以及股骨长估计胎儿体重,分娩后记录新生儿出生体重,根据公式[(较大儿体重-较小儿体重)/较大儿体重×100%]计算双胎体重的差异,体重差异≥25%考虑存在胎儿发育不均衡,<25%为胎儿发育均衡.分析双胎妊娠胎儿发育不均衡的发生率;比较胎儿发育不均衡者(不均衡组,68例)与胎儿发育均衡者(均衡组,508例)的母体并发症(子痫前期、胎膜早破、妊娠期糖尿病、产后出血等)发生率、早产率、围产儿病死率、新生儿出生体重和新生儿合并症(心血管系统疾病和颅内病变)发生率.统计学分析采用t检验或卡方检验. 结果 576例双胎妊娠中,胎儿发育不均衡总体发生率为11.8%(68/576).单绒毛膜双胎胎儿发育不均衡发生率[17.6%(40/227)]高于双绒毛膜双胎[8.0%(28/349)],差异有统计学意义(x2=11.40,P<0.05).胎儿发育不均衡组分娩孕周小于均衡组[(35.6±4.1)周与(36.6±3.2)周,t=1.66,P<0.05],早产率高于均衡组[58.8%(40/68)与47.6% (242/508),x2=3.85,P<0.05].不均衡组围产儿病死率高于均衡组[9.6%(1 3/136)与4.7% (48/1 016),x2=5.84,P<0.05].胎儿发育不均衡者中,单绒毛膜双胎妊娠新生儿颅内病变的发生率明显高于双绒毛膜双胎组[20.9%(14/67)与6.8%(3/44),x2=4.06,P<0.05].结论 双胎妊娠胎儿发育不均衡孕妇较易发生不良妊娠结局.应加强产前保健,并及时评估胎儿的宫内状况,分娩后建议对新生儿进行全面检查并长期随访.%Objective To investigate clinical characteristics and outcomes of twin pregnancies complicated with growth discordance.Methods Five hundred and seventy-six twin pregnancies who delivered between January 1

  8. Twin Pregnancy in a Woman with Uterus Didelphys

    Directory of Open Access Journals (Sweden)

    Sohini Bhattacharya,

    2011-01-01

    Full Text Available Uterus didelphys is one of the congenital uterine anomalies due to defective medial fusion of mullerian ducts. This anomaly is known to have poor reproductive outcome and women with this condition often have to be treated for infertility. Multiple gestation is rare with this condition. An 18 years old primigravida presenting with threatened abortion at eight weeks, was found to have uterus didelphys. She was managed conservatively, aborted one of the fetuses at 16weeks of gestation, and went till term to deliver a healthy baby by cesarean section.

  9. Twin Pregnancy with Hydatidiform Mole and Coexisting Fetus: Report of Three Cases and Review of Literature

    Directory of Open Access Journals (Sweden)

    Fariba Yarandi

    2009-03-01

    Full Text Available A twin pregnancy with a coexisting complete hydatidiform mole and a healthy fetus (CMCF is rare. Here we report three cases of CMCF with different clinical courses but similar outcome without a surviving neonate. Two women required uterine evacuation before 20 weeks of gestational age because of vaginal bleeding and medical complications and the other patient underwent termination of her pregnancy at 24 weeks of gestation due to severe pre-eclampsia. The pathologic diagnosis of complete hydatidiform mole was confirmed in each case and the chromosome complement was 46XX in two molar gestations and 46XY in one gestation. One of the three women required chemotherapy for treatment of low-risk gestational trophoblastic disease. The hCG level was normalized after 4 cycles and the patient was free of disease at 1 year follow-up. Review of the literature discussing the diagnostic tools, clinical features, management and outcome of pregnancies with CMCF are presented.

  10. [Selective termination of pregnancy for monochorionic twins: a national survey of professional practice].

    Science.gov (United States)

    Arlicot, C; Potin, J; Simon, E; Perrotin, F

    2014-06-01

    Selective Termination of Pregnancy (STOP) for discordant fetal condition in monochorionic twin pregnancy is a rarely performed procedure raising technical and ethical considerations. There are no epidemiological data available in France concerning STOP and no guideline or scientific consensus on how or when to perform has been published. We conducted a study of national practice using a declarative questionnaire sent by e-mail to each medical coordinator of every 48 Multidisciplinary Center for Prenatal Diagnosis in France. The questions focused on the issues of 2010 and 2011. Two reminders were sent in case of no answer. The response rate to the questionnaire was 56 %; 81 % of centers have experienced at least once during the two years 2010-2011 a discordant fetal anomaly in monochorionic twin pregnancy. Only 59 % of centers perform all the techniques of STOP. When interruption of the umbilical blood flow is considered, bipolar forceps coagulation is the most used (75 %). Achieving STOP during a cesarean section is a common practice (75 % of centers). Locoregional anesthesia is the preferred mode of anesthesia for STOP. STOP on monochorionic twin pregnancy is not practiced in all Multidisciplinary Center for Prenatal Diagnosis in France. The most widely practiced and most studied technique is bipolar forceps coagulation. The option of an expectant management should always be considered and its risks should be balanced with those of STOP. The practice of STOP during cesarean section is not unusual. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Fetal cardiac activity analysis during twin pregnancy using a multi-channel SQUID system

    Science.gov (United States)

    Costa Monteiro, E.; Schleussner, E.; Kausch, S.; Grimm, B.; Schneider, A.; Hall Barbosa, C.; Haueisen, J.

    2001-05-01

    The use of SQUID magnetometers for non-invasive in utero assessment of cardiac electrical disturbances has already been shown to be a valuable clinical tool. In this way, its applicability also for the complicated case of twin pregnancy, in which the proximity of the cardiac magnetic source of each fetus can hamper the individual analysis of cardiac electrical activity, is of clinical interest. In this paper, we present fetal magnetocardiography performed on a mother pregnant of twins with 26 weeks gestational age, measured inside a magnetically shielded room, by using two identical 31-channel low- Tc SQUID magnetometer systems. Each sensor array has been positioned over one of the fetuses, according to its heart position previously assessed with the aid of ultrasound measurements. The raw data is initially averaged in time and, afterwards, analyzed by means of time plots and isofield maps. The time recordings allow the study of the morphology of each fetus’ cardiac signal and the cardiac time intervals. The resultant equivalent dipole obtained from the isofield maps indicates the position and orientation of each fetus heart. The results agree with the ultrasound analysis performed immediately before the measurements and used to obtain the approximate location of the fetuses’ hearts. Since a distinct analysis of the cardiac electrical activity of each fetus could be achieved, the results indicate the potential of the fetal magnetocardiography in the individual antenatal diagnosis of each one of the fetuses of a twin pregnancy.

  12. Fetal abnormalities leading to termination of twin pregnancies: the 17-year experience of a single medical center.

    Science.gov (United States)

    Melcer, Yaakov; Svirsky, Ran; Vaknin, Zvi; Levinsohn-Tavor, Orna; Feldman, Noa; Maymon, Ron

    2017-02-01

    To assess fetal abnormalities leading to termination of pregnancy (TOP) performed in twin pregnancies. The current study consisted of all women with dichorionic twin pregnancies (study group) who underwent TOP due to fetal abnormalities in our institute from 1999 to 2015. The data were compared to our registry of all parturient women with a singleton pregnancy (control group) that underwent TOP due to fetal anomalies at the same period. There were 2495 cases of TOP because of fetal indications during the study period. Of them, 86 (3.4%) and 2409 (96.6%) were from the study and control group, respectively. Structural anomalies were the leading indication for TOP in twins compared with singleton pregnancies (81.4% versus 50.9%, respectively, p leading indication for TOP was central nervous system (CNS) abnormalities and it was more common compared with singleton pregnancies (26.1% versus 12.2%, respectively, p leading to TOP in twins versus singleton pregnancies. The main indication for TOP in the study group was structural malformations, with a predominance of CNS abnormalities.

  13. A successful twin pregnancy in a patient with HbE-β-thalassemia in western India.

    Science.gov (United States)

    Merchant, R; Italia, K; Ahmed, J; Ghosh, K; Colah, R B

    2015-01-01

    Improvements in medical facilities have helped a large number of clinically severe hemoglobin E (HbE)-β-thalassemia patients reach adulthood. Consequently, there is a new challenge, that of managing women with HbE-β-thalassemia during pregnancy. In particular, they have a high risk of abortion, preterm delivery, intrauterine growth restriction, and thromboembolism. A 27-year-old HbE-β-thalassemia patient on regular transfusion, who was splenectomized and heptatitis C (HCV)-positive, conceived for the first time without any infertility treatment. However, there was incomplete abortion with heavy bleeding at 3 months of gestation, which required bilateral uterine artery angiography. The angiogram showed the left uterine artery to be moderately hypertrophied. This was embolized with 300-500 micron polyvinyl alcohol (PVA) to stop the bleeding. Soon after, she conceived again with a twin pregnancy, and at 33.3 weeks of gestation, there was a normal delivery of twin girls without any postpartum hemorrhage or perineal tear. Both babies were given prematurity care. The mother and children were both normal up till the last follow-up 18 months after delivery, and both the girls are HbE heterozygous. Thorough monitoring of endocrine functions along with proper management of transfusions and iron overload can help in reducing the complications related to pregnancy in these patients.

  14. Cervical conization doubles the risk of preterm and very preterm birth in assisted reproductive technology twin pregnancies

    DEFF Research Database (Denmark)

    Pinborg, A; Ortoft, G; Loft, A

    2015-01-01

    and cervical conization are both risk factors for PTB. STUDY DESIGN, SIZE, DURATION: In this national population-based controlled cohort study, we included all ART singletons and twin deliveries from 1995 to 2009 in Denmark by cross-linkage of maternal and child data from the National IVF register......STUDY QUESTION: Does cervical conization add an additional risk of preterm birth (PTB) in assisted reproduction technology (ART) singleton and twin pregnancies? SUMMARY ANSWER: Cervical conization doubles the risk of preterm and very PTB in ART twin pregnancies. WHAT IS KNOWN ALREADY: ART......, respectively, with an aOR 1.94 (95% CI 1.36-2.77), and the risk of VPTB was also doubled. Furthermore, previous dysplasia (without conization) increased the risk of VPTB in ART twins (aOR 1.74, 95% CI 1.04-2.94). Cervical dysplasia did not increase the risk of any of the other adverse outcomes in ART...

  15. Successful term delivery of spontaneous twin pregnancy in a woman with bicorporeal septate uterus: A case report.

    Science.gov (United States)

    Li, Yanfang; Yang, Lilin; Tian, Yuanyuan; Li, Daocheng; Luo, Songping

    2016-08-01

    Herein, we report the first case of successful term delivery of twins in a patient with bicorporeal septate uterus via natural conception. The patient had been diagnosed with complete septate, didelphys and bicornuate uterus during different phases of her three pregnancies. Based on follow-up data at six weeks and then six months post-partum of the last pregnancy, we found that the abnormalities presented in our case did not fit the criteria of any categories following American Fertility Society and European Society of Human Reproduction and Embryology-European Society for Gynaecological Endoscopy classification systems. After comprehensive review of the uterine morphologic characteristics, embryology and pregnancy outcome, we considered 'bicorporeal septate uterus' the most appropriate diagnosis. This case emphasized the atypical changes of uterine shape as twin pregnancy advances and its influence on productive performance and pregnancy outcome in uterine malformation. It also raised concern regarding the usability and comprehensiveness of the two most popular classification systems.

  16. Chorioamniotic membrane separation after fetoscopy in monochorionic twin pregnancy: incidence and impact on perinatal outcome.

    Science.gov (United States)

    Ortiz, J U; Eixarch, E; Peguero, A; Lobmaier, S M; Bennasar, M; Martinez, J M; Gratacós, E

    2016-03-01

    To evaluate the incidence of chorioamniotic membrane separation (CMS) after fetoscopy in monochorionic diamniotic (MCDA) twins and its impact on pregnancy outcome. The study group comprised a consecutive series of 338 women with an MCDA pregnancy complicated by twin-twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR) treated with selective laser photocoagulation of communicating vessels (SLPCV) or cord occlusion (CO). Data obtained included cervical length, gestational age at procedure, type and duration of surgery and placental location. The incidence of CMS, the rates of miscarriage and preterm prelabor rupture of membranes (PPROM), gestational age at delivery and neonatal survival were recorded. Of the study population of MCDA pregnancies, 270 (79.9%) had TTTS and 68 (20.1%) had sIUGR. SLPCV was performed in 252 (74.6%) cases and CO in 86 (25.4%). Postoperative CMS was observed in 70 (20.7%) cases. Patients with CMS had higher rates of miscarriage (14.3% vs 7.1%; P = 0.049), PPROM before 32 weeks (43.3% vs 13.7%; P < 0.001) and preterm delivery before 32 weeks (53.3% vs 26.1%; P < 0.001) and a lower rate of neonatal survival of at least one twin (81.7% vs 93.6%; P = 0.003). Multivariate analysis showed that gestational age at surgery was the only independent predictor, with the highest proportion of CMS occurring in cases that underwent surgery before 18 weeks' gestation (odds ratio, 2.941 (95% CI, 1.640-5.275); P < 0.001). There was no influence of cervical length, placental location, duration of surgery or type of surgery on the risk of CMS. CMS complicated one-fifth of all MCDA pregnancies that underwent fetoscopy. It appeared to be more common in those who underwent surgery before 18 weeks' gestation and was associated with poorer outcomes. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  17. Cloacal dysgenesis sequence with bilateral renal agenesis and normal pulmonary development in twin pregnancy.

    Science.gov (United States)

    Jegadeesh, Sundram; Mahajan, Jai Kumar

    2016-01-20

    Cloacal dysgenesis sequence (CDS) is a rare congenital anomaly. It is characterised by a smooth perineum with absence of anal and genitourinary orifices, with reported incidence of 1:50,000-250,000 births. Association with bilateral renal agenesis is still rarer and resultant severe oligohydramnios is associated with pulmonary hypoplasia. Only a few cases of CDS with bilateral renal agenesis have been reported in the English language literature, with associated pulmonary hypoplasia as a default phenomenon. We report a case of CDS and bilateral renal agenesis without associated pulmonary hypoplasia in a twin pregnancy, which, to the best of our knowledge, is the second reported case of this amalgamation.

  18. [Twin pregnancy with complete hydatiform mole and coexistent fetus: Report of 4 cases and review of literature].

    Science.gov (United States)

    de Marcillac, F; Akladios, C Y; Hui-bon-hoa, I; Fritz, G; Nisand, I; Langer, B

    2015-11-01

    Twin pregnancy with complete hydatiform mole and coexistent fetus is a rare clinical condition, occurring in 1 in 22,000 to one in 100,000 pregnancies. Continuation of pregnancy in these cases is controversial because of a high risk of immediate and long-term maternal morbidity. It allows, however, in 33 % of the case the delivery of a healthy child. This retrospective study included all patients presenting a complete hydatiform mole coexisting with a live twin fetus antenatally diagnosed between 2007 and 2012 in the level III maternity of the Strasbourg University Hospital. Informations concerning diagnostic circumstances, pregnancy follow-up and outcome were studied. Four pregnancies were included in the study, all of them were spontaneous. Medical termination of pregnancies was related to maternal reasons in the four cases. One before 17 weeks of gestation, the three other after 2 weeks of gestation, leading to delivery of a healthy child. All patients developed a mild to severe preeclampsia. One patient developed a gestational trophoblastic disease, requiring chemotherapy by methotrexate. There was no fatal evolution. Twin pregnancy with complete hydatifom mole and coexistent fetus is associated with increased risk of gestational trophoblastic disease. This risk is not increased by continuation of pregnancy. In case of prenatal diagnosis of complete hydatiform mole coexisting with a live twin fetus, patients should be aware of the potential high risk of morbidity and a regular follow-up during and after the pregnancy should be intaured. In absence of maternal complications, continuation of the pregnancy is possible. Copyright © 2015. Published by Elsevier Masson SAS.

  19. The association between Placental T2* measured by MRI in dichorionic twin pregnancies and intertwin birth weight differences

    DEFF Research Database (Denmark)

    Sørensen, Anne Nødgaard Weidemann; Sinding, Marianne Munk; Peters, David Alberg;

    ABSTRACT FINAL ID: P22.06 TITLE: The association between Placental T2* measured by MRI in dichorionic twin pregnancies and intertwin birth weight differences AUTHORS (FIRST NAME, LAST NAME): Anne Sørensen1, 2, Marianne Sinding1, David Peters3, Jens B. Frøkjær4, 2, Astrid Petersen6, Niels Uldbjerg5...... the association between the intertwin placental T2* difference and the intertwin birth weight difference Methods: A total of 21 dichorionic twin pregnancies (gestational age 20.1 – 34.1 weeks) were included in this study and placental T2* was measured using a gradient recalled echo MRI sequence with readout at 16......: Intertwin placental T2* difference is strongly related to intertwin birthweight difference, even when performed several weeks before birth. Placental T2* might be a future method to predict intertwin birthweight difference in dichorionic twin pregnancies. Further studies should be performed in order...

  20. Uterine rupture in twin pregnancy with normal fetus and complete hydatidiform mole.

    Science.gov (United States)

    Sánchez-Ferrer, María Luisa; Hernández-Martínez, Florentina; Machado-Linde, Francisco; Ferri, Belén; Carbonel, Pablo; Nieto-Diaz, Anibal

    2014-01-01

    We describe a rare case of complete hydatidiform mole with twin live fetus (CHMTF) confirmed by histopathology, flow cytometry and polymerase chain reaction techniques. No malformations were observed, fetal karyotype was normal and β-human chorionic gonadotropin levels were high (>100,000 IU/ml). The patient was informed of the risks and decided to continue with the pregnancy, but at week 15, she had to undergo hysterectomy due to uterine rupture. She subsequently developed persistent trophoblastic disease (PTD) with pulmonary metastases that required treatment with polychemotherapy. Patients with CHMTF should be informed of all known risks, including the considerable risk of PTD, which is similar to or, even higher than that associated with a singleton complete mole. The risk does not appear to be increased by continuing the pregnancy. Because so few series have been published, there is a lack of evidence-based clinical management guidelines. To our knowledge, this is the first report of uterine rupture in CHMTF.

  1. Pregnancy in a Previously Conjoined Thoracopagus Twin with a Crisscross Heart

    Directory of Open Access Journals (Sweden)

    Bassam H. Rimawi

    2015-01-01

    Full Text Available Background. Crisscross heart (CCH is a complex, rare, congenital, rotational, cardiac abnormality that accounts for <0.1% of congenital heart defects (CHD. CCH is characterized by the crossing of the inflow streams of the two ventricles due to an abnormal twisting of the heart. A case of maternal CCH has not been previously reported. Case. We report a case of a primigravida with a CCH, who was separated at birth from her thoracopagus conjoined twin. Pregnancy was managed by congenital cardiology, maternal-fetal medicine, anesthesiology, and obstetrics. She underwent a 39-week vaginal delivery without maternal or neonatal complication. Conclusion. A successful term pregnancy outcome was achieved in a patient with CCH using a multidisciplinary approach to address her cardiac condition.

  2. Serum concentrations of secretory IgA in pregnancies delivering at term or preterm.

    Science.gov (United States)

    Wilson, T; Ganendren, R

    1992-10-01

    Secretory component (SC) is a phospholipase A2 inhibitor possibly associated with pregnancy maintenance and in serum is bound either to IgA (sIgA) or IgM (sIgM). To determine if serum secretory component levels a) increase during pregnancy, b) fall as term approaches, c) are low in women who will deliver prematurely, serum sIgA was measured at "booking in" and related to weeks of gestation and length of gestation at subsequent noninduced delivery. Levels of sIgA increased during pregnancy; sIgA increased from a non-pregnant value of 1.6 nM +/- 0.2 (mean +/- SEM) to 2.8 nM +/- 0.3 at the end of the second trimester, then fell significantly between 31-34 weeks. Delivery before 37 weeks was associated with significantly reduced serum sIgA levels, particularly in women who delivered before 32 weeks and in whom sIgA concentrations were similar to those of nonpregnant women.

  3. Progestogens to prevent preterm birth in twin pregnancies: an individual participant data meta-analysis of randomized trials

    Directory of Open Access Journals (Sweden)

    Schuit Ewoud

    2012-03-01

    Full Text Available Abstract Background Preterm birth is the principal factor contributing to adverse outcomes in multiple pregnancies. Randomized controlled trials of progestogens to prevent preterm birth in twin pregnancies have shown no clear benefits. However, individual studies have not had sufficient power to evaluate potential benefits in women at particular high risk of early delivery (for example, women with a previous preterm birth or short cervix or to determine adverse effects for rare outcomes such as intrauterine death. Methods/design We propose an individual participant data meta-analysis of high quality randomized, double-blind, placebo-controlled trials of progestogen treatment in women with a twin pregnancy. The primary outcome will be adverse perinatal outcome (a composite measure of perinatal mortality and significant neonatal morbidity. Missing data will be imputed within each original study, before data of the individual studies are pooled. The effects of 17-hydroxyprogesterone caproate or vaginal progesterone treatment in women with twin pregnancies will be estimated by means of a random effects log-binomial model. Analyses will be adjusted for variables used in stratified randomization as appropriate. Pre-specified subgroup analysis will be performed to explore the effect of progestogen treatment in high-risk groups. Discussion Combining individual patient data from different randomized trials has potential to provide valuable, clinically useful information regarding the benefits and potential harms of progestogens in women with twin pregnancy overall and in relevant subgroups.

  4. Analysis of Clinical Data of 177 Patients with Preterm Twin Pregnancies%双胎妊娠早产177例临床分析

    Institute of Scientific and Technical Information of China (English)

    吴芹; 杨茵; 邱娜璇

    2011-01-01

    Objective To investigate the cause and delivery time and mode of preterm twin preg nancies. Methods Clinical data of twin pregnancies delivered in this hospital from 2000 to 2009 were col lected and analyzed, including 177 preterm twins and 208 term twins. Results Spontaneous preterm birth accounted for the most proportion of all preterm twins, Iatrogenic preterm birth was the second a mong the late preterm twins(P<0. 05) ;There was significant difference in both caesarean and vaginal de livery rates of twin pregnancy at different gestational age(P<0.05); The incidence of single intrauterine demise, discordant fetal growth and small for gestational age showed statistical difference among three groups; The lower Apgar score rates and mortality rates in twins decreased with the increase of gestational age. Conclusion Spontaneous preterm birth is the main cause of preterm delivery in twins. The deliv ery mode of twins should be considered comprehensively. Selection of appropriate delivery gestations is thne important measures to improve the neonatal outcomes.%目的 探讨双胎妊娠早产的病因、终止妊娠的方式和时机.方法 对2000年1月-2009年12月双胎妊娠病例资料进行回顾性分析.双胎早产共177例,其中早期早产组(A组)72例,晚期早产组(B组)105例;选择双胎足月产208例为对照组(C组).结果 双胎早产发生原因以自发性早产为首位,晚期早产中医源性早产比率高于早期早产组,差别有统计学意义(P<0.05);双胎妊娠剖宫产率及阴道分娩率在不同孕周组间差异有统计学意义(P<0.05);3组一胎宫内死胎率、生长不一致率和小于孕龄儿率均不同,差别有统计学意义(P<0.05);随着分娩孕周的增加,双胎儿低Apgar评分率及死亡率下降.结论 双胎早产的主要原因为自发性早产;其分娩方式应综合决定.为改善围产儿结局,应选择适宜的分娩孕周.

  5. Computer-Delivered Screening and Brief Intervention for Alcohol Use in Pregnancy: A Pilot Randomized Trial

    Science.gov (United States)

    Ondersma, Steven J.; Beatty, Jessica R.; Svikis, Dace S.; Strickler, Ronald C.; Tzilos, Golfo K.; Chang, Grace; Divine, W.; Taylor, Andrew R.; Sokol, Robert J.

    2015-01-01

    Background Although screening and brief intervention (SBI) for unhealthy alcohol use has demonstrated efficacy in some trials, its implementation has been limited. Technology-delivered approaches are a promising alternative, particularly during pregnancy when the importance of alcohol use is amplified. The present trial evaluated the feasibility and acceptability of an interactive, empathic, video-enhanced, and computer-delivered SBI (e-SBI) plus three separate tailored mailings, and estimated intervention effects. Methods We recruited 48 pregnant women who screened positive for alcohol risk at an urban prenatal care clinic. Participants were randomly assigned to the e-SBI plus mailings or to a control session on infant nutrition, and were reevaluated during their postpartum hospitalization. The primary outcome was 90-day period-prevalence abstinence as measured by timeline follow-back interview. Results Participants rated the intervention as easy to use and helpful (4.7-5.0 on a 5-point scale). Blinded follow-up evaluation at childbirth revealed medium-size intervention effects on 90-day period prevalence abstinence (OR = 3.4); similarly, intervention effects on a combined healthy pregnancy outcome variable (live birth, normal birthweight, and no NICU stay) were also of moderate magnitude in favor of e-SBI participants (OR=3.3). As expected in this intentionally under-powered pilot trial, these effects were non-significant (p = .19 and .09, respectively). Conclusions This pilot trial demonstrated the acceptability and preliminary efficacy of a computer-delivered screening and brief intervention (e-SBI) plus tailored mailings for alcohol use in pregnancy. These findings mirror the promising results of other trials using a similar approach, and should be confirmed in a fully-powered trial. PMID:26010235

  6. To Explore the Clinical Features of Twin Pregnancy%双胎妊娠的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    马智慧

    2015-01-01

    ObjectiveTo investigate the clinical characteristics and treatment of twin pregnancy.MethodsThe twin pregnancy in the maternity department of our hospital were selected in this study. The clinical features, complications and treatment were analyzed in gestation period and the stage of labor.Results In the 30 patients of twin pregnancies, 10 cases received vaginal delivery, 20 cases received cesarean section, without the death of perinatal infants.Conclusion The incidence of complication for the twin pregnancy is high in gestation period and the stage of labor, with high incidence of premature delivery, low birth weight and children with birth defect which increase the perinatal mortality. So twin pregnancy is high-risk pregnancy.%目的:探讨双胎妊娠的临床特点与处理。方法选取我院的30例双胎妊娠产妇,对妊娠期与分娩期的临床特点、并发症及处理方法进行分析。结果双胎妊娠患者30例,阴道分娩10例,剖宫产20例,无围生儿死亡。结论双胎妊娠孕期及分娩期并发症多,早产率、低体重儿、畸形儿发生率高,使围产儿死亡率增加,为高危妊娠范畴。

  7. Profile of peroxidative injury and antioxidant indicators in singleton, twins and multiple bearing goats throughout pregnancy

    Institute of Scientific and Technical Information of China (English)

    Abdel-Ghani MA; T.M. El-sherry TM; Hayder M; Abou-Khalil NS

    2016-01-01

    Objective:To investigate the changes in profile of the oxidant and antioxidant indicators throughout pregnancy in goats.Methods: Estrus in goats was synchronized using an intravaginal progestogen impregnated sponge and the buck was introduced in the herd during the experiment for breeding purpose. Serum nitric oxide (NO) as standard angiogenic marker, total antioxidant capacity (TAC) as a cryoprotectant indicator, total peroxide (TPX) as a pathogenetic effector were measured, followed by calculation of OSI% (TPX/TAC)×100 as a reflector of the oxidant/antioxidant status, andmalondialdhyde were estimated.Results:Compared with values in singleton and twins bearing goats, TAC values in multiple bearing goats were higher in 4thmonth and lower in 5th month (P<0.05). Values of TPX were lower in multiple bearing goats in 4th month and higher in 5th month (P<0.05) when compared with singleton and twins bearing goats.In contrary, NO values started to increase from the 2nd month until 4th month of gestation in all pregnant goats. However, the NO was lower in 5th month (P<0.05) in multiple bearing goats.Values of NO were negatively correlated with OSI % in allbearing goats.Conclusion: Knowing the relationship between the fetal number and oxidative stress indicators could be useful in the clinical management of such pregnancies and could be useful in the early detection or prediction adverse pregnancy outcome. Particularly, the 4th and 5th month of gestation increases the liability to reactive oxygen species in goats.

  8. Fatal alloimmune thrombocytopenia due to anti-HLA alloimmunization in a twin pregnancy: A very infrequent complication of assisted reproduction.

    Science.gov (United States)

    Meler, Eva; Porta, Roser; Canals, Carme; Serra, Bernat; Lozano, Miguel

    2016-11-02

    The most frequently involved antigen in severe fetal and neonatal alloimmune thrombocytopenia (FNAIT) is the human platelet antigen 1a. Platelets express the HLA-A and B antigens on their membrane and some studies report that maternal anti-HLA class I antibody can also cause FNAIT. We report here a very unusual case of a first twin pregnancy produced in vitro by oocyte and semen donation where the mother developed markedly elevated HLA antibodies, in the absence of anti-platelet or anti-neutrophil antibodies, that provoked in one of the twins a profound thrombocytopenia and intracranial hemorrhage and a mild thrombocytopenia and neutropenia in the second twin lasting until the fourth month of life. In addition, anti-D alloimmunization provoked hemolytic disease of the newborn with intrauterus anemia detected in the first twin and post-natal anemia in the second twin that required red blood cell transfusion and phototherapy. We hypothesize that the complete HLA-incompatible twin pregnancy due to the oocyte donation might have contributed to the severity of the clinical manifestations.

  9. Twin-to-twin delivery time: neonatal outcome of the second twin.

    Science.gov (United States)

    Schneuber, Susanne; Magnet, Eva; Haas, Josef; Giuliani, Albrecht; Freidl, Thomas; Lang, Uwe; Bjelic-Radisic, Vesna

    2011-12-01

    To examine the effect of twin-to-twin delivery time (TTDT) on neonatal outcome. We evaluated twin deliveries >34 weeks of gestation. Twin pregnancies with both twins delivered by cesarean section and pregnancies with antenatal complications were excluded. We analyzed TTDT and neonatal outcomes of the second twin (umbilical arterial pH value (pH(art)), Apgar scores at 1, 5 and 10 minutes, need for intensive care). The study population was divided into two homogenous groups based on the mode of delivery: (A) vertex presentation and vaginal delivery of both twins, (B) vertex presentation and vaginal or vaginal operative delivery of twin I, breech or transverse presentation and vaginal breech delivery or cesarean section (CS) of twin II. A total of 207 twin pairs were included in our study. In Group A (n = 151) there were no significant correlations between TTDT and pH(art) or Apgar scores at 1,5 and 10 minutes of twin II (p = .156; 0.861; 0.151 and 0.384, respectively). In Group B (n = 56), the mean pH(art) of twin II was inversely correlated to TTDT, but not significantly (p = .417). TTDT was inversely related to 1-min and 5-min Apgar scores, but not significantly (p = .330; p = .138, respectively). The 10-min Apgar score showed no correlation with TTDT (p = .638). Increasing TTDT was not associated with adverse fetal outcome. Expectant management of the second twin appears possible and elapsed time alone does not appear to be an indication for intervention.

  10. The impact of loop electrosurgical excision procedure (LEEP) for CIN 2,3 on spontaneous preterm delivery in twin pregnancies by assisted reproductive technique: preliminary data.

    Science.gov (United States)

    Ciavattini, Andrea; Stortoni, Piergiorgio; Mancioli, Francesca; Puglia, Danila; Tranquilli, Andrea Luigi; Liverani, Carlo Antonio

    2014-07-01

    The objective of this study was to compare the frequency of spontaneous preterm delivery before 35 weeks in 7 dichorionic twin pregnancies obtained after loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 2,3 with respect to 21 twin pregnancies without previous cervical treatment. All the pregnancies were obtained after assisted reproduction techniques (ART). Same age at delivery was observed between two groups (p = 0.81) and none of our twin pregnancies after LEEP had a threatened preterm labor while four controls (19%) underwent a spontaneous preterm delivery (p = 0.35). These preliminary data seem to indicate that LEEP may not be responsible of spontaneous preterm delivery in twin pregnancies subsequent to ART.

  11. Serum levels of N-terminal fragment of precursor protein brain-type natriuretic peptide (NT-proBNP) in twin pregnancy.

    Science.gov (United States)

    Yamada, Takashi; Koyama, Takahiro; Furuta, Itsuko; Takeda, Masamitsu; Nishida, Ryutaro; Yamada, Takahiro; Morikawa, Mamoru; Minakami, Hisanori

    2013-01-16

    Twin pregnancy differs considerably from singleton pregnancy in many aspects and it is unknown how serum NT-proBNP level behaves in women with twin pregnancies. Serum NT-proBNP levels were determined longitudinally at gestational weeks (GW) 24 and 35 in normotensive women with 13 twin and 99 singleton pregnancies. The effects of maternal demographic characteristics on NT-proBNP levels were also analyzed. The serum NT-proBNP levels (pg/ml) in twin pregnancies, which were not different from those in singleton pregnancies at 24 GW (26±15 vs. 40±27, respectively, P=0.0718), increased significantly (P=0.0038) and were significantly higher than those in singleton pregnancies at 35 GW (72±49 vs. 34±24, Ptwin pregnancy were likely to exhibit an increase in serum NT-proBNP levels in the late stage of pregnancy, especially in lean and nulliparous women. The relative greater blood volume expansion occurring in twin than in singleton pregnancies was considered to be responsible for this phenomenon.

  12. Clinical outcomes of twin pregnancies conceived by in vitro fertilization compared with spontaneous twin pregnancies%试管婴儿双胎及自然受孕双胎临床分析

    Institute of Scientific and Technical Information of China (English)

    张惠琴; 樊蕊; 田国华; 李凌; 张志红; 张月萍

    2015-01-01

    目的:分析试管婴儿双胎与自然受孕双胎产妇和新生儿的临床结局。方法收集2010年1月至2014年4月106例试管婴儿双胎妊娠(试管组)与256例自然受孕双胎妊娠(对照组)的产妇年龄、妊娠周期、分娩方式、妊娠期合并症、新生儿体格发育、新生儿出生缺陷及新生儿围生期疾病等临床资料,并进行统计学比较分析。结果试管组产妇平均年龄(32±4岁)高于对照组(28±4岁,P0.05)。结论本研究显示试管婴儿双胎与自然受孕双胎围生期结局无明显差异;试管婴儿双胎妊娠的产妇在妊娠期需密切关注血压及血糖的波动情况。%Objective To compare the maternal and perinatal outcomes of twin pregnancies conceived by in vitro fertilization (IVF) with outcomes of spontaneous twin pregnancies. Methods A retrospective analysis was conducted between January 2010 and April 2014 to investigate the maternal age, gestation length, modes of delivery, pregnancy complications and neonatal physical development, birth defects and perinatal diseases in 106 IVF-assisted twin pregnancies (IVF group) and 256 spontaneous twin pregnancies (control group). Results The mothers in the IVF group were signiifcantly older than those in the control group (32±4 years vs 28±4 years, P0.05). Conclusions Twins conceived by IVF have similar outcomes as spontaneously conceived twins in the perinatal period. However, special attention is needed to monitor the levels of blood pressure and blood glucose for pregnant women with twins conceived by IVF during prenatal checkups.

  13. Does amniotic fluid volume affect fetofetal transfusion in monochorionic twin pregnancies? Modelling two possible mechanisms

    Science.gov (United States)

    Umur, Asli; van Gemert, Martin J. C.; Ross, Michael G.

    2002-06-01

    Clinical evidence suggests that increased amniotic fluid volume due to polyhydramnios increases placental vascular resistance. We have sought to model the possible effects of an increased amniotic fluid volume on the net fetofetal transfusion in monochorionic twin pregnancies. We wanted to compare these effects with the results of previous simulations, which aimed to explain why the twin-twin transfusion syndrome (TTTS) placentas more often include bidirectional arteriovenous (AV) rather than AV plus arterioarterial (AA) anastomoses. We extended our mathematical model of TTTS by simulating two different mechanisms that increase the placental vascular resistance as a consequence of polyhydramnios. First, there is an increase in the placental capillary resistance and hence in deep AV and opposite AV (denoted as VA) resistances due to polyhydramnios. Second, there is an increase in the resistance of chorionic veins due to polyhydramnios, assuming that these veins act as Starling resistors. We then simulated the effects of polyhydramnios on different placental anastomotic patterns. The results were as follows. In the first mechanism (polyhydramnios affects AV-VA resistances), an increased amniotic fluid volume hardly affected bidirectional AV, but slightly decreased fetofetal transfusion in AV plus AA anastomoses. However, for these effects to change the natural development of the pregnancy, polyhydramnios needed to persist for approximately 4 weeks, and by comparing the effects of polyhydramnios with the effects of amnioreduction, amnioreduction was more beneficial for normalizing the donor amniotic fluid volume. Therefore, these beneficial effects due to polyhydramnios have no practical clinical significance. In the second mechanism (Starling resistor for chorionic veins), polyhydramnios slightly increased fetofetal transfusion and hence slightly increased TTTS severity in bidirectional AV and AV plus VV, but did not affect AV plus AA anastomoses. In conclusion, we

  14. Assessment and specific nutritional recommendations for women during and after pregnancy of twins

    Directory of Open Access Journals (Sweden)

    Natalia Mira de Assumpção Werutsky

    2008-03-01

    Full Text Available Objective: To update and adjust nutritional recommendations for twin pregnancy during prenatal and postpartum periods in order to improve care provided to these women and ensure their quality of life, as well as to assess the practices adopted by the Institution and referral hospitals, in view of what was learned in specialized literature. Methods: This literature review was conducted by searching scientific papers in  databases (SciELO, Pubmed, Sibi, Medline, Lilacs, published from 1964 through 2006, as well as by surveying some authors directly by e-mail. Results: In studies selected, the age of pregnant women with twins was > 27, and the subjects were divided into three gestational periods ( 28 weeks gestational age. The nutritional program recommends: the intake of 3.000 to 4.000 kcal/day according to the pregnant body mass index (BMI, distributed as: proteins (20%, carbohydrates (40%, and fat (40%; in addition to the supplemental intake of 3 g of calcium, 1.2 g of magnesium, and 45 mg of zinc, with the prescription of two tablets of multivitamin per day after week 20. The daily diet must be divided into three meals and three snacks. The few studies found about these puerperal women recommended the addition of 500 to 600 calories/day per  child to ensure the production of the appropriate volume of milk to meet the necessary demand. Discussion: Research demonstrates that this program increases the gestational period and  newborns weight, and reduces the risk of prenatal and postpartum complications for mothers and children. The appropriate weight gain during pregnancy benefits the mother and their newborns, facilitating breast-feeding and milk volume production according to the demand. Comparing twin and single pregnant women there are differences related to weekly and total weight gain, recommendations for macro and micronutrients intake, number of portions, and nutritional status classification according to BMI. Conclusions: Nutritional

  15. A prospective study of twinning and perinatal mortality in urban Guinea-Bissau

    Science.gov (United States)

    2012-01-01

    Background Despite twinning being common in Africa, few prospective twin studies have been conducted. We studied twinning rate, perinatal mortality and the clinical characteristics of newborn twins in urban Guinea-Bissau. Methods The study was conducted at the Bandim Health Project (BHP), a health and demographic surveillance site in Bissau, the capital of Guinea-Bissau. The cohort included all newborn twins delivered at the National Hospital Simão Mendes and in the BHP study area during the period September 2009 to August 2011 as well as singleton controls from the BHP study area. Data regarding obstetric history and pregnancy were collected at the hospital. Live children were examined clinically. For a subset of twin pairs zygosity was established by using genetic markers. Results Out of the 5262 births from mothers included in the BHP study area, 94 were twin births, i.e. a community twinning rate of 18/1000. The monozygotic rate was 3.4/1000. Perinatal mortality among twins vs. singletons was 218/1000 vs. 80/1000 (RR = 2.71, 95% CI: 1.93-3.80). Among the 13783 hospital births 388 were twin births (28/1000). The hospital perinatal twin mortality was 237/1000. Birth weight twin mortality. Male sex (RR = 1.38, CI: 0.97-1.96), unawareness of twin pregnancy (RR = 1.64, CI: 0.97-2.78) and high blood pressure during pregnancy (RR = 1.77, CI: 0.88-3.57) were borderline non-significant. Sixty-five percent (245/375) of the mothers who delivered at the hospital were unaware of their twin pregnancy. Conclusions Twins had a very high perinatal mortality, three-fold higher than singletons. A birth weight twin pregnancy was common. Urgent interventions are needed to lower perinatal twin mortality in Guinea-Bissau. PMID:23216795

  16. Monozygotic Twin Pregnancy Associated with In Vitro Fertilization: Report and Revision of Three Cases Presented in a Clinic at 10,925 Feet Above Sea Level.

    Science.gov (United States)

    Tominaga, Luis Vargas; Cáceres, Ricardo Pella; Lechuga, Alberto Vargas; Durán, Livia Bartolo; Vargas, Mariela Serrano

    2015-08-01

    3 cases of monozygotic twin pregnancies associated with IVF presented at Centro de Fertilidad y Ginecología del Sur. In this study, we describe the cases and review the literature, noting possible related factors.

  17. Early neonatal morbidity and mortality in growth-discordant twins.

    Science.gov (United States)

    Alam Machado, Rita De Cássia; Brizot, Maria De Lourdes; Liao, Adolfo Wenjaw; Krebs, Vera Lucia Jornada; Zugaib, Marcelo

    2009-01-01

    To evaluate early neonatal morbidity and mortality in twin pregnancies with growth discordance. Retrospective study. Tertiary teaching hospital, Sao Paulo, Brazil. A total of 151 twin pregnancies managed and delivered at the Multiple Pregnancy Unit at Sao Paulo University Hospital between 1998 and 2004. METHODS; Comparison between twin pregnancies with weight discordance > or =20% and pregnancies concordant for fetal weight. Cases with fetal death, abnormalities, twin-to-twin transfusion and delivery before 26 weeks or in another hospital were excluded. Early neonatal morbidity (Apgar at 5 minutes pregnancies presented discordance > or =20% and 111 (73.5%) were concordant. In the discordant group, 75% of pregnancies had at least one growth restricted fetus (pregnancies, monochorionic cases (22.5%) presented with lower gestational age (34.3 vs. 36.2 weeks), lower birthweight (2,067 vs. 2,334 g) and a longer period of hospital stay (5.5 vs. 3.0) compared to dichorionic concordant twins. No differences between monochorionic and dichorionic subgroups were observed in discordant twins. Pregnancies in which at least one baby was born with a birthweight below the 10th centile showed that discordant pregnancies had a lower gestational age at delivery (35.2 vs. 36.8 weeks) and a longer period of hospital stay (9 vs. 4 weeks) compared to concordant cases. Neonatal mortality was similar in discordant (3.7%) and concordant (4.5%) twins. Early perinatal morbidity is increased in twin pregnancies with birthweight discordance > or =20% only when associated with fetal growth restriction and low birthweight.

  18. Noninvasive prenatal testing (NIPT) in twin pregnancies with treatment of assisted reproductive techniques (ART) in a single center

    DEFF Research Database (Denmark)

    Tan, YueQiu; Gao, Ya; Lin, Ge

    2016-01-01

    Objective: The objective of the study is to report the performance of noninvasive prenatal testing (NIPT) in twin pregnancies after the treatment of assisted reproductive technology (ART). Method: In two years period, 565 pregnant women with ART twin pregnancies were prospectively tested by NIPT......-test counseling. Results: In total of 565 cases, NIPT had a failure rate of 0.9% (5/565). Four cases of T21 were identified by NIPT and confirmed by karyotyping, resulting in 100% (95%CI 39.8%-100%) positive predictive value. Among 556 cases with NIPT negative results, 506 cases (91.0%) were confirmed by follow......-up of postnatal phenotypes, while 33 cases (5.9%) had adverse pregnant outcomes with unconfirmed reasons because of the lack of cytogenetic samples. The remaining 17 cases (3.1%) refused follow-up. No false negative result was reported. Conclusion: With apparently high positive predictive value and low false...

  19. Prenatal Diagnosis of Cantrell’s Pentalogy Associated with Agenesis of Left Limb in a Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Yigit Cakiroglu

    2014-01-01

    Full Text Available Pentalogy of Cantrell is a rare malformation described in the literature. We report a case of pentalogy of Cantrell associated with left limb deficiency in a twin pregnancy. The fetus with multiple anomalies revealed kyphosis, ectopia cordis, and a large defect with protruding liver and bowel loops at 12 weeks and 3 days of gestational age on ultrasound scan. The other fetus was ultrasonographically normal. We diagnosed a case of pentalogy of Cantrell in a twin pregnancy after exclusion of limb body wall complex, body stalk anomaly, and amniotic band syndrome and after delivery of the fetuses. Macroscopic examinations were ectopia cordis, extrusion of the abdominal organs without membranes surrounding, and agenesis of the left limb.

  20. Postpartum posterior reversible encephalopathy syndrome (PRES) in a twin pregnancy complicated by preeclampsia-eclampsia: case report.

    Science.gov (United States)

    Papoutsis, D; El-Attabi, N; Sizer, A

    2014-01-01

    This is the second case in literature of posterior reversible encephalopathy syndrome (PRES) in a twin pregnancy complicated by preeclampsia-eclampsia. A 27-year-old primigravida with dichorionic diamniotic twin pregnancy was admitted at 36 weeks of gestation for induction of labour due to preeclampsia. On the second day postpartum, the patient developed severe hypertension, visual symptoms, confusion, headache, and eclamptic fits. Head computed tomography (CT) showed hypodense basal ganglia lesions. The patient was treated in the intensive treatment unit with hydralazine and labetalol infusions and anticonvulsants. Five days later, there was complete clinical improvement and follow-up magnetic resonance imaging (MRI) was normal. The patient was discharged 11 days post-delivery. Diagnosis of PRES is based on the presence of clinical features of acute neurologic compromise, abnormal neuroimaging findings, and complete reversibility of findings after prompt treatment. Early recognition and proper treatment result in complete reversibility of this condition.

  1. Twin delivery: method, timing and conduct.

    Science.gov (United States)

    Barrett, Jon F R

    2014-02-01

    The incidence of twin pregnancy has increased worldwide over the past 10 years, largely as a consequence of the assisted reproductive technologies. Issues such as intrapartum monitoring and operative interventions, especially relating to the second twin, provide a unique challenge in labour and delivery. Epidemiological and cohort data suggest that twins have a three-fold higher mortality rate than singletons, and that the second twin might have a better outcome if delivered by lower segment caesarean section. The recently completed Twin Birth Study has found that planned vaginal lower segment caesarean section is not advantageous to the fetus. In the light of this large randomised-controlled trial, vaginal delivery if twin A presents by the vertex is recommended as long as guidelines for the conduct of such delivery are followed.

  2. Prenatal ultrasonic features of twin pregnancy with fetal abnormalities%双胎妊娠胎儿异常的产前超声特征

    Institute of Scientific and Technical Information of China (English)

    张一休; 杨筱; 孟华; 欧阳云淑; 姜玉新; 戴晴; 徐钟慧; 杨萌; 袁岩; 鲁嘉

    2012-01-01

    Objective To investigate the diagnostic value of ultrasound in twin pregnancy with fetal abnormalities. Methods The ultrasonic features and clinical data of 14 twin pregnancies with fetal abnormalities found by prenatal ultrasound were analyzed retrospectively. Results Among 14 twin pregnancies, there were 5 twins with structurally anomalous in 1 fetus, 1 with structurally anomalous in both fetuses, 1 with twin-to-twin transfusion syndrome, 2 with selective intrauter-ine growth restriction, 1 with co-twin neurological abnormality following the death of 1 twin, 2 with conjoined twins, 2 with twin reverse arterial perfusion sequence. Conclusion Ultrasound can diagnose structural complications and abnormalities of twin pregnancy, and plays an important role in clinical treatment.%目的 探讨产前超声诊断双胎妊娠胎儿异常的价值.方法 回顾性分析14对双胎妊娠胎儿异常的产前声像图特征及临床资料.结果 超声诊断5对为双胎之一结构畸形,1对为双胎均结构畸形,1对为双胎输血综合征,2对为选择性胎儿宫内发育迟缓,1对为双胎之一死亡后孪生胎神经系统损伤,2对为联体双胎,2对为双胎反向动脉灌注序列症.结论 超声有助于诊断多种双胎妊娠并发症和畸形,有重要临床指导意义.

  3. Fetal Aneuploidy Detection by Cell-Free DNA Sequencing for Multiple Pregnancies and Quality Issues with Vanishing Twins

    Directory of Open Access Journals (Sweden)

    Sebastian Grömminger

    2014-06-01

    Full Text Available Non-invasive prenatal testing (NIPT by random massively parallel sequencing of maternal plasma DNA for multiple pregnancies is a promising new option for prenatal care since conventional non-invasive screening for fetal trisomies 21, 18 and 13 has limitations and invasive diagnostic methods bear a higher risk for procedure related fetal losses in the case of multiple gestations compared to singletons. In this study, in a retrospective blinded analysis of stored twin samples, all 16 samples have been determined correctly, with four trisomy 21 positive and 12 trisomy negative samples. In the prospective part of the study, 40 blood samples from women with multiple pregnancies have been analyzed (two triplets and 38 twins, with two correctly identified trisomy 21 cases, confirmed by karyotyping. The remaining 38 samples, including the two triplet pregnancies, had trisomy negative results. However, NIPT is also prone to quality issues in case of multiple gestations: the minimum total amount of cell-free fetal DNA must be higher to reach a comparable sensitivity and vanishing twins may cause results that do not represent the genetics of the living sibling, as described in two case reports.

  4. Hemolytic disease of the newborn associated with anti-Jra alloimmunization in a twin pregnancy: the first case report in Korea.

    Science.gov (United States)

    Kim, Hyungsuk; Park, Min-Jeong; Sung, Tae-Jung; Choi, Ji Seon; Hyun, Jungwon; Park, Kyoung Un; Han, Kyou-Sup

    2010-10-01

    Jr(a) is a high-frequency antigen found in all ethnic groups. However, the clinical significance of the anti-Jr(a) antibody has remained controversial. Most studies have reported mild hemolytic disease of the newborn and fetus (HDNF) in Jr(a)-positive patients. Recently, fatal cases of HDNF have also been reported. We report the first case of HDNF caused by anti-Jr(a) alloimmunization in twins in Korea. A 33-yr-old nulliparous woman with no history of transfusion or amniocentesis was admitted at the 32nd week of gestation because of vaginal bleeding caused by placenta previa. Anti-Jr(a) antibodies were detected in a routine laboratory examination. An emergency cesarean section was performed at the 34th week of gestation, and 2 premature infant twins were delivered. Laboratory examination showed positive direct antiglobulin test and Jr(a+) phenotype in the red blood cells and the presence of anti-Jr(a) antibodies in the serum in both neonates. The infants underwent phototherapy for neonatal jaundice; this was followed by conservative management. They showed no further complications and were discharged on the 19th postpartum day. Preparative management to ensure the availability of Jr(a-) blood, via autologous donation, and close fetal monitoring must be performed even in cases of first pregnancy in Jr(a-) women.

  5. Parental Relationship with Twins from Pregnancy to Three Months: the Relation Among Parenting Stress, Infant Temperament, and Well-being

    Directory of Open Access Journals (Sweden)

    Laura Elvira Prino

    2016-10-01

    Full Text Available Objective: The transition to parenthood, from pregnancy to postpartum period, is a critical process, particularly for couples expecting twins. There is very little literature regarding the links between anxiety, depression, dyadic adjustment, parental stress, and infant temperament spanning from pregnancy to postpartum. This study has two aims: first, to examine whether mothers’ and fathers’ anxiety, depression, and dyadic adjustment, assessed at the sixth month of pregnancy and three months postpartum, are associated with infants' negative affectivity and parenting stress; second, to examine whether there is any difference between fathers’ and mothers’ levels of parenting stress and perception of the twins’ temperament, as well as to evaluate, separately for mothers and fathers, whether the levels of parenting stress and perception of child temperament differ for each twin.Method: The study participants were 58 parents (29 couples and their healthy 58 twin babies (51.7% boys, 48.3% girls. Mothers’ ages ranged from 30 to 44 years, (MAge = 36.3 years, SD = 3.2 years, and fathers’ ages ranged from 32 to 52 years, (MAge = 38.2 years, SD = 4.4 years. The parents, during the pregnancy period and three months after delivery, filled out the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, and the Dyadic Adjustment Scale. Three months after delivery they also filled out the Parenting Stress Index—Short Form and the Infant Behavior Questionnaire Revised. Results: The analyses showed a significant correlation between parental anxiety/depression symptoms and infants’ negative affectivity and parenting stress (in both mothers and fathers. Moreover, compared to fathers, mothers reported higher scores on specific dimensions of the infants’ negative affectivity, (t (28 = -2.62 and p < .05; t (28 = 2.09 and p < .05, and parenting stress, (t (28 = 2.19 and p < .05; t (28 = 2.23 and p < .05, but only for Twin 2. Finally

  6. Analysis of pregnancy results of singleton pregnancy and twin pregnancy by assisted reproductive technology%辅助生殖技术单胎妊娠和双胎妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    诸蕾; 张丁; 蒲娇

    2016-01-01

    目的:分析辅助生殖技术助孕成功妊娠的单胎妊娠和双胎妊娠妇女的妊娠结局,旨在为患者选择单胚胎或双胚胎移植提供参考。方法对我院通过辅助生殖技术助孕成功的237例单胎妊娠(单胎妊娠组)和126例双胎妊娠(双胎妊娠组)孕妇进行回顾性分析。结果单胎妊娠组平均分娩孕周长于双胎妊娠组(P <0.05);双胎妊娠组早产率、妊娠并发症发生率、妊娠高血压疾病发生率、低体重出生儿发生率均高于单胎妊娠组(P <0.05)。结论与多胎妊娠比较,单胎妊娠能够明显降低孕期并发症的风险,降低早产率和剖宫率。%Objective To provide the advice on choosing singleton embryo transfer or multiple embryo transfer by analyzing the abortion,premature birth,and the mode of production of singleton pregnancy and twin pregnancy by assisted reproductive technolo-gy.Methods The clinical data of two hundred and thirty-seven cases of twin pregnancy (twin pregnancy group)and 126 cases of sin-gle pregnancy (single pregnancy group)by assisted reproductive technology in our hospital were retrospective analyzed.Results In twin pregnancy group,premature delivery rate,pregnancy complications occurrence rate,hypertension of pregnancy rate,low birth weight newborns rate was higher,the average birth gestational age was shorter than in single pregnancy group(P <0.05).Conclusion Com-paring with multiple pregnancy,single pregnancy could reduce the risk of pregnancy complications,the rate of preterm birth rates and cesarean section rate significantly.

  7. Dizygotic monochorionic twin pregnancy conceived following intracytoplasmic sperm injection treatment and complicated by twin-twin transfusion syndrome and blood chimerism

    DEFF Research Database (Denmark)

    Ekelund, Charlotte Kvist; Skibsted, L.; Søgaard, Kirsten

    2008-01-01

    reported cases of dizygotic monochorionic twins. Nearly all of these cases have been conceived after assisted reproductive technology procedures. It is of clinical importance to be aware of this rare phenomenon in relation to TTTS, prenatal screening and parental counseling Udgivelsesdato: 2008/11...

  8. TWIN GESTATION : A CHALLENGING TASK

    Directory of Open Access Journals (Sweden)

    Vrunda V.

    2015-03-01

    Full Text Available INTRODUCTION In the era of modern obstetrics when multiple pregnancies are on increase it is very important to know the incidence and obstetric outcomes of twin deliveries. Twin pregnancy is still associated with increased maternal and perinatal morbidity and mortality as well as healthcare costs . ( 1 , 2 , 3 MATERIALS AND METHODS : This is a r etrospective study of twin deliveries done in the rural medical college teaching hospital over a period of 3 years. RESULTS : During the study period , incidence of twin delivery was 19.37 per 1000 deliveries. Majority cases of twins were young primies in ag e group (20 - 30 years . Preterm delivery occurred in 68% cases and was therefore , the most common morbidity followed by anaemia (38% and PIH (28%. Most common presentation was vertex (66% and malpresentation were present in 44% of cases. 54% were deliver ed by caesarean section. In 88% second baby delivered within 15 minutes. Uterine inertia , PROM , fetal distress , PPH , cord prolapse and abruption were complications during labour. There was no maternal mortality in present study. Average weight of first baby was 1679.63 gms and 2 nd baby was 1586.94 gms. Perinatal mortality of 1 st baby was 27.55 for 1 st baby and 37.25% for 2 nd baby . Average gestational age for patients in whom cervical encirclage was done was 34 weeks. CONCLUSION: P reterm delivery and low birth weight babies are main challenges to the obstetrician. Incidence of LSCS is quite high with malpresentation of leading (twin A baby is a major indication for LSCS . The use of antenatal care services and good intrapartum mana gement will help improve outcome in twin pregnancies.

  9. Comparison of second-trimester maternal serum free-β-human chorionic gonadotropin and α-fetoprotein between normal singleton and twin pregnancies: a population-based study

    Institute of Scientific and Technical Information of China (English)

    ZHENG Ming-ming; ZHONG Xiao-ling; HU Ya-li; ZHANG Chun-yan; RU Tong; LIU Qi-lan; XU Bi-yun; CHEN Qi-guang; XU Zheng-feng; ZHANG Yin

    2010-01-01

    Background The second-trimester maternal serum screening in twin pregnancy is still controversial, as the serum marker levels in twins are not as clear as those in singletons. This study aimed to evaluate the relationship between the levels of the second-trimester maternal serum free p-human chorionic gonadotropin (free β-HCG) and a-fetoprotein (AFP) in normal twin and singleton pregnancies and to estimate feasible analysis methods for utilizing these markers in second trimester screening for twin pregnancy. Methods On the basis of a prospective population-based study of second-trimester maternal serum screening, the concentrations of maternal serum AFP and free β-HCG of 195 normal twin pregnancy and 26 512 singleton controls at gestational weeks 15 to 20 were measured by time-resolved fluoroimmunoassay in one laboratory. The levels of markers were compared between the twins and singletons using weight-correction and gestational age-specific model. Results According to the research protocol, 95 communities were randomly sampled, which covered the whole Jiangsu province, the east of China. A total of 26 803 pregnant women (98%), from the target population accepted prenatal screening for maternal serum AFP, β-HCG detection, and all babies were followed up for at least six months. There were 197 (0.73%) twin pregnancies, of which one case had fetal trisomy 18, and one case with fetal anencephaly. The others were normal twin pregnancy. From a total enrollment of 26 803 women participants, 26 512 women with normal singleton pregnancies were selected as the model controls. The other 291 pregnancies, including trisomy 21, neural tube defect (NTD), trisomy 18, and other fetal abnormalities, were excluded. No significant differences were found in the medians of gestational age-specific maternal serum free β-hCG and AFP in normal twin pregnancy comparing with twice those in model controls with the exception of the medians for free β-hCG during the 16th gestational week

  10. The influence of maternal undernutrition in ovine twin pregnancy on fetal growth and Doppler flow-velocity waveforms.

    Science.gov (United States)

    Newnham, J P; Kelly, R W; Patterson, L; James, I

    1991-11-01

    The effects on placental blood flow velocity of maternal undernutrition during mid pregnancy were investigated in 38 twin bearing pregnant sheep by Doppler analysis of umbilical and uteroplacental arterial waveforms. Mid pregnancy undernutrition resulted in fetal growth restriction manifest at term gestation by reduced mean birth weight. Arterial waveform systolic/diastolic ratios from the umbilical and uteroplacental arterial circulations were not influenced by maternal nutrition either during the dietary deprivation or during a subsequent period of dietary supplementation. An effect of heart rate on systolic/diastolic ratios could not be demonstrated. The results indicate that the fetus responds to mid pregnancy maternal undernutrition with restricted growth but without alterations in systolic/diastolic ratios in umbilical or uteroplacental arterial waveforms.

  11. Preliminary report of altered insulin secretion pattern in monochorionic twin pregnancies complicated with selective intrauterine growth restriction.

    Science.gov (United States)

    Chang, Yao-Lung; Wang, Tzu-Hao; Abufraijeh, Seham M; Chang, Shuenn-Dyh; Chao, An-Shine; Hsieh, Peter C C

    2017-02-01

    Fetuses with intrauterine growth restriction (IUGR) have adaptive hormonal changes including changes in insulin, which may increase their future risks for developing diabetes mellitus. This study compared cord blood insulin concentrations in IUGR and appropriate for gestational age (AGA) fetuses in a monochorionic (MC) twin model. Ten pairs were classified as selective IUGR (sIUGR) based on having one twin weight below the 10th percentile and with an intertwin birth weight discordance>20%. Fourteen pairs without IUGR were included as a comparison group. Pregnancies with twin-twin transfusion syndrome, congenital structural malformations, and genetic abnormalities were excluded. Insulin and glucose concentrations were measured in cord venous blood at the time of delivery. Cord blood insulin concentrations of sIUGR fetuses were significantly lower than those of AGA counterpart fetuses in MC twins affected by sIUGR (5.1±4.1 mU/L, range: 0.7-9.9 mU/L for sIUGR fetuses and 12.2±7.6 mU/L, range: 3.5-23.7 mU/L for AGA fetuses, p=0.019). No significant difference in insulin concentrations between larger and smaller fetuses in MC twins without IUGR was observed. Insulin concentration was inversely correlated with gestational age of delivery in all fetuses except in those with sIUGR. We did not find any difference in cord blood glucose concentrations between the two fetuses in both groups. Our data show reduced insulin secretion and loss of the physiological decline in concentration over time as gestational age increases in fetuses with sIUGR compared to AGA counterparts. Copyright © 2017 Taiwan Association of Obstetrics & Gynecology. Published by Elsevier B.V. All rights reserved.

  12. The effect of a 'vanishing twin' on biochemical and ultrasound first trimester screening markers for Down's syndrome in pregnancies conceived by assisted reproductive technology

    DEFF Research Database (Denmark)

    Gjerris, A C; Loft, A; Pinborg, Anja

    2008-01-01

    . The presence of a perished embryo may further complicate prenatal screening among women pregnant after ART. The aim of this study was to assess the impact of a 'vanishing twin' on first trimester combined biochemical and ultrasound screening in pregnancies conceived after IVF and intracytoplasmatic sperm...... injection. METHODS: From a national prospective cohort study concerning first trimester combined screening among women pregnant after ART, 56 cases of pregnancies with a vanishing twin were identified. As control group 897 cases of ART singleton pregnancies were used. All women completed a first trimester......) or late vanishing twin (gestational week 9-13, LVT) or singleton pregnancies (0.98, 1.13 and 0.95 for free beta-hCG and 0.84, 0.80 and 0.74 for PAPP-A, respectively). Likewise, no difference was seen for NT measurements. The gestational age at the time of blood sampling and NT scan was similar...

  13. Successful twin pregnancy after orthotopic liver transplantation Gravidez gemelar com sucesso após transplante hepático

    Directory of Open Access Journals (Sweden)

    Júlio Cezar Uili Coelho

    2002-10-01

    Full Text Available AIM: Report of a case of successful twin pregnancy following liver transplantation. PATIENT AND METHOD: A 42-year-old nulliparous-woman was subjected to an orthotopic liver transplantation due to Budd-Chiari syndrome. Sixteen months after the transplantation, an ultrasonography revealed twin pregnancy. Her prenatal course was uneventful, except for mild arterial hypertension. The immunosuppressive agents used during pregnancy were cyclosporine and prednisone. RESULT: The patient gave birth to two healthy girls at 37 weeks of gestation. The patient's postpartum course was uneventful with normal liver and renal function tests. CONCLUSION: Following successful pregnancy, women may become pregnant and give birth to normal children, including twinsOBJETIVO: Descrição de um caso de gravidez gemelar com sucesso após transplante hepático. PACIENTE E MÉTODO: Paciente nulípara de 42 anos de idade com síndrome de Budd-Chiari foi submetida a transplante hepático. Dezesseis meses após o transplante, uma ultra-sonografia revelou gravidez gemelar. As avaliações pré-natais foram normais, exceto por apresentar hipertensão arterial leve. Os imunossupressores utilizados durante a gravidez foram ciclosporina e prednisona. RESULTADO: Cesariana foi realizada na 37ª semana de gravidez, com nascimento de duas meninas sadias. A evolução pós-cesárea foi normal, com os exames de avaliação hepática e renal normais. CONCLUSÃO: Após o transplante hepático com sucesso, as mulheres podem engravidar e ter filhos normais, inclusive gêmeos.

  14. Successful outcome in a twin pregnancy with hereditary motor and sensory neuropathy type –II complicated with heart disease and preclampsia superimposed on chronic hypertension

    Directory of Open Access Journals (Sweden)

    Debasmita Mondal

    2008-06-01

    Full Text Available Heridetary motor and sensory neuropathy (HMSN TYPE-2 reflects reduction in the number of primary motor and sensory neurons. The occurrence of this disease is rare in pregnancy but may be exaggerated in pregnancy leading to preeclampsia / eclampsia. Here is a 28 years old 2nd gravidae with twin pregnancy at 31 weeks hospitalized with HMSN TYPE-2 disease and was managed successfully with good feto maternal outcome

  15. The Relation of Maternal Birth Weight to African-American and Non-Latina White Twin Pregnancy Outcomes: A Population-Based Study.

    Science.gov (United States)

    McAndrew, Sarah; Chihara, Izumi; Rankin, Kristin M; Collins, James W

    2016-07-28

    Objectives The authors investigated the association between maternal birth weight and adverse birth outcome as measured by rates of low birth weight (<2500 g, LBW), preterm birth (<37 weeks, PTB), and small for gestational age (weight <10th percentile for gestational age, SGA) among African American and White twin pregnancies. Methods Stratified and multivariable regression analyses were performed on the Illinois transgenerational dataset of non-Latina African American and non-Latina White twin pairs (born 1989-1991) and their mothers (born 1956-1976). Results Former LBW (n = 104) and non-LBW (n = 742) African American mothers had LBW rates in both twins of 76 and 56 %, respectively; RR (95 % CI) = 1.4 (1.2-1.6). Former LBW (n = 105) and non-LBW (n = 2136) White mothers had LBW rates in both twins of 41 and 34 %, respectively; RR = 1.2 (0.9-1.5). In multivariable regression models, the adjusted (controlling for maternal age, education, marital status, parity, prenatal care usage, and cigarette smoking) RR of LBW in both twins among former LBW (compared to non-LBW) African American and White mothers equaled 1.4 (1.2-1.6) and 1.2 (0.9-1.5), respectively. Maternal LBW was associated with a modestly increased risk of PTB but not SGA among African American twin pregnancies: adjusted RR = 1.3 (1.1-1.4) and 1.1 (0.8-1.5), respectively. Conclusions In African American twin pregnancies, maternal LBW is a risk factor for LBW in both twins. Further research is needed to determine whether a similar generational association occurs among non-Latina White twin pregnancies.

  16. Screening for trisomy 21 in twin pregnancies in the first trimester: does chorionicity impact on maternal serum free beta-hCG or PAPP-A levels?

    Science.gov (United States)

    Spencer, K

    2001-09-01

    In a study of 180 twin pregnancies I have examined the distribution of maternal serum free beta-human chorionic gonadotrophin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A), in addition to fetal nuchal translucency thickness (NT), in twins classified as monochorionic or dichorionic, based on ultrasound appearance at 10-14 weeks of gestation. In 45 monochorionic and 135 dichorionic twin pregnancies the median MoM free beta-hCG was not significantly different (1.00 vs 1.01), whilst that for PAPP-A was lower (0.89 vs 1.01) but again with no statistical significance. Previous reports of an increased fetal NT in monochorionic twins pregnancies could not be confirmed (1.03 vs 1.00). It is concluded that the existing pseudo risk twin correction algorithm is appropriate for both monochorionic and dichorionic twins in providing accurate first trimester risks for trisomy 21. Copyright 2001 John Wiley & Sons, Ltd.

  17. I. 'Street of twins': multiple births in Cuba II. The Cuban twin registry: an update / twin research reports: cord entanglement; heritability of clubfoot; school separation / twins and twin researchers in the news: reunited at seventy-eight; basketball duo dissolved; delivered holding hands; the better brew; award winners.

    Science.gov (United States)

    Segal, Nancy L; Marcheco-Teruel, Beatriz

    2014-08-01

    I was part of a people-to-people tour of Havana, Cuba during the first week in April 2014. Among the many highlights of that adventure were an informal meeting with Dr Beatriz Marcheco-Teruel, from Cuba's National Center for Medical Genetics, and a visit to the famous 'Street of Twins'. A fortuitous meeting with parents of twins in the fishing town of Jaimanitas was also an extraordinary event. The Cuban experience is followed by summaries of recent twin research, covering umbilical cord entanglement, the heritability of clubfoot and school separation policies for twins. Media reports include twins reunited at age 78, the future of UCLA's twin basketball players, MZ twins born holding hands, a twin conflict over beer and a pair of American Psychological Association honors for Drs Nancy L. Segal and Thomas J. Bouchard, Jr.

  18. Maternal serum steroid levels are unrelated to fetal sex: a study in twin pregnancies.

    NARCIS (Netherlands)

    Cohen-Bendahan, C.C.; Goozen, S.H. van; Buitelaar, J.K.; Cohen-Kettenis, P.T.

    2005-01-01

    Increased prenatal exposure to testosterone (T) in females of an opposite-sex (OS) twin pair may have an effect on the development of sex-typical cognitive and behavioral patterns. The prenatal exposure to T due to hormone transfer in OS twin females may occur in two ways, one directly via the feto-

  19. STOPPIT Baby Follow-up Study: the effect of prophylactic progesterone in twin pregnancy on childhood outcome.

    Directory of Open Access Journals (Sweden)

    Helen Christine McNamara

    Full Text Available To determine the long-term effects of in utero progesterone exposure in twin children.This study evaluated the health and developmental outcomes of all surviving children born to mothers who participated in a double-blind, placebo-controlled trial of progesterone given for the prevention of preterm birth in twin pregnancies (STOPPIT, ISRCTN35782581. Follow-up was performed via record linkage and two parent-completed validated questionnaires, the Child Development Inventory and the Health Utilities Index.Record linkage was successfully performed on at least one record in 759/781 (97% children eligible for follow-up. There were no differences between progesterone-exposed and placebo-exposed twins with respect to incidence of death, congenital anomalies and hospitalisation, nor on routine national child health assessments. Questionnaire responses were received for 324/738 (44% children. The mean age at questionnaire follow-up was 55.5 months. Delay in at least one developmental domain on the Child Development Inventory was observed in 107/324 (33% children, with no evidence of difference between progesterone-exposed and placebo-exposed twins. There was no evidence of difference between the progesterone and placebo groups in global health status assessed using the Health Utilities Index: 89% of children were rated as having 'excellent' health and a further 8% as having 'very good' health.In this cohort of twin children there was no evidence of a detrimental or beneficial impact on health and developmental outcomes at three to six years of age due to in utero exposure to progesterone.

  20. Human placental lactogen and unconjugated estriol concentrations in twin pregnancy: monitoring of fetal development in intrauterine growth retardation and single intrauterine fetal death.

    Science.gov (United States)

    Trapp, M; Kato, K; Bohnet, H G; Gerhard, I; Weise, H C; Leidenberger, F

    1986-11-01

    Human placental lactogen and unconjugated estriol concentrations in maternal serum were evaluated in 100 uneventful twin pregnancies, and these values were compared with those observed in 16 twin pregnancies associated with intrauterine growth retardation or single intrauterine fetal death. In pregnancies associated with intrauterine growth retardation (n = 8), human placental lactogen levels were at the lower limit of normal range for singleton pregnancies, whereas estriol levels were normal in most cases. When one of the fetuses had died before week 33 of pregnancy (n = 5), both human placental lactogen and estriol levels were low and they were almost at the levels in singleton pregnancy. When intrauterine fetal death occurred after week 36 of pregnancy (n = 3), both hormone levels remained normal until term. Thus human placental lactogen rather than estriol is a good indicator of intrauterine growth retardation in twin pregnancy. Both human placental lactogen and estriol are useful for the monitoring of the surviving fetus in the case of single intrauterine fetal death.

  1. Fetal Cholelithiasis: Antenatal Diagnosis and Neonatal Follow-Up in a Case of Twin Pregnancy – A Case Report and Review of the Literature

    Science.gov (United States)

    Hurni, Yannick; Vigo, Francesco; von Wattenwyl, Begoña Lipp; Ochsenbein, Nicole; Canonica, Claudia

    2017-01-01

    Fetal cholelithiasis is a rare finding during a third-trimester ultrasound with an average incidence rate of 0.07–1.15%. We report a case of fetal cholelithiasis in twins, observed in a patient with monochorionic diamniotic twin pregnancy hospitalized at our unit for signs of premature labor. We present the outcome of the 2 neonates with a clinical and sonographic follow-up. In addition, we offer a comprehensive review of the literature available to date. PMID:28210714

  2. Successful twin pregnancy outcome after in utero exposure to FOLFOX for metastatic colon cancer: a case report and review of the literature

    DEFF Research Database (Denmark)

    Jeppesen, Johanne Bakker; Østerlind, Kell

    2011-01-01

    many dilemmas and concerns for the physician and patient. A delay in treatment may compromise maternal survival; however, therapy for the cancer may be harmful to the fetus. We present a case of a 26-year-old woman pregnant with twins who was diagnosed with metastatic colon cancer and treated with 5......There is limited experience in treating advanced colorectal cancer diagnosed during pregnancy because it is a rare occurrence; however, the incidence of colorectal cancer complicating pregnancy is expected to increase in the future. The combination of cancer and pregnancy is complicated and causes......-fluorouracil, leukovorin, and oxaliplatin (FOLFOX) from 13 weeks gestational age to birth. The patient gave birth to healthy twins without malformations at 33 weeks gestational age. At follow-up examination, the 2-year-old twins are developing normally. The patient herself died 1 year after the initial cancer...

  3. Cervical length measurement for the prediction of preterm birth in symptomatic women with a twin pregnancy: a systematic review and meta-analysis.

    Science.gov (United States)

    Liem, S M S; van de Mheen, L; Bekedam, D J; van Pampus, M G; Opmeer, B C; Lim, A C; Mol, B W J

    2013-01-01

    Objective. The aim of this study was to assess whether cervical length measurement (CL) could predict preterm birth (PTB) in symptomatic women with a twin pregnancy. Methods. We searched MEDLINE and EMBASE to identify studies investigating the accuracy of CL measurement in predicting PTB in symptomatic women with a twin pregnancy. We extracted data to construct two-by-two tables and used bivariate meta-analysis to generate point estimates of sensitivity and specificity. Results. Five studies (N = 226) were included. Variation in definition of PTB and cut-off points for CL was strong. One study investigated delivery within seven days, demonstrating a sensitivity of 1.0 (95% CI: 0.83-1.0) and a specificity of 0.31 (95% CI 0.2-0.43) for a CL cutoff at 25 mm. Three studies reported on predicting PTB twin pregnancy, especially on the most important outcome, that is, delivery within 7 days.

  4. Twin Reversed Arterial Perfusion Sequence: A Rare Entity

    Science.gov (United States)

    Khanduri, Sachin; Chhabra, Saakshi; Raja, Anshul; Bhagat, Saurav

    2015-01-01

    Twin reversed arterial perfusion (TRAP) sequence is an extremely rare complication of monochorionic multi-fetal pregnancy, occurring once in 35,000 births. This condition is characterized by a malformed fetus without a cardiac pump being perfused by a structurally normal (pump) twin via an artery-to-artery anastomosis in a reverse direction. We report a case of a primigravida, who came for routine antenatal checkup to our hospital at 31 weeks gestational age. Ultrasound imaging and magnetic resonance imaging revealed twin monochorionic intrauterine pregnancy with a viable, normal-appearing first twin and amorphous structured second twin connected by umbilical vessels. The patient was monitored with weekly ultrasonography, echocardiography, and Doppler ultrasound examination to ascertain the well-being of the pump twin. She delivered successfully at term a normal live baby and an acardius acephalus fetus. Plain X-ray of the acardius acephalus fetus confirmed the absence of cephalic structures. The perinatal mortality of the pump twin ranges from 35 to 55%; hence, it is essential to diagnose the presence of a pump twin at an early gestational age through improved imaging techniques, so that intervention can be planned early in the pregnancy for a better outcome of the pump twin. PMID:25861543

  5. 双胎妊娠112例结局分析%Analysis of 112 cases of twin pregnancy outcome

    Institute of Scientific and Technical Information of China (English)

    马静波

    2013-01-01

    目的 探讨双胎妊娠的母儿围生结局及孕期处理对围生结局的影响.方法 对2010年1月至2012年1月期间在洛阳市妇女儿童医疗保健中心住院分娩的112例双胎妊娠病例进行回顾性分析.结果 双胎妊娠胎儿死亡率为5.36%,新生儿死亡率为4.46%,剖宫产率为77.68%,双胎妊娠母亲合并内科疾病占76%.围生期定期进行产前检查的孕妇孕期并发症及合并症及胎儿死亡率均低于不定期产检的孕妇,差异有统计学意义(P<0.05).阴道分娩组新生儿窒息率、脑瘫发生率和死亡率明显高于剖宫产组.结论 双胎妊娠母亲及围生儿合并症、并发症及死亡率均较高,因此定期产前检查,积极防治妊娠期各种并发症,选择有利的分娩时机和分娩方式对降低双胎围生儿患病率和死亡率有重要意义.%Objective To investigate the mother child perinatal outcomes and pregnancy treatment of twin pregnancy impact on perinatal outcome.Methods One hundred and twelve cases of twin pregnancy in women and children health care Center of Luoyang from 2010 to 2012 were analyzed retrospectively.Results The incidence of twin pregnancy' s fetal mortality rate was 5.36%,neonatal mortality rate was 4.46%,cesarean section rate was 77.68%.the pregnancy complications,complications and fetal mortality were significantly lower in pregnant woman with regular perinatal conduct,than those in pregnant woman with irregular perinatal conduct.the difference were statistically significant (P <0.05) Neonatal asphyxia rate,the incidence of cerebral palsy and mortality were significantly higher in vaginal delivery group,than that in cesarean section group.Conclusions Complications and mortality of mother of twin pregnancy and perinatal children are higher.Therefore regular prenatal care,active prevention and treatment of various complications,and proper choice for the time and mode of delivery are important measures to decrease the twin

  6. Discordance for Cri du Chat Syndrome in a dichorionic–diamniotic twin pregnancy

    Directory of Open Access Journals (Sweden)

    Mireia González-Comadran

    2015-07-01

    Full Text Available We report on the prenatal diagnosis through array CGH of a dichorionic–diamniotic (DC/DA twins discordant for Cri du Chat Syndrome. Structural anomalies on one of the twins lead to amniotic fluid sampling, which revealed a partial deletion on the short arm of the chromosome 5. Selective feticide of the affected twin was performed at 34 + 1 weeks' and elective Cesarean section at 37 + 2 weeks. Postnatal cytogenetic analysis confirmed pre-natal genetic findings.

  7. Neonatal morbidity in growth-discordant monochorionic twins: comparison between the larger and the smaller twin.

    Science.gov (United States)

    Lopriore, Enrico; Sluimers, Carolien; Pasman, Suzanne A; Middeldorp, Johanna M; Oepkes, Dick; Walther, Frans J

    2012-08-01

    Fetal growth restriction in singletons has been shown to enhance fetal lung maturation and reduce the risk of respiratory distress syndrome due to increased endogenous steroid production. However, data on lung maturation in growth-discordant monochorionic (thus, identical) twins are lacking. Our objective was to compare the risk of severe neonatal morbidity between the larger and the smaller twin in monochorionic twins with birth weight discordance (BWD). We included in the study all consecutive monochorionic diamniotic pregnancies with severe BWD (≥25%) and two live-born twins delivered at our center (n=47 twin pairs). We compared the incidence of neonatal morbidity, particularly respiratory distress syndrome (RDS), and cerebral lesions between the larger and the smaller co-twin. The incidence of severe neonatal morbidity in the larger and smaller twin was 38% (18/47) and 19% (9/47), respectively (odds ratio (OR) 2.66, 95% confidence interval (CI) 0.94-7.44) and was due primarily to the higher incidence of RDS, 32% (15/47) and 6% (3/47), respectively (OR 6.88, 95% CI 1.66-32.83). In conclusion, this study shows that the larger twin in monochorionic twin pairs with BWD is at increased risk of severe neonatal morbidity, particularly RDS, compared to the smaller twin.

  8. National Pregnancy and Health Survey: Drug Use Among Women Delivering Live Births (NPHS-1992)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The primary objective of the National Pregnancy and Health Survey (NPHS) was to produce national annual estimates of the percentages and numbers of mothers of live...

  9. Delivery in Twin Gestation

    Directory of Open Access Journals (Sweden)

    Mark T. Peters

    1995-01-01

    Full Text Available Objective: The objective of this study was to determine whether prophylactic treatment with oral broad-spectrum antimicrobial therapy improves pregnancy outcomes in twin gestations.

  10. Two consecutive twin and a singleton pregnancy in a patient with chronic myeloid leukemia.

    Science.gov (United States)

    Halim, T A; Nabeel, N

    2014-01-01

    Consecutive multiple pregnancies with Chronic myeloid leukemia is a rare event and little is known about its prevalence and management with or without chemotherapy. We present a case of three consecutive pregnancies in a woman with CML, two of which were multiple pregnancies.

  11. Mifepristone-induced abortion in one horn and a growing fetus in another horn in a patient with a twin pregnancy in a bicornuate uterus.

    Science.gov (United States)

    Chao, Angel; Chao, An-Shine; Wang, Shih-Tíen; Wang, Tzu-Hao

    2006-12-01

    To report a case of mifepristone-induced abortion in only one horn but a growing fetus in another horn for a twin pregnancy in a bicornuate uterus. Case report. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taiwan. A 31-year-old woman who conceived spontaneously presented with 37 days' gestation. Mifepristone 600 mg orally followed by misoprostol 400 mug orally 2 days later. Termination of pregnancy. Induced abortion in only one horn but a growing fetus in another horn for a twin pregnancy in the bicornuate uterus detected by ultrasound. Surgical abortion with vacuum curettage was performed, and menstruation resumed 1 month later. As medical abortion with mifepristone and misoprostol becomes more prevalent, more studies are necessary to establish the dosage and regimens for multiple pregnancies associated with uterine anomalies.

  12. 体外受精-胚胎移植受孕与自然受孕双胎妊娠临床结局比较%Comparison of pregnancy outcomes between twin pregnancy conceived by IVF-ET and twin pregnancy conceived naturally

    Institute of Scientific and Technical Information of China (English)

    周晶; 李博; 陈书强; 肖西峰; 黄剑磊; 孙惠君; 董杰; 王晓红

    2016-01-01

    Objective: To compare the obstetric and neonatal outcomes between the twin pregnancy conceived by IVF-ET and the twin pregnancy conceived naturally. Methods: The retrospective cohort study included 89 twin pregnancy conceived by IVF-ET and 56 twin pregnancy conceived naturally in Tangdu hospital during 2014. The maternal complications,childbirth and neonatal outcomes were compared between the two groups. Results: The women in the IVF-ET conceived group were older than the naturally conceived group [ (30. 45 ±4. 40) vs. (28. 63±5. 12)] (P Conclusions: Twin pregnancy conceived by IVF-ET is associated with adverse pregnancy outcomes. The prevention of complications and prenatal & intrapartum care after twin pregnancy conceived by IVF-ET should be strengthened.%目的:探讨体外受精-胚胎移植( IVF-ET)对双胎妊娠母胎结局的影响。方法回顾性分析2014年1~12月于我院产科分娩的双胎妊娠产妇的临床资料。按照受孕方式分为两组:IVF-ET组(89例)和自然妊娠组(56例)。比较两组的孕产妇并发症、分娩情况及新生儿结局。结果 IVF-ET组孕产妇平均年龄(30.45±4.40)岁显著高于自然妊娠组的(28.63±5.12)岁,IVF-ET组孕妇妊娠期高血压疾病发生率(25.8%)、新生儿极早产(28~31+6周)发生率(10.1%)、极低出生体重(<1500 g)发生率(10.1%)及转新生儿科比例(55.1%)均显著高于自然妊娠组(分别为12.5%、3.6%、3.6%和34.8%)(P均<0.05)。结论 IVF-ET助孕的双胎妊娠发生不良妊娠结局的风险相对较高,建议临床上应加强IVF-ET术后双胎妊娠并发症的防治及产前、产时监护。

  13. Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options.

    Science.gov (United States)

    Lust, Annelies; De Catte, Luc; Lewi, Liesbeth; Deprest, Jan; Loquet, Philippe; Devlieger, Roland

    2008-04-01

    The aim of this study was to evaluate the effect of selective feticide (SF) compared to expectant management (EM) on perinatal outcome in dichorionic and monochorionic twins discordant for anencephaly. For this purpose, we conducted a systematic review of literature and added ten unpublished cases. As a result, we found that in dichorionic twins, mean gestational age (GA) at birth in the SF group was 38.0 weeks versus 34.9 weeks (P = 0.0002). Mean birth weight was 2922 g in the SF group versus 2474 g (P = 0.03). In monochorionic twins, mean GA at birth was 35.2 weeks versus 32.7 weeks (P = 0.1). Mean birth weight was 2711 g versus 1667 g (P = 0.0001). We conclude that while SF does not reduce perinatal mortality, it does result in significantly longer gestations and higher birth weight, and appears to be the management of choice in dichorionic twins discordant for anencephaly. In monochorionic twins, SF also increases birth weight, but in view of the complexity of this group, no clear recommendations can be made.

  14. Effect of uterine fibroids on fetal growths and neonatal outcomes in twin pregnancies%子宫肌瘤对双胎胎儿生长发育及新生儿结局的影响

    Institute of Scientific and Technical Information of China (English)

    王红梅; 代荫梅; 田玉翠; 薛智方

    2015-01-01

    Objective To prospectively estimate the effect of fibroids on fetal growths and neonatal outcomes in twin pregnancies. Methods Data of 46 twin pregnancies with fibroids delivered from June 2013 to December 2014 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University who have already established their records were collected. And data were also collected from 63 twin pregnancies without fibroids as matched group. The monitoring parameters of ultrasounds in their early, middle and late pregnancy and neonatal conditions and obstetric outcomes were observed and recorded. Results Twin pregnancies with fibroids were more likely to be of advanced maternal age ﹝(35.04±4.24)years vs (31.67±3.56)years, P=0.000﹞, higher pre-pregnancy body mass index ﹝(21.46± 3.69)kg/m2 vs (20.77±2.38)kg/m2, P=0.009﹞ and had lower amniotic fluid volume﹝(3.14±0.55)cm vs (3.38±0.55)cm, P=0. 001﹞ in 11-14 weeks ultrasound compared with twin pregnancies without fibroids. However, other parameters of fetal growths in early, middle and late pregnancy, neonatal conditions and obstetric outcomes had no statistical significance between twin pregnancies with fibroids and those without fibroids. Conclusion Fibroids’ effect on fetal growths and neonatal outcomes in twin pregnancies is not obvious. But twin pregnancy is a high risk factor for pregnancy and we should give more monitoring and management for twin pregnancy with fibroids, so that mothers and newborns get more reasonable and secure treatment.%目的:前瞻性评估子宫肌瘤对双胎胎儿生长发育及新生儿结局的影响。方法选取在首都医科大学附属北京妇产医院建档并于2013年6月至2014年12月分娩的双胎妊娠合并子宫肌瘤患者共46例作为研究组,以及双胎妊娠无肌瘤者63例作为对照组,观察并记录其孕早期、中期、晚期B超监测胎儿生长发育指标、新生儿出生情况及妊娠结局。结果与对照组相比,双胎妊娠合

  15. Clinical features of maternal and neonatal outcomes of twin preeclampsia pregnancies%双胎妊娠并发子痫前期临床比较分析

    Institute of Scientific and Technical Information of China (English)

    梅吉; 乔东艳; 徐玉娟; 于红

    2014-01-01

    目的:探讨双胎妊娠并发子痫前期的临床特点及围产结局。方法:回顾分析江阴市人民医院妇产科及东南大学附属中大医院妇产科2009年1月至2012年12月收治的双胎妊娠并发子痫前期30例孕妇及同期双胎正常妊娠30例孕妇的临床资料。对所有纳入对象进行临床流行病学调查,分析比较两组临床资料,包括孕妇一般情况、个人史、既往史及家族史、月经及婚育史、孕期情况和分娩结局等。结果:双胎妊娠并发子痫前期组与双胎正常妊娠组孕前及分娩前BMI、孕期体重增长比较,差异有统计学意义(均P<0.05);双胎妊娠并发子痫前期组中低蛋白血症、早产、产后出血发生率显著高于双胎正常妊娠组(均P<0.05);双胎正常妊娠组胎膜早破发生率高于双胎妊娠并发子痫前期组(P<0.05);双胎妊娠并发子痫前期组中血白蛋白、血小板计数显著低于双胎正常妊娠组,而血肌酐显著高于双胎正常妊娠组(均P<0.05);双胎妊娠并发子痫前期组剖宫产率高于双胎正常妊娠组(P<0.05)。结论:临床资料分析显示,孕前BMI过高、孕期体重增长过多为双胎妊娠并发子痫前期的常见表现;早产、低蛋白血症、产后出血为双胎妊娠并发子痫前期较常见的并发症;双胎妊娠并发子痫前期可出现血小板减少、血肌酐升高、白蛋白降低等表现。%Objective: To explore clinical features of maternal and neonatal outcomes of twin preeclampsia pregnancies .Methods:Thirty twin pregnant women with preeclampsia were selected as observation group .Thirty cases of normal twin pregnant women , clinical data over the same period , were selected as a control group .All of them came from Jiangyin People's Hospital and Zhongda Hospital Affiliated to the Southeast University from January 2009 to December 2012.All of them were Chinese Han people and all

  16. The effects of twin pregnancy on uterine pull tension%双胎妊娠对子宫牵张力影响的研究

    Institute of Scientific and Technical Information of China (English)

    陶志云; 张晓慧; 张英; 魏兆莲

    2016-01-01

    Objective To study the effects of the uterine contraction when the uterine pull tension of twin pregnan-cy has changed. Methods The uterine smooth muscle of single and twin pregnant women in the second trimester of pregnancy (26 ± 6) W and late pregnancy(37 ± 6) W were collected to be made into 30 strips each group, ob-served the change of uterine pull tension of single and twin pregnancy and the effects to uterine contraction, when oxytocin concentration gradient was stimulated. Results In Krebs solution, the uterine pull tension of late single pregnancy was bigger than that in the second trimester, and the uterine pull tension of late twin pregnancy was big-ger than that in the second trimester, and the uterine pull tension of the second trimester of twin pregnancy was big-ger than that of single pregnancy at the same time, and the uterine pull tension of late twin pregnancy was bigger than that of single pregnancy at the same time. There was statistical significance (P<0. 05). With the progress of pregnancy, the uterine pull tension was enlarged. Moreover, the uterine contraction of late single pregnancy caused by the change of uterine pull tension was more obvious than that of late twin pregnancy under the oxytocin concen-tration gradient. There was statistical significance (P<0. 05). Conclusion The uterine contraction begins to de-cline with the uterine pull tension of twin pregnancy increases.%目的 探讨双胎妊娠子宫牵张力变化对子宫收缩能力的影响. 方法 采集单胎妊娠及双胎妊娠孕妇中期妊娠(孕26 ± 6周)和晚期妊娠(孕37 ± 6 周)的子宫平滑肌组织,制作成肌条各30份,给予缩宫素浓度梯度刺激,观察单胎妊娠与双胎妊娠的子宫牵张力变化及对子宫收缩力的影响. 结果 在Krebs液中,单胎妊娠晚孕阶段子宫牵张力大于中孕阶段,双胎妊娠晚孕阶段子宫牵张力大于中孕阶段,中孕阶段的双胎妊娠子宫牵张力大于单胎妊娠,晚孕阶段的双

  17. 双胎妊娠与单胎妊娠的并发症及妊娠结局比较%The comparative observation of complications and pregnancy outcomes between twin pregnancy and singleton preg-nancies

    Institute of Scientific and Technical Information of China (English)

    魏景仙; 申更存; 霍强; 赵继广; 李存娟

    2014-01-01

    Objective To comparative observation the complications and pregnancy outcomes between twin pregnancy and singleton pregnancies .Methods Selected 100 patients with twin preanancy ,and 100 patients with singleton pregnancies . After treatment,compared the complications,postpartum hemorrhage,the incidence of low-weight children,neonatal asphyxia rate and the perinatal child mortality of 2 groups .Results The complication rate of twin pregnancy was higher than that of control group,the difference was statistically significant (P<0.05).The postpartum hemorrhage,the incidence of low-weight children,nenoatal asphyxia rate and the perinatal child mortality were higher than that of control group ,the difference was sta-tistically significant(P<0.05).Conclusion The twin pregnancy can improve the complication rate ,increase the adverse out-comes,Strengthen the Prenatal guidance and guardianship has an important significant .%目的:观察双胎妊娠与单胎妊娠孕产妇并发症和妊娠结局的差异。方法选择待产双胎妊娠孕产妇(双胎妊娠组)和单胎妊娠孕产妇(单胎妊娠组)各100例,比较2组孕产妇的并发症、产后出血量、低体质量儿发生率、新生儿窒息率、围生儿病死率,评价单胎妊娠与双胎妊娠并发症、妊娠结局差异。结果双胎妊娠组的并发症发生率高于单胎妊娠组(P<0.05),产后出血量、低体质量儿发生率、新生儿窒息率、围生儿病死率明显高于单胎妊娠组(P<0.05)。结论双胎妊娠使孕产妇并发症增多,增加了新生儿预后不良的出现,加强对双胎妊娠的产前指导和监护,对双胎妊娠结局具有重要意义。

  18. EFFECT OF EARLY PREGNANCY BODY MASS INDEX ON PREGNANCY OUTCOMES IN WOMEN DELIVERING SINGLETON BABIES- AN OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Divya Vishnu

    2017-02-01

    Full Text Available BACKGROUND Maternal overweight/obesity causes many complications during pregnancy and delivery. It can also increase neonatal and infant morbidity and mortality. BMI is an important measure of under/overweight. This observational study examines the correlation between maternal Body Mass Index (BMI with maternal outcome in women. MATERIALS AND METHODS This study was conducted at Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, for a period of one year. A sample of 300 pregnant women with intrauterine pregnancy of gestational age <12 weeks at first visit was taken for this study with an age between 18 and 35 years with singleton pregnancy. BMI of these women were calculated and they were classified into two categories (BMI <23 kg/m2 and BMI ≥23 kg/m2 . The Chi-square test was done to find the association of BMI and various maternal outcomes. RESULTS In the sample of 300 pregnant women, 39% were having BMI <23 kg/m2 and 61% were having BMI ≥23 kg/m2 . Pregnant women with BMI ≥23 kg/m2 were found to have significantly increased risk of developing gestational hypertension, gestational diabetes and macrosomia. We found that a significantly increased need of induction and increased risk of developing intrapartum and postpartum complications in those with BMI ≥23 kg/m2 . Our study also found out that an increased incidence of elective as well as emergency caesareans and increased risk of neonatal complications in women whose BMI ≥23 kg/m2 . CONCLUSION Adverse maternal and perinatal outcomes are significantly related to extremes of BMI categories and least complications were seen in normal BMI group. Therefore, it is ideal to reduce the body weight to an optimal level so that the complications, which are attributed to overweight and obesity can be reduced. We recommended future research on the association of BMI and maternal outcomes involving large samples comparable to those done in developed countries.

  19. Perinatal hepatic infarction in twin-twin transfusion.

    LENUS (Irish Health Repository)

    O'Sullivan, M J

    2012-02-03

    We report a case of a twin pregnancy which was complicated by a twin-twin transfusion in which the recipient twin was noted to have an intra-abdominal echogenic mass. This twin died at two days of age of hepatic infarction. The donor twin was healthy at birth, at thirty weeks\\' gestation, and did not have any subsequent problems. Fetal intra-abdominal echogenicity may be a marker of hepatic infarction.

  20. Profile of peroxidative injury and antioxidant indicators in singleton, twins and multiple bearing goats throughout pregnancy

    Directory of Open Access Journals (Sweden)

    M.A. Abdel-Ghani

    2016-09-01

    Conclusion: Knowing the relationship between the fetal number and oxidative stress indicators could be useful in the clinical management of such pregnancies and could be useful in the early detection or prediction adverse pregnancy outcome. Particularly, the 4th and 5th month of gestation increases the liability to reactive oxygen species in goats.

  1. Accuracy of diagnosing double corpora lutea and twin pregnancy by measuring serum progesterone and bovine pregnancy-associated glycoprotein 1 in the first trimester of gestation in dairy cows.

    Science.gov (United States)

    Szelényi, Zoltán; Répási, Attila; de Sousa, Noelita Melo; Beckers, Jean Francois; Szenci, Otto

    2015-07-01

    Progesterone (P4) and bovine pregnancy-associated glycoprotein 1 (bPAG-1) concentrations during gestation are dependent on the number of CL and fetuses, respectively. The objective of this present study was to measure and evaluate the usefulness of measuring the P4 and bPAG-1 concentrations in cases of single versus twin pregnancies and one versus two CL at the first 4 months of gestation. We hypothesized that both the number of the CL and the number of fetus might have an effect on P4 and pregnancy protein concentrations, and we can set up clinically useful threshold levels to predict twin gestations. Eighty-four Holstein-Friesian dairy cows were enrolled in this prospective observational clinical trial. Blood was collected at time point 1: between Days 29 and 42, time point 2: between Days 57 and 70, time point 3: between Days 85 and 98, and time point 4: between Days 113 and 126 of gestation, and bPAG-1 and P4 concentrations were measured. Binary logistic regression analyzing serum P4 concentrations differed at time point 2 compared with baseline level, but the area under the curve (AUC) had low sensitivity. The bPAG-1 concentrations were statistically different at each time point of gestation. The AUC cutoff values of serum bPAG-1 concentrations were sufficiently sensitive to differentiate between twin gestations from singleton ones. At time points 3 (cutoff value of 3.4 ng/mL) and 4 (cutoff value of 56.5 ng/mL), statistically significant differences with low sensitivity, high specificity, and a high AUC were found. On the basis of these results, the diagnosis of twin pregnancy using pregnancy protein measurements is clinically insufficient before Day 85 of gestation; however, the ability to confirm the early twin pregnancy diagnosis with bPAG-1 measurements appears to be promising. To achieve high sensitivity, further studies are required.

  2. Influence on the Childbirth Way and Pregnancy Outcome in Twin Pregnancy%双胎妊娠经阴道分娩的经验交流

    Institute of Scientific and Technical Information of China (English)

    冯秀山; 张延珍; 陈玲

    2013-01-01

    目的:探讨孕周≥34周双胎妊娠产妇的分娩方式对母亲和新生儿结局的影响。方法收集福建医科大学附属协和医院2006年6月至2013年5月60例孕周≥34周双胎妊娠产妇的临床资料,根据分娩方式的不同分为阴道分娩组(11例)和剖宫产组(49例),对其资料进行回顾性分析。结果阴道分娩组胎方位以头-头位为主,余为头-臀位,而剖宫产组胎方位多样。阴道分娩组无妊娠合并症,而剖宫产组妊娠合并症为37例(75.51%)。两组产妇的分娩孕周、产后出血发生率、输血发生率均无显著性差异(χ2=1.97,P=0.16;χ2=0.63,P=0.43;χ2=1.88,P=0.17)。活产新生儿120例。两组新生儿体重、窒息发生率、入住NICU(新生儿重症监护室)率无显著性差异(χ2=1.53,P=0.22;χ2=2.78,P=0.10;χ2=0.24,P=0.62)。但剖宫产组住院时间显著增加(t=5.46, P<0.05)。结论双胎妊娠产妇无合并症或者合并症轻微,胎方位为头/头、头/臀位,胎儿体重相对较小,可考虑经阴道分娩。%Objective To study the relationship between childbirth way and pregnancy outcome in twin pregnancy after 34 weeks. Methods Clinical data of 60 cases of twin pregnancy women, which were divided into two groups according to the delivery mode from Jan. 2006 to May. 2013 were analyzed retrospectively. Results The head-head position is the main fetal position in vaginal delivery group, and the other is head-breech. Cesarean group fetal position is diverse. Vaginal delivery group had no pregnancy complications, and there is 37cases (75.51%) in cesarean group. There was no difference in gestational weeks, postpartum hemorrhage, transfusion rate (χ2=1.97,P=0.16;χ2=0.63,P=0.43;χ2=1.88, P=0.17). There are 120 cases of live birth. There was no difference in neonatal weight, neonatal asphyxia and neonatal NICU (Neonatal Intensive Care Unit) occupancy rate of two groups (χ2=1.53,P=0.22;

  3. Perinatal Outcome of Second Twin with Respect to Mode of Delivery: An Observational Study

    Science.gov (United States)

    Nadkarni, Trupti K

    2016-01-01

    Introduction With the advent of assisted reproductive techniques, multi-fetal pregnancies are on the rise. While caesarean section is the defined mode of delivery for triplets and higher order pregnancies, the picture for twin delivery is not so clear. While a trial for vaginal delivery is attempted, the second twin is considered vulnerable to complications. Whether this translates into worsened perinatal outcomes is not well defined. Aim To study the perinatal outcome and to identify the various factors influencing the perinatal outcome of second twin with respect to mode of delivery. Materials and Methods Data was collected from hospital birth records regarding the mode of delivery of viable twins (period of gestation >28 weeks) and outcome of second twin with respect to APGAR scores, NICU stay, neonatal morbidity and mortality, over a period of 12 months. Results Of the 93 pairs of twins delivered, in 21(22.6%) pregnancies both twins were delivered vaginally, in 70(75.2%) pregnancies both were delivered by caesarean section and in 2 (1.8%) pregnancies 1st twin was delivered by vaginal route and 2nd by caesarean. In the vaginal delivery group, 85.7% times both twins were in vertex position. In the caesarean group, vertex/non-vertex (38.57%) was the most common presentation followed by non-vertex /non-vertex (25.71%) and vertex/vertex (24.28%). Comparing the perinatal outcome of second twin in both groups, the odds for APGAR score ≤7 was 3.385 times (OR-3.384, 95% CI 1.2099- 9.4684, p=0.02) in the vaginal group compared to the caesarean group. There was no association (OR-1.054, 95% CI 0.3344- 3.3268, p=0.9) between neonatal morbidity of second twin compared to mode of delivery. All 3 perinatal deaths were in the vaginal group (all between 28-32 weeks of gestation). Conclusion There is an increased preference for caesarean delivery in twin pregnancies except in cases where both the twins are in vertex position and not associated with any other maternal or fetal

  4. [Problems posed by the death of one fetus in a twin pregnancy].

    Science.gov (United States)

    Dallay, D; Soumireu-Mourat, J

    1985-12-01

    Much recent works has highlighted the problems posed by the death of one fetus in utero during multiple pregnancy. This is a rare but serious accident which exposes the mother and the surviving fetus to the transfer of placentary and fetal thromboplastins or to the direct embolization of necrosed fragments of the placenta. Only fetal death occurring during the second and third terms of pregnancy is considered.

  5. Analysis of intracranial hemorrhage grade in preterm singleton pregnancies delivered vaginally or by cesarean section

    Directory of Open Access Journals (Sweden)

    Ljuština Saša

    2013-01-01

    Full Text Available Background/Aim. Preterm birth is the leading cause of neonatal mortality. Periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH remains a significant cause of both morbidity and mortality in infants prematurely born. The aim of the study was to evaluate the perinatal outcome regarding IVH of premature babies according to the mode of delivery. Methods. A total of 126 women in preterm singleton pregnancies with vertex presentation and 126 neonates weighted from 750 g to 1,500 g at birth were enrolled. The outcomes of 64 neonates born vaginally were compared to 62 neonates born by cesarean section. Results. There was no significant difference in the incidence of IVH among both groups. Conclusion. Our data is consistent with the hypothesis that the mode of delivery does not influence IVH and consenquently perinatal outcome in preterm neonates.

  6. Massively Parallel Sequencing (MPS) of Cell-Free Fetal DNA (cffDNA) for Trisomies 21, 18, and 13 in Twin Pregnancies.

    Science.gov (United States)

    Du, Erqiu; Feng, Chun; Cao, Yuming; Yao, Yanru; Lu, Jing; Zhang, Yuanzhen

    2017-06-01

    Massively parallel sequencing (MPS) technology has become increasingly available and has been widely used to screen for trisomies 21, 18, and 13 in singleton pregnancies. This study assessed the performance of MPS testing of cell-free fetal DNA (cffDNA) from maternal plasma for trisomies 21, 18, and 13 in twin pregnancies. Ninety-two women with twin pregnancies were recruited. The results were identified through karyotypes of amniocentesis or clinical examination and follow-up of the neonates. Fluorescent in-situ hybridization was used to examine the placentas postnatally in cases of false-positive results. The fetuses with autosomal trisomy 21 (n = 2) and trisomy 15 (n = 1) were successfully detected via MPS testing of cffDNA. There was one false-positive for trisomy 13 (n = 1), and fluorescence in-situ hybridization (FISH) identified confined placental mosaicism in this case. For twin pregnancies undergoing second-trimester screening for trisomy, MPS testing of cffDNA is feasible and can enhance the diagnostic spectrum of non-invasive prenatal testing, which could effectively reduce invasive prenatal diagnostic methods. In addition to screening for trisomy 21, 18, and 13 by cffDNA, MPS can detect fetal additional autosomal trisomy. False-positive results cannot completely exclude confined placental mosaicism.

  7. Increased doses of vaginal progesterone for the prevention of preterm birth in twin pregnancies: a randomised controlled double-blind multicentre trial.

    Science.gov (United States)

    Serra, V; Perales, A; Meseguer, J; Parrilla, J J; Lara, C; Bellver, J; Grifol, R; Alcover, I; Sala, M; Martínez-Escoriza, J C; Pellicer, A

    2013-01-01

    Previous trials have shown little benefit for preventing preterm birth in twin pregnancies using 90-200 mg of daily vaginal natural progesterone. Higher doses have not been tested. Our aim was to determine the efficacy and safety of two different daily doses of vaginal natural progesterone (200 and 400 mg), compared with placebo, for preventing preterm birth in unselected twin pregnancies. Randomised controlled double-blind multicentre trial (1:1:1). The study was carried out in five university centres from Valencia, Murcia and Alicante (Spain). Women with dichorionic diamniotic twin pregnancies. The women self-inserted two vaginal pessaries daily, containing placebo (n = 96), 200 mg of natural progesterone (n = 97) or 400 mg of natural progesterone (n = 97), from 20 to 34 weeks of gestation or delivery. Randomisation was performed by an external centre. Data were analysed on an intention-to-treat basis. Preterm birth rate. The baseline characteristics for placebo and progesterone groups were similar. Comparison of the three groups and analysis of progesterone-treated versus untreated women showed similar pregnancy and neonatal outcomes. The proportion of preterm and very preterm births, low birthweight, perinatal mortality and neonatal morbidity showed no differences between the three groups. Similar results were also obtained when comparing the 200- versus 400-mg progesterone groups. No serious adverse effects were encountered. Vaginal progesterone therapy was generally well tolerated, but failed to prevent preterm births in unselected dichorionic diamniotic twin pregnancies. The 400-mg progesterone dose offered no advantages over the 200-mg regimen. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  8. Having Twins? How to Stay Healthy

    Science.gov (United States)

    ... Listen Español Text Size Email Print Share Having Twins? How to Stay Healthy Page Content Article Body ... the eyes of obstetricians. Many would call a twin pregnancy a high-risk pregnancy , but don’t ...

  9. The clinical study of twin pregnancy complicated by preeclampsia%双胎妊娠并发子痫前期的临床研究

    Institute of Scientific and Technical Information of China (English)

    朱秀君

    2015-01-01

    Objective To investigate the effects of twin pregnancies complicated by pre eclampsia of pregnancy complications and neonatal outcomes,further guide clinical.Methods retrospective analysis of the clinical data of 48 patients with twin pregnancies com-plicated by pre eclampsia patients and the same period in our hospital from 201 1 January to 2014 January were 48 cases of normal sin-gleton pregnancies,the twin pregnancies complicated by pre eclampsia patients as the observation group,while the normal single preg-nancy patients as a control group,the two groups were observed and compared analysis of the influence of comorbidity and maternal and neonatal outcomes of pregnancy.Results the group of premature rupture of membranes,the rate of postpartum hemorrhage,premature delivery,cesarean section and neonatal asphyxia was significantly higher than that in the control group,the difference was significant, with statistical significance (P<0.05 ).Conclusion The twin pregnancies complicated by pre eclampsia were more prone to pregnancy induced hypertension syndrome,affects the prognosis of mother and child,clinical worth attention.%目的:探讨双胎妊娠并发子痫前期对妊娠合并症及母婴结局的影响,进一步指导临床。方法:回顾性的分析48例双胎妊娠并发子痫前期患者和同期收治的48例双胎妊娠无并发子痫前期患者的临床资料,将双胎妊娠并发子痫前期患者作为观察组,而双胎妊娠无并发子痫前期患者作为对照组,观察两组患者对妊娠合并症及母婴结局的影响进行对比分析。结果:观察组胎膜早破、产后出血率、早产、剖宫产率及新生儿窒息情况明显高于对照组,差异具有统计学意义(P<0.05)。结论:双胎妊娠并发子痫前期较易发生妊娠期合并症,影响母婴的预后,临床值得加以重视。

  10. Analysis of 328 cases of pregnancy outcome of twin%双胎妊娠328例结局分析

    Institute of Scientific and Technical Information of China (English)

    赵勇; 张敏华

    2014-01-01

    Objective To investigate the twin pregnancy mother and child during pregnancy perinatal outcome and treatment on perinatal outcome.Methods for January 2010 to December 2013 during the First Hospital of Sanming City, Fujian hospital delivery of 328 cases of twin pregnancy were retrospectively analyzed . Results twin pregnancy fetal mortality rate was 2.13%, neonatal mortality rate was 1.83%, cesarean section rate was 53.7% . Perinatal regular prenatal care for pregnant women and fetal complications of pregnancy complications and mortality rates were lower than the occasional check-ups of pregnant women, the difference was statistically signiifcant (P<0.05 ) .Conclusion twin pregnancy mother and child perinatal complications, complications and mortality rates are high, so regular prenatal care, to prevent and treat complications of pregnancy, childbirth choose favorable timing and mode of delivery to reduce perinatal twins child morbidity and mortality is important.%目的:探讨双胎妊娠的母儿围生结局及孕期处理对围生结局的影响。方法对2010年1月~2013年12月期间在福建三明市第一医院住院分娩的328例双胎妊娠病例进行回顾性分析。结果双胎妊娠胎儿死亡率为2.13%,新生儿死亡率为1.83%,剖宫产率为53.7%。围生期定期进行产前检查的孕妇孕期并发症及合并症及胎儿死亡率均低于不定期产检的孕妇,差异具有统计学意义(P<0.05)。结论双胎妊娠母亲及围生儿合并症、并发症及死亡率均较高,因此定期产前检查,积极防治妊娠期各种并发症,选择有利的分娩时机和分娩方式对降低双胎围生儿患病率和死亡率有重要意义。

  11. Can a health coaching intervention delivered during pregnancy help prevent excessive gestational weight gain?

    Science.gov (United States)

    Hill, Briony; Skouteris, Helen; Fuller-Tyszkiewicz, Matthew; McPhie, Skye

    2016-10-01

    This study evaluated: (1) the efficacy of a health coaching (HC) intervention designed to prevent excessive gestational weight gain (GWG); and (2) whether there were improved psychological, motivational, and behavioural outcomes for women in the HC intervention compared to a "usual care" control group. In this quasi-experimental study, 267 pregnant women ≤18 weeks gestation were recruited between August 2011 and June 2013 from two hospital antenatal clinics in Melbourne, Australia. Intervention women received four individual HC and two group HC/educational sessions informed by theories of behaviour change. Women completed questionnaires assessing psychological, motivational and behavioural outcomes at 16-18 (baseline) and 33 (post-intervention) weeks gestation. Weight measures were collected. Compared to usual care, the intervention did not limit GWG or prevent excessive GWG. However, HC women reported greater use of active coping skills post-intervention. Despite lack of success of the HC intervention, given the risks associated with excessive weight gain in pregnancy, health professionals should continue to recommend appropriate GWG.

  12. Cell-free fetal DNA analysis in maternal plasma as a screening test for trisomy 21, 18 and 13 in twin pregnancies.

    Science.gov (United States)

    Le Conte, Grégoire; Letourneau, Alexandra; Jani, Jacques; Kleinfinger, Pascale; Lohmann, Laurence; Costa, Jean-Marc; Benachi, Alexandra

    2017-08-18

    To evaluate the utility of noninvasive prenatal testing using cell-free circulating fetal DNA (cfDNA) in screening for the three main autosomal fetal trisomies in twin pregnancies. CfDNA testing was offered to 492 patients with twin pregnancies without ultrasound anomalies as a first-line screening test or after serum screening in clinical practice. Data were collected prospectively and a retrospective analysis was performed. CfDNA analysis was performed by massively parallel sequencing. The fetal fraction threshold for test evaluation was 8%. Regression analysis was performed to investigate the effect on the test failure rate of various variables. Performance of the test is also reported. The test was performed first line (after first-trimester scan) in 377 patients and following serum screening in 115. 78.8% of pregnancies were dichorionic-diamniotic. The test failed at the first attempt in 12 (2.9%) of 420 pregnancies with available outcomes, and regression analysis demonstrated that only maternal weight was a significant independent predictor of test failure. After redraw, a result was achieved in 10 cases. CfDNA identified all 3 cases of trisomy 21, and the only case of trisomy 18. For trisomy 21, the specificity was 99.8% (95% CI [98.7% - 100.0%]). When considering the spontaneous or ART origin of pregnancies, there were no significant differences in terms of maternal weight or of no-result rate for cfDNA screening in the two groups. In twin pregnancies without fetal ultrasound abnormalities, cfDNA had a high success rate and performance. Therefore, in routine practice, cfDNA could be considered as a first- or second-line screening test. This article is protected by copyright. All rights reserved.

  13. Influence of chorionicity on perinatal outcome in a large cohort of Danish twin pregnancies

    DEFF Research Database (Denmark)

    Oldenburg, Anna; Rode, Line; Bødker, Birgit

    2012-01-01

    with two live infants at 28 days after delivery was 97.5% and 95.1%, respectively. Conclusion The increased incidence of fetal loss and neonatal death in MC compared to DC pregnancies predominantly occurs before 24 weeks’ gestation. Although risk of IUFD is slightly higher in MC than DC after 24 weeks...

  14. 超声测量晚孕期正常双胎生长参数的初步分析%Preliminary Analysis of Ultrasound Measurement of Growth Parameters of Normal Twin Pregnancy in the Last TrimesterPregnancy

    Institute of Scientific and Technical Information of China (English)

    王晶; 杨太珠

    2011-01-01

    Objective To initially establish the growth parameters of normal twin pregnancy in 28-34 gestational ages according to the ultrasound measurement, and to compare the intrauterine growth patterns between the singleton and twin pregnancy. Methods The relevant index of the twin pregnancy, including the biparietal diameter (BPD), femur length, head circumference (HO, abdominal circumference (AC), were measured. The transverse cerebellar diameter (TCD) was measured and the virtural organ computer-aided analysis was used to detect the fetal cerebellar volume (FCV). The intrauterine growth patterns between the singleton and twin pregnancy was compared. Results After the gestational age of 30 weeks, the mean values of BPD of the twins pregnancies (1. 7 mm) were lower than those of the singleton pregnancies (2. 3 mm). After the gestational age of 32 weeks, the mean value of HC of the twins pregnancies (5. 8 mm) was lower than that of the singleton pregnancies (6. 7 mm). After the gestational age of 30 weeks, the mean values of AC of the twins pregnancies (5. 3 mm) were lower than those of the singleton pregnancies (6. 9 mm). After the gestational age of 28 weeks, the mean value of FL of the twins pregnancies (1. 7 mm) was lower than the singleton pregnancies (2. 0 mm). After the gestational age of 28 weeks, the growth of twin pregnancy fetuses is more slowly. After the gestational age of 28-34 weeks, the differences in mean values of TCD and FCV between the twin pregnancy and singleton pregnancy was not significant. Conclusion The twin pregnancy and singleton pregnancy have different growth patterns in the third trimester pregnancy.%目的 拟初步建立孕28~34周的双胎胎儿生长参数超声测量值的正常范围,比较晚孕期单、双胎妊娠胎儿的宫内生长发育模式.方法 对2009年5月-2010年4月超声诊断为正常宫内双活胎、单活胎孕妇,采用超声测量胎儿相关生长发育指标,包括双顶径、头围、腹围、股骨长

  15. Insulin requirements in type 1 diabetic pregnancy

    DEFF Research Database (Denmark)

    Callesen, Nicoline; Ringholm, Lene; Stage, Edna;

    2012-01-01

    To evaluate the insulin requirements in women with type 1 diabetes during twin pregnancy compared with singleton pregnancy.......To evaluate the insulin requirements in women with type 1 diabetes during twin pregnancy compared with singleton pregnancy....

  16. 双胎妊娠98例临床分析%A Study of 98 Cases Twin Pregnancy on the Maternal and Fetal Harm

    Institute of Scientific and Technical Information of China (English)

    李林娜

    2011-01-01

    Objective: To study the harm of the twin pregnancy on the maternal and fetal harm. Method: 98 cases outpatients with the twin pregnancy for nearly 3 years was retrospectively analysed. Result: Of 98 cases with twin pregnancy, 16 cases( 16.33% ) complicated with pregnancy-induced hypertension; 29 cases pregnancy anemia( 29.59% ); 11 cases polyhydramnios (11.22% ); 12 cases of premature rupture of membranes( 12.24% ); 41 cases birth process appears hypodynamic(68.33% ); 14 cases postpartum hemorrhage ( 14.29% ); 28 cases preterm birth ( 28.57% ) and 3 cases of premature death; 29 c.ases fetal growth restriction(29.59%); 46 cases fetal azimuth(46.94%); 3 cases double twin transfusion syndrome(3. 06% ); 6 cases asphyxia(6.12% ). Conclusion: The twin pregnancy women should be closely monitored,do more missionary, strengthen antenatal, perfected health measures, timely treated the complications.%目的:了解双胎妊娠对母婴的危害.方法:对近3年收治的98例双胎妊娠进行回顾性分析.结果:98例双胎妊娠中,合并妊娠期高血压疾病16例,发生率16.33%;妊娠贫血29例,发生率29.59%;羊水过多11例,发生率11.22%;胎膜早破12例,发生率12.24%;产程中出现宫缩乏力41例,发生率68.33%;产后出血14例,发生率14.29%;早产28例,发生率28.57%,其中早产儿死亡3例;胎儿生长受限29例,发生率29.59%;胎方位异常46例,发生率46.94%;双胎输血综合征3例,发生率3.06%;新生儿窒息6例,发生率6.12%.结论:一旦双胎妊娠,必须严密监护,向孕妇做详细宣教,加强产前检查,完善保健措施,及时处理并发症.

  17. Twin-to-twin transfusion syndrome : from placental anastomoses to long-term outcome

    NARCIS (Netherlands)

    Lopriore, Enrico

    2006-01-01

    Twin-to-twin transfusion syndrome (TTTS) is a severe complication of monochorionic twin pregnancies associated with high perinatal mortality and morbidity rates. Placental vascular anastomoses, almost invariably present in monochorionic placentas, are the essential anatomical substrate for the devel

  18. Twin-to-twin transfusion syndrome : from placental anastomoses to long-term outcome

    NARCIS (Netherlands)

    Lopriore, Enrico

    2006-01-01

    Twin-to-twin transfusion syndrome (TTTS) is a severe complication of monochorionic twin pregnancies associated with high perinatal mortality and morbidity rates. Placental vascular anastomoses, almost invariably present in monochorionic placentas, are the essential anatomical substrate for the

  19. Twin-to-twin transfusion syndrome : from placental anastomoses to long-term outcome

    NARCIS (Netherlands)

    Lopriore, Enrico

    2006-01-01

    Twin-to-twin transfusion syndrome (TTTS) is a severe complication of monochorionic twin pregnancies associated with high perinatal mortality and morbidity rates. Placental vascular anastomoses, almost invariably present in monochorionic placentas, are the essential anatomical substrate for the devel

  20. 双胎妊娠妇女心理健康状况的调查分析%Investigation on the mental health of twin pregnancy women during pregnancy period

    Institute of Scientific and Technical Information of China (English)

    贾曼; 廖碧珍

    2016-01-01

    目的 了解双胎妊娠妇女心理健康状况及影响因素,为改善其不良心理状况的干预措施提供依据.方法 对建卡并定期产检的双胎妊娠妇女60例,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和自编问卷进行调查.结果 双胎妊娠妇女SAS得分为(52.87±10.19)分,SDS得分为(50.61±4.31)分;不同年龄、孕周及妊娠方式对双胎妊娠妇女焦虑程度构成比比较,不同孕周、妊娠方式和有过流产史、生育史的双胎妊娠妇女抑郁构成比比铰,差异均有统计学意义(F/t=12.74~ 54.93,P< 0.05或0.01);回归分析显示,孕周和妊娠方式是影响双胎妊娠妇女焦虑、抑郁的主要因素.结论 双胎妊娠妇女存在不同程度的焦虑、抑郁情绪,孕周增加和接受辅助生殖技术是加重双胎妊娠妇女焦虑、抑郁的主要因素,需从加强心理护理、建立标准化的助产模式、鼓励孕妇自我调节、发挥社会家庭支持系统作用等方面加以改进.%Objective To investigate the mental health state of twin pregnancy women and influencing factors,so as to provide reference for measures to improve their mental condition.Methods Sixty twin pregnancy women who have made regular antenatal examination received the investigation of Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS) and self-designed questionnaire.Results The score of SAS for twin pregnancy women was (52.87±10.19) points,SDS was (50.61±4.31) points.There were significant differences in twin pregnancy women degree of anxiety with different age,gestational weeks,and pregnancy way and degree of depression with different gestational weeks,pregnancy way and abortion,reproductive history (F/t=12.74-54.93,P < 0.05 or 0.01).Regression analysis showed that gestational weeks and pregnancy way were the main factors of anxiety and depression influencing twin pregnancy women.Conclusions The anxiety state of twin pregnancy women is in a moderate level,and the

  1. A prospective study of twinning and perinatal mortality in urban Guinea-Bissau

    Directory of Open Access Journals (Sweden)

    Bjerregaard-Andersen Morten

    2012-12-01

    Full Text Available Abstract Background Despite twinning being common in Africa, few prospective twin studies have been conducted. We studied twinning rate, perinatal mortality and the clinical characteristics of newborn twins in urban Guinea-Bissau. Methods The study was conducted at the Bandim Health Project (BHP, a health and demographic surveillance site in Bissau, the capital of Guinea-Bissau. The cohort included all newborn twins delivered at the National Hospital Simão Mendes and in the BHP study area during the period September 2009 to August 2011 as well as singleton controls from the BHP study area. Data regarding obstetric history and pregnancy were collected at the hospital. Live children were examined clinically. For a subset of twin pairs zygosity was established by using genetic markers. Results Out of the 5262 births from mothers included in the BHP study area, 94 were twin births, i.e. a community twinning rate of 18/1000. The monozygotic rate was 3.4/1000. Perinatal mortality among twins vs. singletons was 218/1000 vs. 80/1000 (RR = 2.71, 95% CI: 1.93-3.80. Among the 13783 hospital births 388 were twin births (28/1000. The hospital perinatal twin mortality was 237/1000. Birth weight  Conclusions Twins had a very high perinatal mortality, three-fold higher than singletons. A birth weight 

  2. 试管婴儿双胎与自然受孕双胎产妇和新生儿的临床结局分析%Analysis of clinical outcomes of twin pregnancy women and neonates with twin pregnancy and natural pregnancy

    Institute of Scientific and Technical Information of China (English)

    夏燕; 潘晖; 魏兆莲

    2016-01-01

    目的:探讨试管婴儿双胎与自然受孕双胎产妇和新生儿的临床结局。方法收集2014年8月至2015年6月收治的60例试管婴儿双胎妊娠(试管组)与78例自然受孕双胎妊娠(对照组)产妇的妊娠周期、妊娠期合并症、分娩方式、年龄、新生儿体重、新生儿出生缺陷等资料,对比两组产妇之间的差异性。结果与对照组对比,试管组产妇年龄显著升高,差异有统计学意义( P 0.05);与对照组对比,试管组产妇妊娠期高血压发生率显著升高,差异有统计学意义( P 0.05);与对照组对比,试管组新生儿在28~31孕周早产的发生率显著升高,极低体质量儿及转新生儿科新生儿比率显著升高,差异有统计学意义( P 0.05)。结论试管婴儿双胎较自然受孕双胎发生不良妊娠结局的危险性相对较高,应加强对试管婴儿双胎妊娠的产前及产时监护,防治并发症的发生。%Objective To explore the clinical outcome of twin pregnancy and newborn twins with twin pregnancy in vitro. Methods From August 2014 to June 2015 in our hospital 60 cases of obstetrics and gynecology IVF twin pregnancy(tube group)and 78 cases of naturally conceived twin pregnancies( control group)were collected. Maternal pregnancy cycle,pregnancy complications,mode of delivery,age,birth weight,birth defects of the two groups were collected,and compared. Results Compared with the control group,test tube group of maternal age was significantly increased,the difference was statistically significant( P 0. 05). Compared with the control group,test tube group of maternal gestational hypertension incidence increased significantly,the difference was statistically significant( P 0. 05). Compared with the control group,the premature gestational incidence in 28 ~ 31 in tube group increased significantly,basal body weight infant and newborn proportion increased significantly,the difference was statisti

  3. 单绒毛膜单羊膜囊双胎妊娠17例临床分析%Monochorionic monoamniotic twin pregnancy: a review of 17 cases

    Institute of Scientific and Technical Information of China (English)

    邵长香; 孙路明; 邹刚; 孙琦; 周奋翮; 周艳

    2014-01-01

    Objective To review the diagnosis,monitoring,management and perinatal outcomes of monochorionic monoamniotic (MCMA) twin pregnancy.Methods From July 2010 to August 2013,there were 17 MCMA twin pregnancies diagnosed and delivered in Shanghai First Maternity and Infant Hospital.According to the MCMA management protocol,induced abortion,elective fetal reduction,and anticipant pregnancy were optional.For those anticipant pregnancies,fetal lung underwent maturation promotion at gestational weeks 28; hospitalization with 40 min/day continual fetal electronic monitoring and umbilical blood monitoring twice weekly at gestational weeks 28-30; 40 min continual fetal electronic monitoring twice daily and umbilical blood monitoring once every other day at gestational weeks 30-32; and 40 min continual fetal electronic monitoring three times daily and umbilical blood monitoring once daily at gestational weeks 32-34; and pregnancy ended on time.The presence of umbilical cord entanglement,congenital malformation,intrauterine fetal death,complications exclusive to monochorionic twins (e.g.selective fetal growth restriction,twin reversed arterial perfusion sequence and twin-twin transfusion syndrome) and the perinatal outcomes were retrospectively analyzed.Results Average maternal age of women with 17 MCMA twins was (29.0±2.7) years,and all were primiparas.They were diagnosed at (18.6± 5.5) weeks on average (11 +5-28+1 weeks).Umbilical cord entanglements were detected in all cases by ultrasonography and confirmed postnatally.There were three cases of complications specific to monochorionic twins,including two with selective fetal growth restriction and one with twin reversed arterial perfusion sequence.There were seven women with fetal congenital malformation; four of whom chose induced abortion; one case of anencephaly chose radiofrequency ablation fetal reduction,and the remaining two cases with congenital malformation and ten cases without chose anticipant pregnancy,and there

  4. Aborto en una yegua debido a mellizos, ¿porque conviene reducirlos manualmente?: reporte de un caso - Abortion in a Mare caused by twins pregnancy, the convenience of the manual reduction of one of the twins. A case report

    Directory of Open Access Journals (Sweden)

    González del Pino, Francisco Javier.

    2010-12-01

    Full Text Available ResumenEl artículo describe el caso clínico de un cuadro de aborto en un yegua deraza Peruano de Paso de 10 años de edad, debido a una preñez de mellizoscon fijación bicornual. La misma fue diagnosticada en forma precozmediante ecografía transrectal, pero su desenlace final en un abortoindeseable se debió a que el propietario del animal, no quiso su resoluciónmediante la técnica de reducción manual de uno de los mellizos.SummaryThis article describes a clinical case of an abortion in a 10 year old PeruvianPaso mare, caused by twin pregnancies bilaterally fixed. It was earlydiagnosed by transrectal ultrasound, but its final outcome in an unwantedabortion because the animal's owner declined to its resolution through thetechnique of manual reduction of one of the twins.

  5. A analysis of 34 cases of twin pregnancies with single intrauterine fetal death in pregnancy outcomes%双胎之一胎死宫内34例的妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    林颖; 王蕴慧

    2015-01-01

    ObjectiveTo study the etiology, clinical management and the related factors affecting the pregnancy outcomes of twin pregnancies with single intrauterine fetal death (sIUFD). Methods Retrospective analysis was done in 34 cases of twin pregnancies with sIUFD from April 2003 to October 2012 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University.Results The incidence of twin pregnancies with sIUFD was 6.75% in the hospital. There were 18 cases of dichorionic twins, 9 cases of monochorionic twins (including monoamiotic twins 3 cases) and 7 cases of unknown chorionic twins respectively. In 8 cases, twin pregnancies with sIUFD was found in the first trimester of gestation; in 13 cases, it was found in the second trimester of gestation; and in 13 cases it was found in the third trimester of gestation. A total of 24 patients with expectant treatment, treatment of the median time of 62.5 (41-209) days, median gestational age at delivery 32.6 (16.0-38.7) weeks. The number of live births, birth gestational age and birth weight for twin pregnancies with sIUFD occurred during first trimester of gestation, were higher than in late pregnancy group. In the same way, twin pregnancies with sIUFD occurred for dichorionic twins, were higher than monochorionic twins or unknown chorionic twins group.Conclusion Chorionicity, stillbirth weeks of gestation and delivery gestational age are the significant factors affecting the pregnancy outcomes. To strengthen the monitoring of maternal complications and the survival fetal, expectant treatment is an effective way of improving the pregnancy outcomes of twin pregnancies with sIUFD.%目的 探讨双胎妊娠一胎胎死宫内的病因、临床处理及影响妊娠结局的相关因素.方法 回顾性分析2003年1月至2012年12月在中山大学孙逸仙纪念医院住院分娩的双胎妊娠一胎胎死宫内病例共34例.结果 双胎之一胎死宫内的发生率为6.8%,34例中双绒毛膜双胎18例,单绒毛膜双胎9

  6. An unanticipated cardiac arrest and unusual post-resuscitation psycho-behavioural phenomena/near death experience in a patient with pregnancy induced hypertension and twin pregnancy undergoing elective lower segment caesarean section

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    Mridul M Panditrao

    2010-01-01

    Full Text Available A case report of a primigravida, who was admitted with severe pregnancy induced hypertension (BP 160/122 mmHg and twin pregnancy, is presented here. Antihypertensive therapy was initiated. Elective LSCS under general anaesthesia was planned. After the birth of both the babies, intramyometrial injections of Carboprost and Pitocin were administered. Immediately, she suffered cardiac arrest. Cardio pulmonary resucitation (CPR was started and within 3 minutes, she was successfully resuscitated. The patient initially showed peculiar psychological changes and with passage of time, certain psycho-behavioural patterns emerged which could be attributed to near death experiences, as described in this case report.

  7. An unanticipated cardiac arrest and unusual post-resuscitation psycho-behavioural phenomena/near death experience in a patient with pregnancy induced hypertension and twin pregnancy undergoing elective lower segment caesarean section.

    Science.gov (United States)

    Panditrao, Mridul M; Singh, Chanchal; Panditrao, Minnu M

    2010-09-01

    A case report of a primigravida, who was admitted with severe pregnancy induced hypertension (BP 160/122 mmHg) and twin pregnancy, is presented here. Antihypertensive therapy was initiated. Elective LSCS under general anaesthesia was planned. After the birth of both the babies, intramyometrial injections of Carboprost and Pitocin were administered. Immediately, she suffered cardiac arrest. Cardio pulmonary resucitation (CPR) was started and within 3 minutes, she was successfully resuscitated. The patient initially showed peculiar psychological changes and with passage of time, certain psycho-behavioural patterns emerged which could be attributed to near death experiences, as described in this case report.

  8. Twin Pregnancy with a Complete Hydatidiform Mole and a Coexisting Live Fetus: Rare entity.

    Science.gov (United States)

    Sheik, Shahila; Al-Riyami, Nihal; Mathew, Namitha R; Al-Sukaiti, Rashid; Qureshi, Asim; Mathew, Mariam

    2015-11-01

    A hydatidiform mole with a coexisting live fetus is a rare occurrence and the optimal management for this condition is not yet known. We report the case of a 32-year-old woman (gravida 3, para 2) who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in March 2012 at 13 gestational weeks with abdominal pain and vaginal bleeding. An ultrasound examination revealed a hydatidiform mole pregnancy coexisting with a live fetus. After extensive counselling, the patient and her husband opted for a conservative management approach. Unfortunately, a hysterotomy had to be performed at 17 gestational weeks due to severe haemorrhage. The postoperative period was uneventful and histopathology results confirmed one complete mole with a coexisting fetus and normal placenta. The patient's serum β-human chorionic gonadotropin level remained normal for 18 months following her surgery.

  9. 34 Cases of Twin Pregnancies Complicated by Single Intrautterine Death%双胎妊娠一胎宫内死亡34例临床分析

    Institute of Scientific and Technical Information of China (English)

    谯小勇; 曹曦; 邢爱耘

    2011-01-01

    目的:探讨双胎妊娠一胎宫内死亡的因为、临床处理及预后.方法:回顾性分析2005年1月至2009年12月,我院双胎妊娠一胎宫内死亡34例患者的临床资料.结果:双胎妊娠一胎宫内死亡占我院双胎妊娠的5.2%,34例中单羊膜囊双胎3例,单绒毛膜双胎23例,双绒毛膜双胎8例;及时终止妊娠23例(单羊膜囊双胎均及时终止妊娠),期待治疗11例,平均期待时间单绒毛膜双胎为4.7±5.6周,双绒毛膜双胎为8.6±1.2周;单绒毛膜双胎发现死胎时的孕周、分娩孕周及存活儿的出生体重均小于双绒毛膜双胎.除引产外的30例存活儿发生围生儿死亡6例,随访24例存活新生儿中,2例失访,22例随访中发生脑瘫(四肢瘫,语言障碍)3例,存在其他脑损害(语言或运动发育延迟)4例,余健康存活.结论:单绒毛膜双胎更易发生双胎妊娠一胎宫内死亡,绒毛膜性质和孕周是影响围生儿结局和远期预后的重要因素,存活儿无胎儿窘迫,孕妇无严重妊娠并发症及合并症情况下,期待治疗是一种有效的处理方式.%Objective: To study the causes, clinical management and prognosis of twin pregnancies complicated by single intrauterine death (slUD). Methods: Retrospective analysis was done in 34 cases of twin pregnancies complicated by slUD from January 2005 to December 2009 in West China Second University Hospital of Sichuan University. Results: The incidence rate of twin pregnancies complicated by slUD was 5. 2%. There were 3 monoamnionic twins, 23 monochorionic twins and 8 dichorionic twin pregnancies complicated by slUD respectively. Termination of the pregnancy timely in 23 cases including monoamnionic twins was done. The average expectant time of monochorionic and dichorionic twins were 4. 7 ± 5. 6 weeks and 8. 6 ± 1.2 weeks respectively in 11 cases receiving expectant treatment. The average gestational weeks of fetal death and delivery, birth weight of survivals for monochorionic twins

  10. História natural das gestações gemelares monocoriônicas diamnióticas com e sem transfusão feto-fetal Natural history of monochorionic diamniotic twin pregnancies with and without twin-twin transfusion syndrome

    Directory of Open Access Journals (Sweden)

    Cleisson Fábio Andrioli Peralta

    2009-06-01

    Full Text Available OBJETIVO: avaliar a evolução de gestações gemelares monocoriônicas diamnióticas com e sem síndrome de transfusão feto-fetal (STFF, acompanhadas de forma expectante. MÉTODOS: estudo retrospectivo no qual as gestações sem e com STFF e com as formas leve (estágio I de Quintero e grave (estágios II, III, IV e V de Quintero da doença foram comparadas quanto a parto pré-termo extremo, comprometimento neurológico e alta dos gêmeos do berçário. Os gêmeos pré-termo extremo que tiveram ou não STFF foram comparados quanto à ocorrência de comprometimento neurológico. Foram utilizados os testes do χ2 ou exato de Fisher. RESULTADOS: quinze entre 149 gestações gemelares monocoriônicas diamnióticas apresentaram STFF, 11 (11/15-73,3% na forma grave e 4 (4/15-26,7% no estágio I. O parto pré-termo extremo foi mais frequente (pPURPOSE: to evaluate the evolution of monochorionic-diamniotic twin pregnancies with and without the twin-twin transfusion syndrome (TTTS, followed up in an expectant way. METHODS: retrospective study in which the pregnancies with and without TTTS and with mild (Quintero's stage I and severe (Quintero's stages II, III, IV and V disease manifestations were compared according to extreme preterm delivery, neurological impairment and the twins' nursery discharge. The extreme preterm twins who had had TTTS, or not, were compared whether they had or not neurological impairment. The χ2 or Fisher's exact test were used. RESULTS: among 149 monochorionic-diamniotic twin pregnancies, 15 presented TTTS, 11 (11/15 - 73.3% in the severe form and 4 (4/15 - 26.7% at stage I. The extreme preterm delivery was more frequent (p<0.001 in the cases with the disease (11/15 - 73.3% than in the cases without it (25/134 - 18.7%, and more common (p=0.033 in severe (10/11 - 91.1% than in mild cases (1/4 - 25.0%. Neurological impairment in at least one twin was more frequent in cases with (5/8 - 62.5% than in cases without (9/134 - 6

  11. Twin Pregnancy Obtention of Patient with Nonmosaic Klinefelter’s Syndrome and His Wife with Chromosome 9 Inversion by ICSI Treatment

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    Yueyue Hu

    2013-01-01

    Full Text Available A 24-year-old man was diagnosed with klinefelter’s syndrome (KS and his wife wasfound to have an inversion on chromosome 9-46, XX, inv (9 (p11q21- because of infertility.Intracytoplasmic sperm injection (ICSI was performed for fertilization after fluorescencein-situ hybridization (FISH was used to analyze the aneuploidy rate of the Xand Y chromosomes of the ejaculated sperms of the patient, and 99 sperms were haploidamong 100 sperms that were to be analyzed. A twin pregnancy was achieved. The chromosomesof the two fetuses were identified as 46, XY and 46, XY, inv (9(p11q21 after aprenatal diagnosis at 18 weeks gestation. Two healthy twins were born through caesareansection at 32 weeks gestation because of premature rupture of membranes (PROM.

  12. Contemporary management of complicated monochorionic twins.

    Science.gov (United States)

    Moise, Karen Y; Kugler, Lisa; Jones, Tyra

    2012-01-01

    Monochorionic twins are at increased risk for unique complications including twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and twin-reversed arterial perfusion (TRAP) sequence. Twin-twin transfusion syndrome is treated with laser photocoagulation whereas selective reduction is an option in previable sIUGR or TRAP sequence. The nurse is integral in the management, education, care and support of women with complicated pregnancies. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  13. Gestação múltipla com óbito de um gêmeo Twin pregnancy with one fetal beath

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    Diva de Amorim Novais

    1999-05-01

    Full Text Available Objetivo: avaliar retrospectivamente aspectos obstétricos e perinatais da gestação múltipla com a morte de um dos fetos. Métodos: estudo retrospectivo incluindo 26 gestantes com gestação múltipla com óbito de um gêmeo. Foi tomada conduta conservadora e acompanhamento clínico com coagulograma. Resultados: em 50% dos casos o óbito fetal ocorreu entre 20 e 32 semanas de gestação. O período entre o óbito e a resolução da gravidez variou de 6 horas até 148 horas. Em dois casos ocorreu óbito do outro gemelar. Em 15 casos o gemelar sobrevivente teve boa evolução e apenas um apresentou seqüela neurológica discreta. Em outros nove casos o outro gemelar foi a óbito após o nascimento. Nenhuma gestante desenvolveu quadro de distúrbio da coagulação. Conclusão: a conduta conservadora é vantajosa para o gêmeo sobrevivente, desde que a mãe e feto sejam mantidos sob observação.Purpose: to evaluate retrospectively the obstetrical and perinatal aspects of multiple pregnancies with the death of one fetus. Methods: a retrospective study on 26 pregnant women with multiple pregnancies and death of one twin. A conservative approach was followed and the patients were followed-up clinically with blood clotting tests. Results: in 50% of the cases fetal death occurred between 20 and 32 weeks of pregnancy. The time between death and resolution of pregnancy ranged from 6 to 148 h. Death of the other twin occurred in two cases. In 15 cases, the surviving twin had a good course, with two of them presenting slight neurological sequelae. In the other nine cases the other twin died after birth. No pregnant woman developed coagulation disorders.

  14. Congenital infantile myofibroma causing intrauterine death in a twin.

    Science.gov (United States)

    Aye, Christina Yi Ling; Gould, Steve; Akinsola, S Adeyemi

    2011-12-01

    While infantile myofibromatosis is the most common mesenchymal tumour of infancy, only around 300 cases have been reported. The authors report a 33-year-old para 1 with an uncomplicated, dichorionic diamniotic twin pregnancy who was diagnosed with an intrauterine death of one twin at 36+5 weeks gestation. At caesarean section, a macerated male stillborn weighing 2.72 kg was delivered. Postmortem examination revealed a pedunculated lesion attached to the left shoulder and underlying muscle consistent with a congenital myofibroma. The cause of death was postulated to be haemorrhage from the tumour surface causing fetal anaemia.

  15. Chronic anorexia and weight loss due to extensive fibroid compression of the bowel: an unusual complication of uterine fibroids in a patient with a twin pregnancy.

    Science.gov (United States)

    Narayan, Bhaskar; McCarthy, Fergus; Nelson-Piercy, Catherine

    2016-05-05

    A 36-year-old homeless Eritrean nulliparous woman was admitted to hospital, with abdominal pain, nausea and loss of appetite. She was found to be 17 weeks pregnant with dichorionic diamniotic twins. She was cachectic and had large palpable uterine fibroids. An extensive search for infection and malignancy did not yield any significant results. She was managed with enteral nutritional support and delivered healthy twins by emergency caesarean section at 36 weeks' gestation. She re-presented 19 days postpartum, with fever and abdominal pain. Imaging revealed multiple abdominal collections and large degenerating fibroids. At laparotomy, the fibroids were found to be adherent to, compressing and enveloping large sections of bowel. The patient required a right hemicolectomy, small bowel resection and total abdominal hysterectomy. Histology confirmed an infarcted leiomyoma and the patient made a good postoperative recovery.

  16. 辅助生殖技术助孕与自然受孕双胎妊娠并发妊娠期肝内胆汁淤积症的临床分析%Clinical analysis on twin pregnancy with ICP of assisted reproductive techniques conception and natural conception

    Institute of Scientific and Technical Information of China (English)

    陶志云; 陈先侠; 张英; 杨媛媛; 魏兆莲

    2015-01-01

    To analyse intrahepatic cholestasia of pregnancy ( ICP) occurrence in 582 cases of twin pregnancy con-ceived by assisted reproductive techniques and natural conception retrospectively, and to analyse its influence on perinatal complications. The percentage in the group of assisted reproductive techniques twin pregnancies with ICP ( ART group) was 8. 53%, which was 16. 98% in the group of naturally conceived twin pregnancies with ICP( nat-urally conceived group) , and the severity of ICP in ART group was 22. 73%, which was 54. 55% in the naturally conceived group. To compare the two groups in TBA, ALT, AST, hospitalized pregnant weeks, the weeks of deliv-ery, the rate of cesarean section, the Apgar score, premature birth, premature rupture of membranes and fetal dis-tress, 24-hour postpartum hemorrhage volume, there were no statistically significant differences. The neonatal weight of ART group was greater than the naturally conceived group. Twin pregnancies conceived by assisted repro-ductive technology did not increase the incidence of ICP. And there were no differences in complications of perina-tal period.%回顾性分析582 例辅助生殖技术助孕与自然受孕双胎妊娠中妊娠期肝内胆汁淤积症( ICP)的发生情况及其对围产期并发症的影响. 结果显示辅助生殖技术助孕双胎妊娠并发 ICP 为 8. 53%,自然受孕双胎妊娠并发 ICP 为16. 98%,发生重度ICP的比例分别为22. 73%、54. 55%. 辅助生殖技术助孕与自然受孕双胎妊娠并发ICP在围产期血清总胆汁酸、丙氨酸转移酶、门冬氨酸转移酶、入院孕周、分娩孕周、剖宫产率、Apgar评分、早产、胎膜早破、胎儿窘迫、产后24 h出血量方面比较,差异均无统计学意义. 辅助生殖技术组双胎妊娠并发ICP的新生儿出生体重大于自然受孕组. 辅助生殖技术助孕双胎妊娠并不增加ICP的发生率,围产期并发症无增加.

  17. 双胎胎儿生长不一致妊娠结局的探讨分析%Clinical observation on perinatal outcome in discordant twin pregnancies

    Institute of Scientific and Technical Information of China (English)

    王佳蓉

    2014-01-01

    ObjectiveTo analyze the perinatal outcomes of growth discordant in twins pregnancy. MethodsA retrospective analysis of clinical data was conducted in 24 cases of twin babies who were admitted in our hospital from January 2011 to January 2014, and the 24 cases were divided groups:observation group(14 cases) and control group(10 cases). Twin pairs whose birth weight difference was 20% or more were designated as discordant twins. To compare the difference between of the pairs.ResultsThe perinatal mortality in observation group was significantly higher than that in control group(P0.05). Neonatal occupancy rate in NICU and complication rate were obviously higher in observation group than that in the control group, and there was significant difference(P20%为诊断标准,分为观察组14例和对照组10例(发育一致性),比较两组间孕妇的一般情况。结果观察组并发围生儿死亡率明显高于对照组(P0.05);观察组新生儿入住NICU比率明显高于对照组,两组比较差异有统计学意义(P<0.05)。观察组并发症发生率高于对照组(P<0.05)。结论发育不一致性双胎妊娠并发症及围生儿患病率和死亡率明显高于发育一致性双胎,及早发现和处理双胎发育不一致,是改善胎儿和新生儿预后的关键。

  18. 双胎妊娠一胎宫内死亡18例临床分析%18 cases of Twin Pregnancy Complicated by Single Intrauterine Fetal Death

    Institute of Scientific and Technical Information of China (English)

    史宏; 顾玮; 刘春敏; 孟瑜; 蔡彦卿

    2012-01-01

    Objective: To investigate the cause and factors of the mother and fetus survival in single intrauterine fetal death complicated by twin pregnancy and clinical treatments. Methods: To collect 18 cases of twin pregnancy complicated by single intrauterine fefal death in our hospital from January 2001 to October 2011 and their clinical data were retrospectively analyzed. Results: Single intrauterine fetal death accounted for 1.08% in twin pregnancy, in which 11 cases (61.11%) were monochorionic-diamniotic twin (MCDA), and 7 cases dichorionic-diamniotic twin (DCDA) (38.89%). The cause of fetal death: 3 cases of Placental umbilical cord factor (16.67%),1 case of fetal malformation (5.56%), 3 cases pregnancy complications (16.67%), 3 cases twin-twin transfusion syndrome (TTTs) (16.67 %), 3 cases intrauterine infection (16.67%), and unknown causes in 5 cases (27.78%). Cesarean section was the delivery mode in 15 cases, and 3 cases vaginal delivery. Little effect was on mother's coagulation in twin pregnancy after single intrauterine fetal death (P> 0.05). Conclusions: There were differences in the maternal and fetal outcome between DCDA and MCDA. A lot of impact on the mother and survival fetus occurred after single intrauterine fetal death in twin pregnancy. Expectant therapy was an effective choice for twin pregnancy complicated by single intrauterine death before delivery because the small gestational age and immature fetus.%目的:探讨双胎妊娠中一胎宫内死亡的原因、对母亲和存活胎儿的影响及临床处理方法.方法:对2001年1月至2011年10月分娩的双胎妊娠之一胎宫内死亡的18例产妇临床资料进行回顾性分析.结果:双胎妊娠一胎宫内死胎的发生率占双胎的1.08%,其中单绒毛膜双羊膜囊双胎(monochorioniC-diamniotic twin,MCDA)11例(61.11%),双绒毛膜双羊膜囊双胎(dichorionicdiamniotic twin,DCDA)7例(38.89%).胎儿死因:胎盘脐带因素3例(16.67%),胎儿畸形1例(5.56

  19. Comparison of prenatal ultrasound screening results and fetal health status of twin pregnancy and twin pregnancy in assisted reproductive technology%辅助生殖技术受孕双胎与自然受孕双胎的产前超声筛查结果及胎儿的健康状况比较观察

    Institute of Scientific and Technical Information of China (English)

    蒋华景; 郭津含; 陈静; 林丽璇; 熊剑

    2016-01-01

    Objective To compare the prenatal ultrasound screening results and fetal health status of twin pregnancy and twin pregnancy in assisted reproductive technology (ART). Methods 90 cases of pregnant women with twin pregnancy after ART from January 2011 to June 2015 were selected as observation group, 100 cases of spontaneous twin pregnant women were selected as control group. The relevant data of prenatal ultrasound examination and fetal situation were collected, and pregnancy outcome of the two groups were compared. Results Polyhydramnios, umbilical cord around the neck, the incidence of premature rupture of membranes rate, placenta previa incidence, anemia rate and postpartum hemorrhage incidence of the two groups had no significant difference (P 0.05). Twin transfusion syndrome incidence of observation group was significantly lower than that of control group (P 0.05). The average body weight of observation group was significantly higher than that of control group (P <0.05). Conclusion ART twin pregnancy does not increase the risk of perinatal complications. Compared to natural pregnancy, it has obvious advantages on amniotic fluid abnormalities, changes in the umbilical cord and the twin transfusion syndrome.%目的:比较辅助生殖技术受孕双胎与自然受孕双胎的产前超声筛查结果及胎儿的健康状况。方法选取2011年1月~2015年6月期间在我院应用辅助生殖技术(ART)怀孕双胎90例孕妇设为观察组,及同期自然受孕双胎100例孕妇为参照组,收集产前超声检测得到的相关数据以及胎儿情况,对比分析并比较两组的妊娠结局。结果两组在羊水过多、脐带绕颈发生率、胎膜早破发生率、前置胎盘发生率、贫血发生率和产后出血发生率等方面比较无显著差异(P<0.05);观察组平均羊水量显著多于参照组,羊水过少、脐带附着位置变化发生率显著低于参照组(P<0.05)。两组患者胎儿畸形率、

  20. Lactation Biology Symposium: maternal nutrition during early and mid-to-late pregnancy: Comparative effects on milk production of twin-born ewe progeny during their first lactation.

    Science.gov (United States)

    Paten, A M; Kenyon, P R; Lopez-Villalobos, N; Peterson, S W; Jenkinson, C M C; Pain, S J; Blair, H T

    2013-02-01

    Studies using sheep models indicate that the fetal mammary gland is sensitive to maternal nutrition during gestation; however, results have been inconsistent and do not identify critical feeding periods. This study aimed to clarify previous findings by partitioning the period of maternal nutritional manipulation into 2 stages: early and mid-to-late pregnancy. Sixty-six twin-born, twin-bearing ewes, born to dams that were fed either submaintenance, maintenance, or ad libitum during early pregnancy (d 21 to 50 of pregnancy; SmP21-50, MP21-50, or AdP21-50, respectively) and then either maintenance or ad libitum during mid-to-late pregnancy (d 50 to 140 of pregnancy; MP50-140 or AdP50-140, respectively) were milked once a week, starting from d 7 ± 1 postpartum, for 7 subsequent weeks to enable estimation of daily milk yield and composition. Their lambs were weighed weekly. Ewes born to dams fed MP21-50 tended to have greater accumulated milk (P = 0.10), fat (P = 0.07), and NE (P = 0.06) yields over 50 d compared with ewes born to dams fed SmP21-50 and AdP21-50. In contrast, ewes born to dams fed AdP50-140 tended to have greater accumulated milk (P = 0.10) and lactose (P = 0.09) yields compared with ewes born to dams fed MP50-140. Grandoffspring birth weights were unaffected by granddam nutrition during pregnancy. Ewes born to dams fed AdP21-50 weaned lighter lambs (P = 0.05) than ewes born to dams fed AmP21-50 and tended to wean lighter lambs (P = 0.07) than ewes born to dams fed MP21-50 whereas there were no differences between the weaning weights of lambs (P = 0.43) from ewes born to dams fed AdP50-140 and MP50-140. Maintenance nutrition of dams during early pregnancy appears to be associated with an improved lactation performance of ewe offspring. Higher levels of nutrition during mid-to-late pregnancy also appears to improve the first-lactation performance of ewe offspring. Interestingly, although grandoffspring birth weights were unaffected, weaning weight

  1. The Application of Ultrasound Technology in Diagnosis of Abnormal Twin Pregnancy%超声技术在异常双胎妊娠诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    侯彩霞; 梅红; 黄秀英; 程广婷

    2013-01-01

    目的探讨超声技术在异常双胎妊娠诊断中的价值。方法对2009年1月~2012年12月在我院行超声检查的双胎异常妊娠孕妇的结果进行分析。结果经超声检查,30例孕妇双胎异常妊娠的详细情况均得到了确认。结论超声诊断能够检出大部分胎儿畸形,在异常双胎妊娠的筛查中起着重要作用,可为临床提供可靠信息。%Objective To explore the diagnostic value of ultrasound technology in abnormal twin pregnancy. Methods Ultrasound results of abnormal twin pregnancy of pregnant women who were examined by ultrasound technology form 2009 to 2012 in obstetrical department in our hospital were analyzed. Results The detailed information of abnormal twin pregnancy of 30 cases were conifrmed by ultrasonic diagnosis. Conclusion Ultrasonic diagnosis which can detect most of the fetal abnormalities plays an important role in the screening of abnormal twin pregnancy, and can provide reliable information for clinical results.

  2. 双胎妊娠分娩方式与妊娠结局120例临床分析%Impact of delivery on pregnancy outcome in twin pregnancy.

    Institute of Scientific and Technical Information of China (English)

    何建风; 王彩霞

    2011-01-01

    目的 探讨双胎妊娠的不同分娩方式对妊娠结局的影响.方法 对2008-2010年于我院分娩的120例双胎妊娠资料进行回顾性分析,其中剖宫产76例,阴道产44例.结果 孕周<34周的新生儿窒息率、病死率显著高于孕周>34周者,两者差异有统计学意义(P<0.01);阴道分娩组第2胎窒息率、死亡率显著高于第1胎,且与剖宫产组比较差异亦有统计学意义(P<0.01);两组孕周、产后出血差异无统计学意义(P>0.05).结论 与阴道产相比,双胎妊娠剖宫产可减少新生儿窒息率及死亡率.%Objective To explore the influence of delivery route on pregnancy outcome in twin pregnancy.Methods The date of 120 cases of twin pregnancy from 2008 to 2010 were retrospectively analyzed, among which 76 cases performed cesarean section and 44 underwent vaginal delivery. Results The rate of neonatal asphyxia and case fatality at 34 weeks of gestation, with statistical meaning (P<0.01); the rate of neonatal asphyxia and case fatality of second fetal were higher than that of first fetal,and had significantly difference with cesarean section cases (P<0.01); the weeks of gestation and postpartum hemorrhage had no striking difference between the two groups. Conclusion Compared with vaginal delivery, cesarean section for twin pregnancy can decrease the rate of neonatal asphyxia and case fatality.

  3. 单绒毛膜双胎胎儿生长受限合并脐带帆状附着一例%Intrauterine growth restriction in monochorionic twin pregnancy complicated with velamentous placen-ta:report of one case

    Institute of Scientific and Technical Information of China (English)

    陈嫦娥

    2016-01-01

    单绒毛膜双胎妊娠合并脐带帆状附着在临床较为少见。该文报道了一例单绒毛膜双胎胎儿生长受限合并脐带帆状附着的病例。该例孕妇停经35周、下腹疼痛5 h,在外院及入院 B 超均显示为双胎妊娠、胎儿生长受限,未报告脐带异常;经积极保胎、营养治疗2周后,B 超检查仍显示胎儿生长受限,胎儿2羊水过少、脐动脉舒张期血流消失,不排除双胎脐带受压及胎盘血流异常,即予急诊剖宫产术,先后娩出2活女婴及胎盘,胎盘为一脐带帆状附着,2条脐带并列一处,呈 V 型附着胎膜。2女婴分别为低体重儿及极低体重儿,其中极低体重儿经无创呼吸机辅助通气无效,于住院第3日因 MODS 死亡,低体重儿及产妇分别于住院10 d、20 d 好转出院。该例提示,产前超声应密切监测双胎的生长发育及羊水量差异,仔细观察脐带插入点、脐动脉血流等指标,为产前咨询和临床决策提供更多依据,以改善单绒毛膜双胎妊娠的围生期结局。%Monochorionic twin pregnancy complicated with velamentous insertion of umbilical cord is rarely reported in clinical practice.In this article,we reported one case of fetal growth restriction in monochori-onic twin pregnancy complicated with velamentous insertion of umbilical cord.The pregnant woman experienced menolipsis for 35 weeks and inferior abdominal pain for 5 h.She was diagnosed with fetal growth restriction in twin pregnancy by repeated B-ultrasound in another hospital and upon admission to our hospital.No abnormality of umbilical cord was reported.After active fetal protection therapy and nutrition enrichment for 2 weeks,B-ul-trasound revealed the signs of fetal growth restriction,oligohydramnios of the second fetus and absent end-dias-tolic flow of umbilical artery.The possibility of umbilical cord compression of the twins and placental flow ab-normality was not excluded.She delivered

  4. Monochorionic-diamniotic discordant growth in a twin pregnancy with one fetus affected by Ebstein's anomaly of tricuspid leaflets.

    Science.gov (United States)

    Fukami, Tatsuya; Goto, Maki; Matsuoka, Sakiko; Sorano, Sumire; Tohyama, Atsushi; Yamamoto, Hiroko; Nakamura, Sumie; Matsuoka, Ryoei; Tsujioka, Hiroshi; Eguchi, Fuyuki

    2016-07-01

    Our patient was diagnosed as having discordant twin growth with Ebstein's anomaly in the larger fetus. Cardiac function was deteriorated in accordance with progression of gestational age. Our observation indicated cardiac failure of the larger fetus. The most important issue in this situation is management of the timing of delivery.

  5. Preliminary preventive protocol from first trimester of pregnancy to reduce preterm birth rate for dichorionic–diamniotic twins

    Directory of Open Access Journals (Sweden)

    Masako Matsui

    2017-02-01

    Conclusion: Even though this was a preliminary study, the results are promising, and we propose custom-made management for dichorionic–diamniotic twins: (1 earlier management from before 14 weeks; (2 high-risk selection for cervicitis and a short cervix; and (3 intervention with anti-inflammatory agents and cerclage if indicated.

  6. Route of delivery and pregnancy outcome in 150 cases of twin pregnancy%双胎妊娠的分娩方式与妊娠结局150例

    Institute of Scientific and Technical Information of China (English)

    李蕙琴

    2008-01-01

    目的 探讨双胎妊娠分娩方式与妊娠结局的关系.方法 将1997年1月至2006年12月,150例双胎妊娠妇女按分娩方式分为阴道分娩组及剖宫产组,对其临床资料进行回顾性分析.结果 两组产后出血率差异无统计学意义,孕周及新生儿体重,剖宫产组显著高于阴道分娩组,新生儿窒息发生率,阴道分娩组显著高于剖宫产组,尤以阴道分娩组第2胎新生儿尤为显著,两胎儿分娩出生时间间隔>15 min者新生儿窒息发生率高.结论 正确选择双胎妊娠的分娩方式,将有助于降低新生儿窒息发生率.%Objective To study the relationship between delivery rout and pregnancy outcome in twin pregnancy.Methods 150 twin pregnancy women were divided into two groups,which were cesarean section and vaginal delivery from January 1998 to December 2005.Their data were analyzed retrospectively.Results There was no difference in postpartum hemorrhage of two groups in pregnant week and neonatal.Weight of cesarean section was higher than that of vagingal detivery the incidence of neonatal asphyxia in vaginal delivery was much highter than in cesarean section that the hightest of neonatal asphyxia of second fetal in vaginal delivery.Conclusion The right route of delivery can lower the incidence of secarean section and neonatal asphyxia.

  7. 双胎妊娠中胎儿性别和分娩孕周的相关性研究%Correlation of the Fetal Sex of Twin Pregnancy and Gestational Age

    Institute of Scientific and Technical Information of China (English)

    季景环; 姚晓玲; 李莉; 杨素琴; 张曼丽

    2011-01-01

    Objective To explore the influence of fetus's sex in twin pregnancy on gestation. Methods Retrospectively analyse the 94 cases of twin pregnancy from our hospital during the period from March 2008 to July 2009, which are divided into three groups by fetus's sex of twin male, twin female, a male and a female fpr comparison and analysis of gestation and premature delivery rate. Result No statistical difference in maternal age and average twin body weight( P > 0.05 ). Twin male fetuses average gestation 256.84 day,premature delivery rate 58.06%; twin female fetus 263.65 day, 16. 13% ;one male one female 260.76 day, 24.24%. The average gestation and premature delivery rate are statistically significantly different between twin male fetuses and twin female fetus( P < 0.05 ), Conclusion fetus's sex will influence gestation and premature delivery rate in twin pregnancy, female fetus is one of the premature delivery factors.%目的 探讨双胎妊娠中胎儿性别对分娩孕周的影响.方法 回顾性分析我院2008年3月至2009年7月住院分娩的94例双胎妊娠产妇资料,按胎儿性别分为双男胎、双女胎、一男一女胎三组,对其孕周及早产率进行比较与分析.结果 三组双胎妊娠产妇年龄和双胎儿平均体质量间差异无统计学意义(P>0.05),孕周和早产例数间差异有统计学意义(P<0.05).双男胎组孕周最短,双女胎组孕周最长.三组双胎妊娠产妇双男胎组早产率最高,双女胎组早产率最低.结论 双胎妊娠中胎儿性别影响妊娠孕周,男胎是导致早产的一个因素.

  8. Successful Delivery of Twin Pregnancy in Class U3b/C2/V1 Uterus by Bilateral Caesarean Section after Spontaneous Conception

    Directory of Open Access Journals (Sweden)

    Yasmine El-Masry

    2015-01-01

    Full Text Available A case of a 19-year-old female with class U3b/C2/V1 uterus conceived a twin pregnancy with a fetus in each horn after spontaneous conception. She referred to our department with presentation of premature rupture of membranes, with a history of cesarean delivery of a single full term living fetus a year and a half before this delivery. Examination revealed two completely separate uterine horns with a fetus in each horn, two distinct externally rounded cervices, and a single vagina with a short nonobstructing vaginal septum in the upper part of the vagina. And as the appropriate mode of delivery is still unclear, each case should be managed as the condition requires, and in our case urgent bilateral caesarean sections were performed.

  9. 双绒毛膜及单绒毛膜双胎与妊娠期并发症及围生儿结局分析%Pregnancy Complications and Perinatal Outcomes of Monochorionic and Dichorionic Twin Pregnancy

    Institute of Scientific and Technical Information of China (English)

    周艳; 徐丽玲; 汪平; 吴琼蔚; 陈雯霞; 金皖玲

    2012-01-01

    目的:探讨双胎妊娠绒毛膜性对孕妇妊娠期并发症及围生儿预后的影响及意义.方法:对我院定期随诊并分娩的472例双胎临床资料进行回顾性分析,根据绒毛膜性分为单绒毛膜双羊膜囊组(MCDA组)和双绒毛膜双羊膜囊组(DCDA组),对两组孕妇的分娩孕周、并发症以及围生儿预后等进行比较分析.结果:两组孕产妇妊娠并发症的发生率比较,差异无统计学意义(P>0.05).MCDA组低出生体重儿、极低出生体重儿、新生儿窒息及围生儿死亡的发生率均明显高于DCDA组,其差异有统计学意义(P<0.05),MCDA组中双胎输血综合征发生率为7.32%.结论:绒毛膜性对孕妇妊娠并发症的发生无明显影响,而双胎孕妇于孕早期行B超检查诊断单绒毛膜或双绒毛膜对预测围生儿预后具有重要意义.尽早确定双胎类型,加强对单绒毛膜双胎的监护及干预,是改善胎儿和新生儿预后的关键.%Objective:To investigate the clinical diagnostic significance of chorion properties. Methods: Retrospective analysis of the clinical data including gestational weeks, complications and perinatal outcomes of 472 twin pregnancies was done in Shanghai Changning Maternity and Infant Health Hospital. All the cases were divided into monochorionic diamnionic(MCDA) group and dichorionic diamnionic( DCDA ) group. Results: There was no statistically significant differences in complications between two groups (P>0.05). The incidences of low birth weight infant,extreme low birth weight infant, neonatal asphyxia and perinatal mortality in MCDA group were significantly higher than those in DCDA group (P < 0.05). The incidence of twin-twin transfusion syndrome(TTTS) in MCDA group was 7. 32%. Conclusions:Chorion properties make no difference in twin pregnancy complications. Differentiation between monochorionic and dichorionic twin pregnancy in first trimester of pregnancy by ultrasonography is very important in forecasting the

  10. Cervical assessment at 22 and 27 weeks for the prediction of spontaneous birth before 34 weeks in twin pregnancies: is transvaginal sonography more accurate than digital examination?

    Science.gov (United States)

    Vayssière, C; Favre, R; Audibert, F; Chauvet, M P; Gaucherand, P; Tardif, D; Grangé, G; Novoa, A; Descamps, P; Perdu, M; Andrini, E; Janse-Marec, J; Maillard, F; Nisand, I

    2005-12-01

    This study compared the accuracy of ultrasound cervical assessment (cervical length and cervical index) and digital examination (Bishop score and cervical score) in the prediction of spontaneous birth before 34 weeks in twin pregnancies. In a prospective multicenter study, digital examination and transvaginal sonography were performed consecutively in twin pregnancies attending for routine sonography at either 22 weeks (175 women) or 27 weeks (153 women). The digital examination took place first, and the Bishop score and cervical score (cervical length minus cervical dilatation) were calculated. Ultrasound measurements were then made of cervical length and funnel length to yield the cervical index (1 + funnel length/cervical length). The association between each variable and delivery before 34 weeks was tested by the Mann-Whitney U-test. The receiver-operating characteristics (ROC) curves of the ultrasound and digital indicators were determined for both gestational age periods, and the areas under the ROC curves compared. The best cut-off values for each indicator were used to determine predictive values for delivery before 34 weeks. The median gestational age at delivery among the women included in the 22-week examination period was 36.0 (range, 21-40) weeks; 10.9% (19) gave birth spontaneously before 34 weeks. The median cervical length was 40 (range, 6-65) mm. All four parameters were predictors of delivery before 34 weeks. The areas under the ROC curves for cervical index, cervical length, Bishop score and cervical score did not differ significantly. The median gestational age at delivery among the women in the 27-week examination period was 36.0 (range, 27-40) weeks; 9.2% (14) gave birth spontaneously before 34 weeks. The median cervical length was 35 (range, 1-57) mm. All parameters except the Bishop score were predictors of delivery before 34 weeks. The likelihood ratio of the positive and negative tests for cervical length digital examination at the 27-week

  11. 双胎妊娠中第二胎延迟分娩临床分析及护理%Twin Pregnancy Second Delay Delivery Clinical Analysis and Nursing

    Institute of Scientific and Technical Information of China (English)

    陈朝霞; 杨丽君

    2015-01-01

    目的:探讨1例双胎妊娠第二胎延迟分娩14 d的临床分析、妊娠结局及护理.方法:分析笔者所在医院1例双胎妊娠第二个胎儿延迟分娩的临床资料、妊娠结局及围生期护理.结果:本例孕妇双胎妊娠中第一胎胎膜早破后分娩,第二个胎儿延迟14 d分娩,通过精心护理产妇与两个新生儿健康出院.结论:双胎妊娠中第一个胎儿娩出后,根据实际情况第二个胎儿给予保胎治疗和护理,提高第二个胎儿的生存率.%Objective:To investigate 1 case of delayed interval delivery of the twin including clinical analysis,outcome of pregnancy and nursing measures.Method:1 cases of twin pregnancy, the clinical data of second cases of twin pregnancy, pregnancy outcome and perinatal nursing were analyzed.Result:This case of pregnant woman in the first pregnancy in the first fetal membranes after delivery, second fetal delay of 14 d delivery, through careful nursing maternal and two neonatal health.Conclusion:Twin pregnancy after the first fetal childbirth, according to the actual situation of the second fetus give tocolytic therapy and nursing, and improve the survival rate of the second fetus.

  12. Prenatal diagnosis of chorionicity in twins.

    LENUS (Irish Health Repository)

    Hassan, T

    2012-02-01

    The aim of this audit was to assess the accuracy of transabdominal ultrasound scan in predicting chorionicity in twin pregnancies in our unit. The presence or absence of lambda sign, T-sign, dividing membrane thickness and number of placentae were used to determine chorionicity. We retrospectively analysed these antenatal markers in 268 sets of twins delivered over a 5 year period and compared it with the postpartum placental histology and neonatal gender. Of 268 twin deliveries, 204 (76%) had both chorionicity and placental histology to compare. 67 of 84 (80%) were correctly diagnosed antenatally as monochorionic and 137 of 151 (91%) as dichorionic. In 31 cases (15%) the ultrasound diagnosis of chorionicity didn\\'t match placental histology. Seventeen were thought to be monochorionic antenatally but were confirmed dichorionic on placental histology. Overall chorionicity was correctly diagnosed in 171\\/204 (84%) using transabdominal ultrasound scan (USS) in all trimesters. However the sensitivity and specificity of USS was much higher for dichorionic twins when carried out before 14 weeks of gestation.

  13. Intravenous maternal -arginine administration to twin-bearing ewes, during late pregnancy, is associated with increased fetal muscle mTOR abundance and postnatal growth in twin female lambs.

    Science.gov (United States)

    Sales, F; Sciascia, Q; van der Linden, D S; Wards, N J; Oliver, M H; McCoard, S A

    2016-06-01

    The aims of this study were to determine whether parenteral Arg administered to well-fed twin-bearing ewes from 100 to 140 d of pregnancy influences fetal skeletal muscle growth, the abundance and activation of mechanistic target of rapamycin (mTOR) protein, and postnatal muscle growth of the offspring. Ewes fed 100% of NRC-recommended nutrient requirements for twin-bearing ewes were administered an intravenous bolus of either 345 μmol Arg HCl/kg BW or saline solution (Control) 3 times per day. At 140 d of pregnancy (P140), a group of 11 Control and 9 Arg-treated ewes were euthanized and hind leg muscles and longissimus dorsi (LD) were excised and weighed. A sample of LD was snap frozen in liquid nitrogen for later analysis of free AA (FAA) concentration, mTOR abundance and phosphorylation, and biochemical indices (DNA, RNA, and protein content). For the remaining 25 ewes (Arg, = 13, and Control, = 12), Arg administration was continued until the initiation of parturition and ewes were allowed to lamb. Lambs were weaned at postnatal Day 82 and grazed on pasture until postnatal day 153 (PN153), when a subset of 20 lambs ( = 10 per group) was euthanized. At P140, only the psoas major was heavier in the Arg-administered group compared with the Control group. Female lambs from ewes supplemented with Arg (Arg-F) had increased abundance of total mTOR, RNA concentration, and RNA:DNA ratio in LD compared with female lambs from Control ewes (Con-F), whereas males did not differ. At PN153, Arg-F were heavier than Con-F and had heavier LD and plantaris and a trend for heavier psoas major muscles compared with Con-F. In contrast, BW and individual muscle weights did not differ in male lambs. Lambs from Arg-treated ewes had heavier semimembranosus and tended to have heavier biceps femoris compared with Control lambs. The RNA concentration in LD was greater in Arg-F compared with Con-F, and DNA concentration was greater in the Arg group compared with the Control group. In

  14. 高龄双胎妊娠的围产结局分析%Perinatal outcomes in women aged 35 and over with twin pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈敏玲; 王子莲; 凌家炜; 韩振艳

    2010-01-01

    目的 探讨高龄双胎妊娠的围产结局.方法 回顾性分析我院69例高龄双胎病例,随机对照176例非高龄双胎的临床资料,比较两组在妊娠并发症、妊娠合并症、和胎儿预后等方面的差异.结果 ①高龄组接受辅助生育技术受孕比例显著高于非高龄对照组(P<0.05);②高龄组<32孕周早产发生率明显高于对照组(P<0.05),而其他并发症及合并症两组间未见显著性差异;③高龄组以极低出生体重儿(<1500 g)比例显著高于对照组(P<0.05).高龄组新生儿窒息率及胎儿窘迫发生率明显增高(P<0.05).结论 高龄双胎妊娠不良妊娠结局主要与<32孕周的严重早产、极低体重儿、新生儿窒息及胎儿窘迫密切相关,应针对性加强高龄双胎的围生期监护,警惕严重早产的发生.%Objective The aim of this study is to present perinataloutcomes of twin gestations in older women. Methods We conducted a retrospective cohort study of 69 cases of twin pregnancies maternal age 35 years and older( study group)in our department, compared with 176 twin pregnancies cases of maternal age less than 35 years( control group). Results ①Conceptions after assisted reproductive technology were significantly higher in study group(P<0.05 ). ②The rate of preterm labour lower than 32 gestational weeks was significantly higher in the study group(P<0.05). The other complications rate did not differ singnificantly from the control groups. (3) The very low birth weight ( VLBW < 1,500 g) rate was significantly higher in the study group ( P<0.05 ), the rate of neonatal asphyxia and fetal distress were statistically significant higher in study group (P<0.05). Conclusion Advanced maternal age was related with higher incidence of the severe preterm labour(<32 gestational weeks) ,the very low birth weight(<1,500 g) ,fetal distress,neonatal asphyxia. It is important to close monitoring during perinatal period in women aged 35 and

  15. 双胎妊娠并发重度子痫前期母儿结局分析%Analysis on pregnant outcomes of twin pregnancy combined with severe preeclampsia

    Institute of Scientific and Technical Information of China (English)

    方根娟; 张甦

    2009-01-01

    To explore the pregnant outcomes of twin pregnancy complicated with severe preeclampsia. Methods: The pregnant outcomes of 66 twin pregnancies complicated with severe preeclampsia and 451 singleton pregnancies complicated with severe pre-eclampsia were analysed retrospectively and compared from January 2005 to December 2007. Results: The disease time and the time of ex-pectant treatment in twin pregnancy group were shorter than those in singleton pregnancy group (P0. 05) . There was correlation between pregnant weeks of twin pregnancy and prenatal outcomes. Conclusion: Women of twin pregnancy are required to no-tice more about health care in order to decrease the incidence of severe preeclampsia. As to the affected, the measures such as controlling the development and prolonging the gestational age should be carried out to decrease the incidence of premature delivery. It is advisable to termi-nate pregnancy on the 36th pregnant weeks.%目的:探讨双胎妊娠并发重度子痫前期的母儿结局.方法:回顾总结湖州市妇幼保健院2005年1月~2007年12月收治的66例双胎妊娠和451例单胎妊娠并发重度子痫前期孕妇的妊娠结局,以单、双胎分两组比较其发病情况、母儿并发症及结局.结果:双胎妊娠比单胎妊娠发病孕周早、期待治疗时间短(P0.05);双胎妊娠胎龄不同对围生儿结局会产生不同的影响.结论:双胎妊娠孕妇须注重孕期保健,减少重度子痫前期的发生;对发生重度子痫前期者应积极控制病情、延长孕周、减少低龄早产儿出生;胎龄36周终止妊娠围生儿结局最好.

  16. Gestação gemelar de mola hidatiforme completa com feto vivo Twin pregnancy with complete hydatidiform mole and living fetus

    Directory of Open Access Journals (Sweden)

    Daniela Angerame Yela

    2011-04-01

    Full Text Available A gestação gemelar de uma mola hidatiforme completa coexistindo com um feto vivo é uma entidade rara. Os poucos casos descritos na literatura mostram que, em geral, esse tipo de gestação cursa com risco aumentado de aborto espontâneo, parto prematuro, morte fetal intraútero, sangramento, pré-eclâmpsia e doença trofoblástica persistente. Neste artigo, descreveremos o caso de uma primigesta de 20 anos de idade que apresentou uma gestação gemelar de feto vivo com mola completa, a qual transcorreu sem intercorrências e complicações e cujo diagnóstico diferencial com degeneração da placenta foi feito com anatomopatológico.Twin pregnancy with a complete hydatidiform mole and a living fetus is a rare entity. According to the few cases described in the literature, this kind of gestation commonly has higher risks of miscarriage, preterm delivery, intrauterine fetal death, bleeding, preeclampsia and persistent trophoblastic disease. This study reports the case of a 20 years old primiparous patient with complete hydatidiform mole and living fetus, whose pregnancy was successfully carried to term. The differential diagnosis with placental degeneration was reached through anatomopathological investigation.

  17. A step-by-step diagnosis of exclusion in a twin pregnancy with acute respiratory failure due to non-fatal amniotic fluid embolism: a case report

    Directory of Open Access Journals (Sweden)

    Papaioannou Vasilios E

    2008-05-01

    Full Text Available Abstract Introduction Respiratory failure may develop during the later stages of pregnancy and is usually associated with tocolysis or other co-existing conditions such as pneumonia, sepsis, pre-eclampsia or amniotic fluid embolism syndrome. Case presentation We present the case of a 34-year-old healthy woman with a twin pregnancy at 31 weeks and 6 days who experienced acute respiratory failure, a few hours after administration of tocolysis (ritodrine, due to preterm premature rupture of the membranes. Her chest discomfort was significantly ameliorated after the ritodrine infusion was stopped and a Cesarean section was performed 48 hours later under spinal anesthesia; however, 2 hours after surgery she developed severe hypoxemia, hypotension, fever and mild coagulopathy. The patient was intubated and transferred to the intensive care unit where she made a quick and uneventful recovery within 3 days. As there was no evidence for drug- or infection-related thromboembolic or myocardial causes of respiratory failure, we conclude that our patient experienced a rare type of non-fatal amniotic fluid embolism. Conclusion In spite of the lack of solid scientific support for our diagnosis, we conclude that our patient suffered an uncommon type of amniotic fluid embolism syndrome and we believe that this report highlights the need for extreme vigilance and a high index of suspicion for such a diagnosis in any pregnant individual.

  18. Neonatal outcomes and influencing factors of twin pregnancies in IVF/ICSI%IVF/ICSI双胎妊娠新生儿结局及双胎妊娠影响因素分析

    Institute of Scientific and Technical Information of China (English)

    刘寒艳; 龙晓林; 李磊; 陈仕萍; 刘见桥

    2016-01-01

    目的:比较IVF/ICSI中单双胎妊娠后新生儿结局,并探讨影响双胎妊娠的相关因素。方法:回顾性分析2014年1月至2015年3月在我中心行IVF/ICSI治疗,单双胎妊娠共1026例纳入研究。结果:早期流产率,早期妊娠丢失率单胎组显著高于双胎组(16% vs 5.41%;16% vs 6.98%),晚期流产率单胎组显著低于双胎组(1.93% vs 7.12%),单双胎组整个孕期的总妊娠丢失率没有显著差异。双胎组早产率显著增加(9.19% vs 41.89%),足月抱婴率显著降低(56% vs 37.89%),但是总抱婴率双胎组显著高于单胎组;出生低体重儿双胎组显著增加(1.2% vs 14.8%),出生缺陷儿单双胎组无差异。女方年龄和移植胚胎数在单双胎妊娠组有显著差异。结论:双胎妊娠显著增加晚期流产及早产儿和低体重儿风险。女方年龄和移植胚胎数目是双胎妊娠的危险因素。%Objective To compare perinatal outcomes of the singleton and twin pregnancies , and explore risk factors associated with twin pregnancies. Methods The data of 1 026 patients in single and twin pregnancies treated with IVF/ICSI between January 2014 to March 2015 were retrospectively analyzed. Results The early miscarriage rate and early pregnancy loss rate in the singleton group was significantly higher than the twin group (16% vs 5.41%; 16% vs 6.98%) and the late abortion rate in the singleton group was significantly lower than the twin group (1.93% vs 7.12%), but the total pregnancy loss rate was not significantly different between the groups. The premature delivery rate in the twin group was significantly increased (9.19% vs 41.89%), the term taking-baby-home rate was significantly lower (56% vs 37.89%), but the total taking-baby-home rate was significantly higher in the twin group than the singleton group. The low weight delivery rate in the twin group was significantly increased (1.2% vs

  19. Conjoined Twins

    Science.gov (United States)

    ... sites of conjoined twins. Abdomen. Omphalopagus (om-fuh-LOP-uh-gus) twins are joined near the bellybutton. ... brain tissue. Head and chest. Cephalopagus (sef-uh-LOP-uh-gus) twins are joined at the face ...

  20. Natal Influences and Twin Differences: Draft.

    Science.gov (United States)

    Van den Daele, Leland D.

    1972-01-01

    A classification of natal influences is proposed with a model of their operation. Natal influences affect maternal capacity, maternal load, and maternal efficiency. Since maternal load is increased in twin pregnancy, results of twin studies must be generalized with caution. The method of co-twin control is exemplified by examination of a small…

  1. 应用时间序列分析法在医院双胎妊娠情况统计中的预测研究%Prediction Research of Applied time series analysis method in twin pregnancy statistical analysis

    Institute of Scientific and Technical Information of China (English)

    莫佳琪; 朱淳; 黄艳

    2014-01-01

    目的:探索时间序列分析法ARIMA预测模型在医院双胎妊娠情况统计中的应用。方法运用时间序列分析法ARIMA模型预测医院双胎妊娠情况的发展趋势。结果建立ARIMA(3,1,1)(1,1,1)模型,预测医院未来2年在双胎妊娠情况中有向上的趋势性和季节性,预测数据在5月、8月和12月双胎妊娠情况中呈现高峰。结论 ARIMA(3,1,1)(1,1,1)模型可以较好的拟合2009-2012年湖南省妇幼保健院双胎妊娠情况统计的时间变化趋势。应用时间序列分析法ARIMA模型在医院双胎妊娠情况统计的预测研究精度较高,是一种理想的研究方法,能够为医院管理提供科学依据。%Objective To explore the application of applied time series analysis method ARIMA modeling in twin preg-nancy statistical analysis .Method To predict the development trend of twin pregnancy by using applied time series analysis method ARIMA modeling Results Predicted the rising trend and seasonal feature of the twin pregnancy in the next two years by building ARIMA (1,1,1)(0,1,1),the prediction statistic showed that the twin pregnancy situation will be at the peak time on May, Autumn and December. Conclusion ARIMA(3,1,1)(0,1,1)modeling fitted the time varia-tion trend of twin pregnancy statistic well during 2009 to 2012 in MCH hospital of Hunan province. It is proved that ap-plied time series analysis method ARIMA modeling can provide satisfied predictions of the twin pregnancy in the hospi-tal and to be thought as the ideal research method.for providing scientific support for hospital management.

  2. Twin-twin transfusion syndrome - diagnosis and prognosis

    Directory of Open Access Journals (Sweden)

    Hajrić-Egić Amira

    2003-01-01

    Full Text Available Twin-twin transfusion syndrome is a serious complication of monozygotic, monochorionic, diamniotic twins resulting from transplacental vascular communications. In this syndrome blood is thought to be shunted from one twin - donor,who develops anaemia,growth retardation and oligoamnios, to the other twin - recipient,who becomes plethoric,macrosomic and develops polyhydroamnios. The incidence of twin-twin transfusion syndrome ranges from 5-15% of all twin pregnancies. If this condition develops in the second trimester, it is usually associated with spontaneous abortion and death of one or both fetuses before viability. Developing the syndrome in the third trimester has better perinatal outcome. Mortality rates ranging from 56%-100%, depending on gestational age and severity of the syndrome. The ultrasound criterias for diagnosis, in this study,were the presence of twins of the same sex with discordant growth, with oligohydroamnios in one twin sac and polyhydroamnios in the other one, one placenta and thin membrane between twins. The present study shows clinical course of 14 cases and value of Doppler ultrasound to analyze the usefulness of umbilical artery blood flow velocimetry for predicting the risk of twin-twin transfusion syndrome. 14 twin pregnancies with twin-twin transfusion syndrome were diagnosed during the last four years period and prospectivelly followed. 9 cases were diagnosed before the completion od 28 weeks of gestation.The mean gestational age was 21,6_+4,2 weeks at diagnosis and 23,2+_3,6 weeks at delivery. 5 cases were diagnosed after 28 weeks of gestation. The mean gestational age in this group was 29,6+_2,1 weeks at diagnosis and 33+_3,3 weeks at delivery. The survival rate in this study was 29%(8/28.9 cases ended in spontaneous abortion between 18th and 27th weeks of pregnancy (table 1 and 5 in premature labor (table 2.There were 7 intrauterine death (5 at admission and 2 few days after admission and 13 neonatal deaths

  3. APPLICATION OF FIRST-MIDTRIMESTER PREGNANCY ULTRASOUND COMBINED WITH INVASIVE PRENATAL DIAGNOSIS IN TWIN PREGNANCY%早中孕期超声联合有创性产前诊断在双胎妊娠中的应用

    Institute of Scientific and Technical Information of China (English)

    胡矩锋; 李炳星; 高丽丽

    2015-01-01

    效降低出生缺陷,在提高人口素质方面有重要的应用价值。%Objective Evaluate application value that ultrasound of first‐midtrimester combined with in‐vasive prenatal diagnosis in linyi city .Methods Research of first‐midtrimester pregnancy ultrasound com‐bined with invasive prenatal diagnosis in twin pregnancy from Octobor 2014 to May 2015 clinic in our hos‐pital during the 11 weeks ago ,statistics of pregnant age ,first trimester ultrasound ,18 to 22 weeks ultra‐sound ,invasive prenatal diagnosis ,prenatal diagnosis ,selective reduction ,etc .summary all the data ,a‐nalysis the application value of first‐midtrimester pregnancy ultrasound combined with invasive prenatal di‐agnosis in twin pregnancy in linyi city .Results Included in the study of a total of 1437 cases of twin preg‐nancy ,anomaly detection ,with pregnancy ultrasound system is 56 cases ,ultrasonic detection of first tri‐mestr abnormalities is 7 cases ,abnormal ultrasonic detection of midtrimester is 49 cases ,invasive prenatal diagnosis to all ultrasonic detection pregnancy ,actually have invasive prenatal diagnosis ,27 cases (48 . 2% ) ,including 3 patients to CVS ,24 cases to amniocentesis .The actual number of prenatal diagnosis of fetal 47 (including twins prenatal diagnosis in 21 cases ,one of the tires to prenatal diagnosis of 5 cases) , diagnosis of five chromosome abnormality ,are one of the twins anomalies (including 1 case no abnormal sonographic findings but prenatal diagnosis) ,including 2 cases of one of twins 21 three body syndrome , chromosome abnormality rate 10 .6% (5/47) .7 cases to selective reduction (5 cases of abnormal chromo‐some abnormality and 2 cases of ultrasonic normal chromosome) ,else choose expectation .Avoided the born of abnormal karyotypes including 2 cases of 47 ,+21 (including ultrasonic no abnormality in 1 case)、2 cases of 47 ,+18 and 1 case of 47 ,+13 ,and 1 case of fetal ascites ,1 cases of tetralogy of fallot

  4. Culture systems: embryo culture and monozygotic twinning.

    Science.gov (United States)

    Sparks, Amy E

    2012-01-01

    The incidence of monozygotic twinning in pregnancies achieved with assisted reproductive technologies (ART) is significantly higher than spontaneously conceived pregnancies. The factors associated with ART that predispose the embryos to splitting are not well-characterized. Assisted hatching and extended embryo culture are two ART laboratory methods that have been risk factors for monozygotic twinning. The methods and strategies that may be employed to avoid monozygotic twinning are discussed in this chapter.

  5. 131例双胎妊娠并发重度子痫前期的妊娠结局%Pregnancy outcomes of 131 twin pregnancies complicated with severe pre-eclampsia

    Institute of Scientific and Technical Information of China (English)

    王姗; 罗方媛; 何国琳; 刘兴会

    2013-01-01

    新生儿HIE发生率[8.4%(22/262)与4.7%(27/572)]、新生儿NICU转入率[76.2%(205/262)与58.4%(332/572)]比较,双胎组均高于单胎组(x2=162.000、4.392和31.980,P均<0.05).结论 双胎妊娠较单胎妊娠更易发生重度子痫前期,且更易发生严重并发症,导致围产儿不良结局.临床应重视双胎妊娠的管理,一旦发生妊娠期高血压疾病应积极治疗并预防并发症,根据病情适时终止妊娠.%Objective To explore the clinical characteristics and pregnancy outcomes of twin pregnancies complicated with severe preeclampsia.Methods The pregnant outcomes of 131 twin pregnancies (twin group) and 572 singleton pregnancies (singleton group),all complicated with severe preeclampsia,were analyzed retrospectively.All patients were treated in the Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University from June 2007 to June 2011.The patients' age,onset of disease,gestational weeks at delivery,mean duration of expectant treatment,blood pressure,laboratory parameters and incidence of pregnancy complications,including placental abruption,heart failure,pulmonary edema,postpartum hemorrhage,uteroplacental apoplexy,eclampsia,HELLP syndrome (hemolysis,elevated liver enzymes and low platelets syndrome),hypoproteinemia,retinopathy,intracranial hemorrhage and renal insufficiency,were compared between the two groups.Perinatal outcomes such as premature delivery,perinatal mortality,neonatal intensive care unit (NICU) hospitalization,fetal distress,hypoxic-ischemic encephalopathy (HIE),asphyxia neonatorum,neonatal pneumonia,hyperbilirubinemia and neonatal hypoglycemia of two groups were also compared.Chi-square test,Fisher's exact test or t-test were used for statistical analysis.Results The severe preeclampsia incidence of twin pregnancies (5.03%,131/2604) was higher than that (1.94%,572/29 452) of singleton pregnancy (x2=106.40,P<0.001).The onset time [(33.6±1.8) weeks] and gestations at delivery [(34.6

  6. 双胎之一胎儿宫内死亡51例临床分析%Clinical Analysis of 51 Cases of Single Intrauterine Fetal Demise in Twin Pregnancy

    Institute of Scientific and Technical Information of China (English)

    张奕; 王洁; 王晨虹

    2013-01-01

    Objective:To investigate the cause,clinical management and matemal-neonatal outcomes of single intrauterine fetal demise (sIUFD) in twin pregnancy.Methods:The clinical data of 51 cases of sIUFD in twin pregnancy(sIUFD group) from 2009 to 2012 were retrospectively analyzed.51 cases of normal twin pregnancy in the same period were included as controls.Results:①The incidences of fetal anomalies,fetal growth restriction (FGR),twin-twin transfusion syndrome (TTTS),torsion cord,single umbilical artery,assisted reproductive techniques (ART) in the sIUFD group were significantly higher than those in the control group(P <0.05).There were no statistically significant differences in hypertensive disorders pregnancy,gestational diabetes mellitus,intrahepatic cholestasis of pregnancy between the two groups (P > 0.05).②The average gestational age of single intrauterine fetal demise (sIUFD) in twin pregnancy was 28.7 ± 6.4 weeks,the medium of expectant time was 3.1 weeks,and the quartile intervals was 13.1 weeks.The termination of monochorionic twin pregnancy gestational age was 34.6 ±2.2 weeks on average and that of dichorionic twin was 35.9 ± 1.9 weeks.③There was no statistically significant difference in neonatal asphyxia between the two groups(P>0.05).There was no perinatal mortality in both groups.In the follow-up visit of the sIUFD group,47 survivors were normal,4 cases were lost of follow-up.Conclusions:Fetal anomalies,FGR,TTTS,torsion cord and single umbilical artery are the critical reasons for the sIUFD in twin pregnancy.There is no obvious relationship between maternal complications and sIUFD in twin pregnancy.The connection between ART and sIUFD in twin pregnancy needs to carry on deeper research.sIUFD in monochorionic twin pregnancy should be expected to 34 weeks and sIUFD in dichorionic twin pregnancy should be expected to 37 weeks to improve neonatal outcomes.%目的:探讨双胎之一胎儿宫内死亡(sIUFD)的原因、临床处理及母

  7. Clinical analysis of single or twin pregnancy complicated with preeclampsia%单、双胎妊娠并发子痫前期临床分析

    Institute of Scientific and Technical Information of China (English)

    匡丽云; 汤雯婷; 周燕媚; 孙雯; 龚景进; 李晓梅; 李秀英; 陈敦金

    2016-01-01

    Objective To explore the clinical features and pregnancy outcomes of single or twin pregnancy complicated with preeclampsia.Methods From January 2009 to April 2013, 405 pregnancies complicated with preeclampsia, who were admitted to the Obstetrics department of the Third Affiliated Hospital of Guangzhou Medical University were enrolled in this retrospective study.This study included 43 twin pregnancies in research group and 362 singleton pregnancies in the control group.The clinical features and pregnancy outcomes of the two groups were retrospectively analyzed.Results The length of hospital stay in research group and control group were ( 13.28 ±11.23 ) day and ( 9.48 ±4.97 ) day, respectively.There was significant difference in the two groups (t=2.20, P<0.05).In research group, the incidence of cesarean section, premature rupture of membranes, postpartum hemorrhage, heart failure were 97.67%, 13.95%, 11.63% and 11.63%, respectively, which were higher than that in control group ( 79.83%, 5.25%, 5.25% and 4.14%) with significant difference ( P <0.05 ) .In research group, the incidence of newborn infection and jaundice were 25.58%and 48.84%,which were higher than that in control group ( 15.19% and 32.60%) with significant difference ( P <0.05 ) .Conclusion Compared to singleton pregnancy complicated with preeclampsia, twin pregnancy complicated with preeclampsia increased the incidence of cesarean section, premature rupture of membranes, postpartum hemorrhage and heart failure, and extended maternal hospital stay.%目的探讨单、双胎妊娠并发子痫前期的临床特点及妊娠结局。方法选取2009年1月至2013年4月在广州医科大学附属第三医院产科住院分娩的43例双胎并发子痫前期的孕妇为研究组,362例单胎并发子痫前期产妇作为对照组,回顾性分析两组患者的临床特点及母婴结局的情况。结果研究组住院时间(13.28±11.23)d,较对照组(9.48±4.97)d延长,t=2.20,P<0

  8. Outcomes after physical examination-indicated cerclage in twin gestations.

    Science.gov (United States)

    Miller, Emily S; Rajan, Priya V; Grobman, William A

    2014-07-01

    To compare outcomes of physical examination-indicated cerclage in women with twin gestations to those with singleton gestations and to identify whether risk factors for extremely preterm birth (before 28 weeks) differ between these 2 groups. This is a single institution retrospective cohort study of women who underwent a physical examination-indicated cerclage between Jan. 1, 1980, and Aug. 15, 2012. Differences in characteristics and outcomes were compared between women with twin and singleton gestations. A multivariable analysis was performed to examine whether twin gestation was independently associated with delivery before 28 weeks and whether any effect modification was present between risk factors for preterm birth and the presence of a twin gestation. Of the 442 women who underwent a cerclage during the period of study, 104 (23.5%) had twins. Mean gestational age and digital cervical length at placement did not differ by plurality. Although twins were more likely to deliver at a slightly earlier median gestation than singletons (31.9 weeks; interquartile range, 24.9-35.1 vs 32.7 weeks; interquartile range, 24.6-38.3; P = .015), the frequency of delivery before 28 weeks did not differ between these 2 groups (33.7% vs 35.8%, P = .69). Greater cervical dilation and prolapsing membranes were identified as risk factors for birth digital cervical length twin gestations. Women with a twin pregnancy who received a physical examination-indicated cerclage had similar risk factors for extreme preterm birth and may experience similar obstetric outcomes as women with singleton gestations. Copyright © 2014 Mosby, Inc. All rights reserved.

  9. The Clinical Analysis of Twin Pregnancy Complicated by Preeclampsia%双胎妊娠并发子痫前期的临床分析

    Institute of Scientific and Technical Information of China (English)

    沈晔; 王文娟

    2015-01-01

    目的:探讨双胎妊娠并发子痫前期在临床中的情况。方法选取2011年1月至2014年6月我院治疗的37例双胎妊娠并发子痫前期孕妇为观察组,同期37例单胎妊娠并发子痫前期孕妇为对照组,分析两组的情况。结果两组在分娩方式及胎儿情况方面相比差异不具有显著性(P>0.05),两组在子痫、HELLP综合征、产后出血、胎盘早剥、胎儿窘迫、FGR(胎儿生长发育迟缓)、妊娠期糖尿病、肺水肿等并发症方面相比差异具有显著性(P0.05), the two groups in preeclampsia and HELLP syndrome, postpartum hemorrhage, placental abruption, fetal distress, FGR (fetal growth retardation), gestational diabetes and complications such as pulmonary edema, compared with the difference is signiifcant (P<0.05). Conclusions On the twins with preeclampsia patients, to enhance prenatal guidance and supervision, the childbirth way to choose the most reasonable, improving the quality of labor, to ease the twin pregnancy outcomes and reduce the perinatal mortality is crucial.

  10. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  11. 双(多)胎脑瘫患儿的病因学及临床特征分析%Etiology and Clinical Features of Cerebral Palsy in Twin or Multiple Pregnancies

    Institute of Scientific and Technical Information of China (English)

    孙殿荣; 候梅; 高翔

    2011-01-01

    目的 探讨双(多)胎儿童发生脑瘫的相关因素及临床特征.方法 对52例双胎或多胎脑瘫患儿进行围产期高危因素调查、临床分型、影像学检查及粗大运动功能测评(GMFCS).结果 和结论双(多)胎之一脑瘫的发生和妊娠并发症无明显相关.同性别双胎、出生体重偏重一胎发生脑瘫的机会大.双(多)胎脑瘫以痉挛型双瘫最多见,影像学改变以侧脑室周围白质软化为主.痉挛型双瘫和偏瘫患儿GMFCS多在Ⅰ~Ⅲ级,而不随意运动型、四肢瘫和混合型患儿多在Ⅳ~Ⅴ级.%Objective To analyze the related factors and clinical features of cerebral palsy in twin or multiple pregnancies. Methods 52 cerebral palsy children in twin or multiple pregnancies were reviewed with the risk factors in perinatal period, the clinical type, findings of radiology and the gross motor function (GMFCS). Results and Conclusion No significant link was found between these pregnancy complications and cerebral palsy in twins or multiple pregnancies. The prevalence of cerebral palsy was higher for the one with more birthweight in twins of the same gender. Spastic diplegia was the most type, and most of them were found with periventricular leucomalacia. The GMFCS levels was Ⅰ ~ Ⅲ in spastic hemiplegic or spastic diplegic children, while was Ⅳ ~ Ⅴ in children with spastic quadriplegia, dyskinesia or mixed CP.

  12. 胎儿纤维连接蛋白联合宫颈长度预测无症状双胎妊娠早产%Fetal Fibronectin combined with cervical length to predict preterm delivery in asymptomatic twin pregnancy

    Institute of Scientific and Technical Information of China (English)

    郭雪箐; 莫慧芬

    2015-01-01

    目的探讨无症状的双胎妊娠应用阴道分泌物胎儿纤维连接蛋白(fFN)联合经腹宫颈长度预测早产的价值。方法共纳入98例双胎妊娠孕妇,于妊娠24周~35周检测孕妇宫颈阴道分泌物fFN、经腹B超检测宫颈长度并随访妊娠结局。结果 fFN联合宫颈长度检测预测双胎妊娠早产较两项单独检测预测早产的敏感度、阴性预测值均有所提高。结论 fFN及宫颈长度联合检测可用于筛查无症状的双胎妊娠孕妇早产,具有较高的临床应用价值。%Objective To evaluate transabdominal cervical length measurements and fetal fibronectin detection in the maternal vaginal secretions as predictors of preterm delivery in asymptomatic twin pregnancy. Methods A total of 98 cases of twin pregnancy were recruited. Transabdominal ultrasound assessments of cervical length and fetal bronectin detection were performed from 24 to 35 weeks of gestation. The pregnancy outcomes were followed up. Results The sensitivity of detection of cervical length combined with fetal bronectin as predictors of preterm delivery in asymptomatic twin pregnancies was 82.0%, specificity 76.7%, positive predictive value 49.3%and negative predictive value 91.7%. The sensitivity and negative predictive value of the joint tests were higher than that of the respective detection for predicting preterm delivery. Conclusion For asymptomatic twin pregnancy, fetal bronectin detection combined with cervical length measurements can be used for screening of asymptomatic twin pregnancy.

  13. Twin pregnancy childbirth way with gestational age of pregnancy outcome%双胎妊娠分娩方式与孕龄对妊娠结局的探讨

    Institute of Scientific and Technical Information of China (English)

    陈晓妮

    2014-01-01

    Twin pregnancy childbirth way and gestational age influence on pregnancy outcome.Methods:In twin pregnancy, 240 cases of maternal childbirth obstetrics and gynecology hospital as the research object.Through self-made form col ection of maternal clinical data were retrospectively analyzed. analyze the different gestational age and birth weight, the relationship between neonatal asphyxia, and different position and the way of delivery and neonatal asphyxia. Result: This group of neonatal asphyxia in 15.83% (76/480). Gestational age 28~34 weeks and of 39 weeks or a newborn, the incidence of asphyxia were significantly higher than that of 35~38 weeks gestational age neonates (al P<0.05). First position as head of the women, the vaginal trial production success of newborns, the incidence of first and second child suffocation were significantly higher than that of elective cesarean section newborn (3.67%, 6.42%vs0.00%, 3.67%), statistical y significant difference (P<0.05). Conclusion:Cesarean section can effectively reduce the incidence of postpartum hemorrhage, twin pregnancy maternal extend gestational age can effectively improve the newborn weight, reduce the incidence of neonatal asphyxia, the cutting head first recommended palace childbirth.%探讨双胎妊娠分娩方式和孕龄对妊娠结局的影响。方法:选择在我院妇产科分娩的双胎妊娠产妇240例为研究对象。通过自制的表格收集产妇的临床资料进行回顾性分析。分析不同的孕龄和新生儿体重、新生儿窒息的关系以及不同胎位和分娩方式与新生儿窒息发生的关系。结果:本组新生儿窒息共计15.83%(76/480)。孕龄28~34周和≥39周的新生儿,窒息的发生率均显著高于孕龄35~38周的新生儿(均P<0.05)。第一胎胎位为头位的产妇中,阴道试产成功的新生儿,第一胎和第二胎窒息的发生率均显著高于择期剖宫产的新生儿(3.67%、6.42%vs0.00%、0.92%),

  14. ACARDIAC TWIN

    OpenAIRE

    Vinayachandran; Jyothi,; Bindu; Umadevi

    2014-01-01

    Acardiac twin is a very rare complication occurring in monozygotic twins in which one fetus develops normally (pump twin) and the other (recipient twin) demonstrate cardiac non development and othe r anomalies. This may represent an extreme form of TTTS, also referred to as TRAP sequence. 1,2,

  15. Rapid onset of severe twin-twin transfusion syndrome caused by placental venous thrombosis

    NARCIS (Netherlands)

    Nikkels, PGJ; van Gemert, MJC; Sollie-Szarynska, KM; Molendijk, H; Timmer, B; Machin, GA

    2002-01-01

    We report a case of rapid onset of severe twin-twin transfusion syndrome (TTTS) at 25 weeks gestation in a monochorionic twin pregnancy that was uneventful before that time. Thrombosis of a main venous branch draining several arteriovenous (AV) anastomoses to the donor changed the previous hemodynam

  16. Monozygotic twinning after assisted reproductive technologies: a case report of asymmetric development and incidence during 19 years in an international group of in vitro fertilization clinics.

    Science.gov (United States)

    Tocino, Antonia; Blasco, Víctor; Prados, Nicolás; Vargas, Manuel J; Requena, Antonio; Pellicer, Antonio; Fernández-Sánchez, Manuel

    2015-05-01

    To describe a case of monozygotic twinning with asymmetric development following a single fresh embryo transfer as part of an intracytoplasmic sperm injection (ICSI) treatment. Secondarily, to report the incidence of monozygotic twinning at the IVI (Instituto Valenciano de Infertilidad) clinics. Case report. Private fertility centers. A 33-year-old woman with a 2-year history of primary infertility. Controlled ovarian hyperstimulation and ICSI treatment with single-embryo transfer. Incidence of monozygotic twinning at the IVI clinics. We report a twin pregnancy after a single-embryo transfer. Twins were dichorionic and diamniotic. One fetus had a 6-day delay in its growth compared with the other when observed by ultrasound. Two female infants were delivered, and despite presenting congenital diseases, they were successfully treated and evolved correctly. A subsequent DNA analysis confirmed that the infants were monozygotic. Furthermore, we estimated a monozygotic twinning rate of 1.17% at the IVI clinics, taking into account those cases in which two or more embryos with heart beats were observed by ultrasound scanning after single-embryo transfers. Ultrasound scans performed during pregnancy suggested a possible dizygotic origin of the twins, but DNA analysis performed after birth established that they were monozygotic. Genetic analysis is the only valid tool to confirm if like-sex dichorionic twins are monozygotic or dizygotic. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  17. TWIN BIRTHS IN THE COMOROS MA ABDUL ABSTRACT Objective

    African Journals Online (AJOL)

    hi-tech

    2000-11-11

    Nov 11, 2000 ... Conclusion: Multiple pregnancy is common in the Comoros and the epidemiology and ... Of the 23 twin deliveries in Domoni, only one neonate. (a second twin) had ... including ambiguous genitalia and died in the immediate.

  18. Twins reunited: scientific and personal perspectives/twin research studies: multiple birth effects on IQ and body size; life style, muscles, and metabolism; monochorionic dizygotic twin with blood chimerism; amniocentesis for twins/twins in the media: identical doctors; freedom fighter for twins; twin scholarships; Auguste and Jean-Felix Piccard; twins born apart.

    Science.gov (United States)

    Segal, Nancy L; Mulligan, Christy A

    2014-04-01

    A reunion of 38-year-old female monozygotic twins took place in Daegu, South Korea, on January 14, 2014. Scientific and personal perspectives on this extraordinary event are provided. A review of timely twin research follows, covering the effects of multiple births on IQ and body size, lifestyle and physical fitness associations, a rare case of a dizygotic twin with blood chimerism and definitional issues surrounding amniocentesis-related loss in multiple birth pregnancies. Interesting and informative mention of twins in the media includes twin doctors, a twin freedom fighter, the availability of college scholarships for twins, a new book about the Piccard family (two of whose members were twins), and co-twins born before and after the new year. A follow-up to a previous mention of identical twin biatheletes is also provided.

  19. 双胎妊娠不同分娩方式及时机对新生儿影响的探讨%Twin Pregnancy Different Mode of Delivery and Timing of Impact on Neonatal

    Institute of Scientific and Technical Information of China (English)

    赖娟娟

    2013-01-01

    Objective:To investigate the twin pregnancy, delivery methods and timing of the newborn, and to provide a theoretical basis for the choice of mode of delivery and the timing of delivery of clinical twin. Methods:The retrospective analysis of clinical data for hospital deliveries in the hospital July 2008 to July 2011, 192 cases of twin pregnancy. Results:Twin incidence of 1.10%, the preterm birth rate was 36.00%, vaginal delivery, 19.00%, vaginal assisted deliveries by 4.00%,cesarean section delivery by 77.00%. Conclusion:To strengthen the custody of the twin pregnancy, maternal pregnancy, reduce the incidence of pregnancy complications and preterm delivery, select the appropriate timing of delivery and childbirth in order to reduce the incidence of pregnant women and newborns.%  目的:探讨双胎妊娠不同分娩方式及时机对新生儿的影响,以为临床双胎分娩方式的选择及分娩时机提供理论依据。方法:回顾性分析我院2008年7月至2011年7月住院分娩的192例双胎妊娠孕妇的临床资料。结果:双胎发生率为1.10%,早产率为36.00%,经阴道分娩19.00%,阴道助产分娩4.00%,剖宫产手术分娩77.00%。结论:加强双胎妊娠产妇的孕期监护可以减少妊娠并发症及早产的发生,分娩时选择适当的时机和方式可以降低孕妇及新生儿的发病率。

  20. Perinatal outcomes of twin pregnancies among cases of spontaneous conception and assisted reproduction technology%自然妊娠和辅助生育技术妊娠双胎的母婴围产期预后

    Institute of Scientific and Technical Information of China (English)

    陈蔚琳; 宋英娜; 刘俊涛; 高劲松

    2011-01-01

    Objective The aim of this study was to evaluate and compare the perinatal and neonatal outcomes of assisted reproduction technology (ART) twin pregnancies and those of spontaneously conceived twin pregnancies (SC). Methods The medical files of ART and naturally conceived twin pregnancies were studied retrospectively.Data concerning maternal characteristics, obstetric complications and neonatal outcomes were recorded and compared. Results Mean maternal age was higher in ART group than in SC group [ (34.23±4. 13) ys vs (32. 02±4. 45) ys, P<0. 05)]. No significant differences were found in obstetric complication between the two groups. The mean gestational age and the incidence of neonatal infection were lower in ART group [ (251.87±15. 16) days,3. 7%] than in SC group [ (256. 04±12. 26) d, 9.4%] (P<0. 05). Conclusion The obstetric complications and neonatal outcomes have no significant differences in ART twin pregnancies and naturally conceived twin pregnancies.%目的 比较自然妊娠和辅助牛育技术(assisted reproduction technology,ART)妊娠双胎的母婴围产期预后.方法 选择北京协和医院定期随诊并分娩的双胎211例,其中自然妊娠142例,ART妊娠69例,回顾性分析两组孕妇一般情况、围产期并发症、分娩情况及新生儿并发症.结果 ①ART组孕妇年龄[(34.23±4.13)岁]大于自然妊娠组孕妇[(32.02±4.45)岁],P<0.05.两组孕妇围产期并发症的发生率差异无统计学意义(P>0.05);②ART组新生儿平均孕龄小于自然妊娠组,(251.87±15.16)d比(256.04±12.26)d,且新牛儿感染发牛率低,5(3.7%)比26(9.4%),P<0.05.结论 与自然妊娠双胎相比,ART双胎妊娠不增加孕妇围产期并发症的风险,而且新生儿健康状态与自然妊娠双胎相当.

  1. 助孕治疗与自然妊娠双胎围产期结局的比较%Comparison of perinatal outcomes of twin pregnancy with assisted reproductive techniques and natural pregnancy

    Institute of Scientific and Technical Information of China (English)

    李洁; 杨菁; 徐望明; 程丹

    2013-01-01

    目的 比较辅助生殖技术获得的双胎妊娠与自然妊娠双胎产科合并症及新生儿不良结局的发生情况,探讨在双胎妊娠中辅助生殖技术是否会增加围产期疾病及新生儿不良结局风险.方法 回顾性分析108例经辅助生殖技术助孕的双胎妊娠病例(研究组)和144例自然受孕双胎妊娠病例(对照组)围产期疾病的发生率与产科结局.结果 研究组孕妇平均年龄为31.04±3.63岁,与对照组28.81±4.75岁比较年龄较大,差异有统计学意义(t=2.88,P0.05).其它孕期合并症如重度子痫前期、肝内胆汁淤积症、妊娠期糖尿病、贫血发病率等在研究组与对照组的差异均无统计学意义(均P>0.05).在新生儿结局中,0.05).结论 双胎妊娠围产期疾病及新生儿不良结局风险增加,其发生率与孕妇年龄有关.通过辅助生殖技术获得的双胎妊娠在0.05 ). The differences in other pregnant complications such as severe preeclampsia, intrahepatic cholestasis, gestational diabetes mellitus and anemia between study group and control group were not significant ( all P >0. 05 ). The mild asphyxia of the second neonatorum in study group and control group was 23. 53% and 12. 20% , respectively, and the difference was statistically significant(χ2 =4. 61 ,P 0. 05 ). Conclusion The risk of perinatal disease and neonatal adverse outcomes in twin pregnancy increases, and the incidence is related with maternal age. The incidence of premature rupture of membranes and that of mild asphyxia of the second neonatorum in pregnant women <35 years with twin pregnancy with ART are higher than those of natural twin pregnancy, but the risk of other perinatal diseases and neonatal adverse outcomes is not increased.

  2. Imaging of conjoined twins

    Energy Technology Data Exchange (ETDEWEB)

    McHugh, Kieran [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Kiely, Edward M.; Spitz, Lewis [Great Ormond Street Hospital for Children, Department of Surgery, London (United Kingdom)

    2006-09-15

    The incidence of conjoined twins is estimated to be around 1 in 250,000 live births. There is a distinct female predominance. In this paper the imaging of conjoined twins both antenatally and postnatally is reviewed, in particular taking into consideration recent advances with multidetector CT. Accurate counselling of parents regarding the likely outcome of the pregnancy and the likelihood of successful separation is dependent on good prenatal imaging with ultrasound and MRI. Planning of postnatal surgical separation is aided by accurate preoperative imaging which, depending on the conjoined area, will encompass many imaging modalities, but often relies heavily on CT scanning. (orig.)

  3. Study on the Route of Delivery and Pregnancy Outcome in Twin Pregnancy%双胎妊娠分娩方式对妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    陈志梅

    2013-01-01

    目的:探讨双胎妊娠的分娩方式与妊娠结局之间的关系。方法:将我院273例双胎妊娠产妇按分娩方式的不同分为阴道分娩组(29例)及剖宫产组(224例),回顾性分析两组临床资料,对比两组妊娠结局。结果:剖宫产组224例,阴道分娩组29例;两组产后出血量无明显差异,P>0.05;剖宫产组平均分娩孕周大于阴道分娩组,新生儿出生平均体重显著高于阴道分娩组,P0.05,第二胎儿剖宫产组新生儿窒息率显著低于阴道分娩组,P0.05;cesarean section pregnancy week than vaginal delivery group,the average weight of newborns were significantly higher than those in the vaginal delivery group,P0.05,whereas the second tire has a significant,P<0.05.Conclusion:Cesarean section is the main mode of delivery of twin pregnancy and can reduced the.second fetal neonatal asphyxia rate.

  4. Recurrent spontaneous multiple pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Shazia Parveen

    2016-09-01

    Full Text Available Multiple gestations are usually iatrogenic like use of assisted reproductive techniques (ART, infertility treatment but it is rare in spontaneous conception. High order multiple pregnancies (HOMPs are major cause of maternal, fetal and neonatal morbidity. Multiple gestations carries 2 complications either abortion in early gestation or a preterm delivery in late pregnancy (more common. Preterm delivery is common (50% and patient usually delivers by 30-32 weeks. Discordance of fetal growth is very common and even more than in twins. Perinatal loss is inversely related to birth weight. The mothers should be counseled about regular ante natal care (ANC check-ups for early identification of multiple pregnancies so that proper care can be given to prolong the gestational age and reduce the complications associated with multiple pregnancies. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3208-3209

  5. Pre-eclampsia (PE) and Chorionicity in Women with Twin Gestations

    Science.gov (United States)

    Singh, Anupama; Singh, Arati; Surapaneni, Tarakeswari; Nirmalan, Praveen Kumar

    2014-01-01

    Background: Pre-Eclampsia (PE) affects 6-31% of pregnant women with multiple gestations. There are conflicting reports on the association of PE with Chorionicity and zygosity; however, there is a lack of information on this potential association in a population of pregnant Asian Indian women. Aim: To determine as to whether chorionicity and zygosity were associated with PE in a population of Asian Indian women with twin gestations. Settings and Design: A retrospective observational study was done at a single tertiary care centre in Southern India. Material and Methods: The study included pregnant women with twin gestations, who was delivered at the study institute in 2012. Hypertension in pregnancy was categorized, based on the criteria of the International Society for the Study of Hypertension in Pregnancy. Chorionicity was determined by using ultrasonography and zygosity was determined, based on clinical criteria. Point estimates and the 95% Confidence Intervals (CI) around point estimates of PE and associations of chorionicity and zygosity with PE were determined by using bivariate analysis, logistic regression models and area under Receiver Operator Characteristic (ROC) curves. Results: This study included 208 women with twin gestations. The incidence of PE in dichorionic twin gestations was 13.17% (n=22, 95% CI: 8.66, 18.96), it was 4.87% (n=2, 95% CI: 0.83, 15.19) in monochorionic twin gestations, it was 16.36% (n=9, 95% CI: 8.29, 27.91) in dizygous twin gestations and it was 4.88% (n=2, 95% CI: 0.83, 15.19) in monozygous twin gestations. Neither chorionicity (adjusted OR: 2.59, 95% CI: 0.55, 12.19) nor zygosity (adjusted OR 2.72, 95% CI: 0.49, 15.13) were associated with PE In a multivariate logistic regression model. Conclusion: Although it was not statistically significant, the clinical incidence of PE was higher in dichorionic and dizygous twin gestations. PMID:24596736

  6. Clinical Analysis of Maternal and Perinatal Outcome of 44 Patients with Twin Pregnancy%双胎妊娠44例妊娠结局临床分析

    Institute of Scientific and Technical Information of China (English)

    陈凤霞

    2014-01-01

    目的:探讨改善双胎妊娠的产妇和围产儿的预后。方法回顾分析该院2001年1月-2013年10月病案资料,包括双胎妊娠孕妇基本资料、妊娠并发症、新生儿并发症及新生儿结局,数据经统计学处理。结果双胎妊娠女性年龄相对较大,有较高的平均身高和较重平均体重。虽然没有孕产妇死亡,但妊娠并发症均显着较高,其中早产发生率(36.3%),妊娠期高血压疾病(9.1%),胎膜早破(27.2%),贫血(29.5%),产后出血(15.9%),产前出血(6.8%),妊娠糖尿病(11.3%),羊水过多(4.5%),大多数患者有一个以上并发症。只有8%的患者没有任何并发症。剖宫产与阴道分娩相比没有显著减少或增加围产儿结局。产科医生及时有效的判断行紧急剖宫产可有效降低新生儿死亡率及严重并发症的发病率。结论双胎妊娠具有较高的妊娠并发症和新生儿并发症,剖宫产与阴道分娩相比没有显著减少或增加围产儿结局。%Objective To explore the measures of improving the maternal and perinatal outcome of twin pregnancy by analyzing the treatment and outcome of 44 puerperants with twin pregnancy retrospectively. Methods The clinical data during January, 2001 to October, 2013 in our hospital, including the basic data of puerperants with twin pregnancy, pregnancy complications, neonatal complications and neonatal outcome, were analyzed retrospectively and treated statistically. Results The results showed that the women with twin pregnancy were relatively older, had a higher average height and a heavier body weight. Although there was no maternal mortality, pregnancy complications were remarkably higher, pregnancy complicated by preterm labor(36.3%), hypertensive disorders in pregnancy (9.1%), premature rupture of membrane(27.2%), anaemia(29.5%), postpartum hemorrhage (15.9%), antepar-tum hemorrhage(6.8%), gestational diabetes(11.3%), polyhydramnios(4.5%). Most of the patients had

  7. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde;

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... physical workload). The adverse outcomes considered are: miscarriage, preterm delivery, small for gestational age, low birth weight, pre-eclampsia and gestational hypertension. Systematic review of the literature indicates that these exposures are unlikely to carry much of an increased risk for any...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  8. 产前超声监测羊水量不均衡双胎妊娠的临床价值%Value of prenatal surveillances of ultrasonography in twin pregnancies with amniotic fluid discordance

    Institute of Scientific and Technical Information of China (English)

    刘涛; 吴瑛; 王慧芳; 谭喜平; 甘晗靖; 林琪; 焦阳; 熊奕; 姜燕; 张辉

    2010-01-01

    Objective To evaluate the values of prenatal surveillances of ultrasonography in twin pregnancies with amniotic fluid discordance. Methods Two hundred and seventy cases of diamniotic twins were included. Both postnatal outcomes and prenatal amniotic fluid discordant variations were analyzed,and the incidences of amniotic fluid discordance were compared between the monochorionic-diamniotic(MCDA)and dichorionic-diamniotic (DCDA) gruop. Results Twenty four cases of twins with amniotic fluid discordance were found in the study. The incidence of amniotic fluid discordance in MCDA group was much higher than that in DCDA group (28.9% vs 5.6%, P <0. 001 ) ,and 24 cases of twin-to-twin transfusion syndrome (TTTS) were diagnosed in the former group and none were found in the latter group. Downward tendency of amniotic fluid discordance was shown in non-TTTS cases of MCDA group. Compared with TTTS cases, the postnatal outcomes of non-TTTS cases with amniotic fluid discordance were much better in MCDA group ( P <0.001 ). Conclusions TTTS and MCDA twins with amniotic fluid discordance may overlap each other in the early stage. Serial surveillances of ultrasonography are necessary for prenatal differentiating twin pregnancies complicated by amniotic fluid discordance,and providing strong support to clinical treament.%目的 探讨产前超声监测羊水量不均衡双胎的临床价值.方法 分析270例双羊膜囊双胎中单绒毛膜双羊膜囊双胎(monochorionic-diamniotic twin,MCDA)与双绒毛膜双羊膜囊双胎(dichorionicdiamniotic twin,DCDA)羊水量不均衡的发生率,妊娠过程中羊水量变化趋势及与妊娠结局的关系.结果 共45例双胎间羊水量不均衡,MCDA组37例,其中24例为双胎输血综合征(twin-to-twin transfusion syndrome,TTTS);DCDA组8例,无TTTS发生.MCDA组羊水量不均衡的发生率明显高于DCDA组(P<0.001).MCDA组中羊水量不均衡的非TTTS双胎,羊水量的差异随孕周增加呈减少趋势,且

  9. Risk factors associated with twin pregnancy in double embryo transfer%移植2个胚胎发生双胎妊娠的风险因素分析

    Institute of Scientific and Technical Information of China (English)

    徐维海; 童晓嵋; 竺海燕; 林小娜; 蒋凌英; 张松英

    2011-01-01

    Objective To explore the risk factors associated with twin pregnancy in double embryo transfer.Methods A retrospective analysis was performed for 2970 double embryo transfer cycles,including 1984 cycles of fresh embryo transfer and 986 cycles of frozen-thawed embryo transfer (FET).Multiple factor Logistic regression was used.The twin pregnancy rate was studied in group of age < 35 or age ≥ 35 years old,in group of zero,single or double high-quality embryos transferred and group of fresh embryo transfer or FET cycles.Results (1) There was a significantly negative correlation between women's age and twin pregnancy according to the analysis of multiple factor Logistic regression ( P < 0.01 ).And a significantly positive correlation existed between the number of high-quality embryos transferred,FET and twin pregnancy (P <0.0l ) ; (2)the twin pregnancy rate of both fresh embryo transfer and FET cycles was higher in group of age <35 years than that in group of age ≥35 years ( 16.0% vs 8.0%,P <0.01 ; 26.9% vs 14.2%,P <0.01 ) ; (3) the twin pregnancy rate of fresh embryo transfer cycles with double high-quality embryos transferred was higher than that with zero or single high-quality embryos transferred ( 19.1% vs 5.4% ;19.1% vs 11.0%,P < 0.01 ); the twin pregnancy rate of FET cycles with double high-quality embryos transferred was also higher than that with zero or single high-quality embryos transferred (32.7% vs 10.8% ; 32.7% vs 20.7%,P <0.01 ) ; (4)the twin pregnancy rate of FET cycles was significantly higher than that of fresh embryo transfer cycles (24.7% vs 14.9%,P <0.01 ).Conclusion Women's age,the number of high quality embryos transferred and FET are risk factors associated with twin pregnancy.At reproductive centers with a mature technique of FET,we recommend performing single high-quality embryo transfer in FET cycles to reduce the occurrence of twin pregnancy.%目的 探讨1次移植2枚胚胎时发生双

  10. Mid-luteal phase injection of subcutaneous leuprolide acetate improves live delivered pregnancy and implantation rates in younger women undergoing in vitro fertilization-embryo transfer (IVF-ET).

    Science.gov (United States)

    Check, J H; Wilson, C; Cohen, R; Choe, J K; Corley, D

    2015-01-01

    To see if the single injection of one mg of the gonadotropin releasing hormone agonist (GnRHa) leuprolide acetate given in the mid-luteal phase can increase live delivered pregnancy and implantation rates. Furthermore the purpose was to determine if improvement was found, did the mechanism involve increased secretion of human chorionic gonadotropin (hCG). A prospective study was conducted in women aged 35 who were undergoing in vitro fertilization-embryo transfer (IVF-ET). They were advised of data from Tesarik et al. and a previous pilot study conducted in the present IVF center showing improved pregnancy rates with the injection of a GnRHa three days after embryo transfer. They were offered the option of returning for a one-mg injection s.c. of leuprolide acetate or not. Clinical and live delivered pregnancy rates were compared according to those taking or not the leuprolide acetate one-mg injection. Chi-square analysis was used for statistical comparisons. Serum beta-hCG levels were compared between those conceiving with or without the extra injection of leuprolide. There was a non-significant trend for higher live delivered pregnancy rates in those taking leuprolide (47.8%, 64/134) vs. those not taking it (38.6%, 76/197). For those pregnant there was no difference in hCG levels according to taking the GnRHa or not. The 25% increased live delivered pregnancy rate per transfer was insufficiently powered to detect a significant difference. The results do justify continuing the study. Perhaps the difference could be wider using a slightly older age group whose embryos are frequently less hearty.

  11. Pregnancy

    Science.gov (United States)

    ... occur between 34 and 36 weeks—these are late-preterm births. 5 Infants born in the 37th and 38th ... NICHD News and Spotlights Common tests for preterm birth not useful for ... in treating mildly low thyroid function in pregnancy, NIH Network study finds ...

  12. Dialysis for twins

    DEFF Research Database (Denmark)

    Gramkow, Ann-Maria; Aarup, Michael; Andersen, L. L. T.

    2014-01-01

    A 32-year-old woman with known stage-4 chronic kidney disease due to lupus nephritis presented with twin pregnancy after in vitro fertilization at a gestational age of 24 weeks + 3 days because of imminent preterm labour. Repeated ultrasound evaluations confirmed intrauterine growth restriction...... in both twins and polyhydramnios as the cause of imminent preterm labour. After initiation of haemodialysis treatment, ultrasound evaluation showed a significant decrease in amniotic fluids, and also reduction in blood urea nitrogen and in clinical complaints could be observed. At a gestational age of 28...... weeks + 4 days, delivery was performed by Caesarean section. This case study shows that effective treatment of elevated uraemic toxins significantly reduced the morbidity risks of the twins....

  13. Bilateral Humerus and Right Femur Fracture in a Newborn after Cesarean Section for Breech Presentation in a Twin Pregnancy: A Very Rare Case Report.

    Science.gov (United States)

    Rahul, P; Grover, Amit Rakesh; Ajoy, S M

    2017-01-01

    The most common fractures during vaginal delivery occur in the clavicle, humerus, and femur. Cesarean section reduces the chances of a child having a birth injury. However, in some difficult extractions, long bone fractures may occur. Cesarean section further reduces the incidence of birth injuries, especially in a breech delivery. Maneuvers employed during cesarean section, energetic traction, improper uterine incisions, and contracted uterus may cause these injuries. In the medical literature, there are few articles highlighting the occurrence of long bone fractures during cesarean section. There has been no case reported with a combined bilateral humerus and femur fracture in the medical literature. A 2-day-old neonate born after cesarean section for breech presentation in a twin pregnancy presented with restricted movements of both his arms and right leg. Infantogram revealed bilateral humerus and right femur fracture. Biochemical tests were normal, and there were no other findings on clinical examination. There was no evidence of child abuse or any positive family history. Child was splinted for 3 weeks. X-rays suggested good callus at the fracture site of the right femur and bilateral humerus fracture were united. To conclude, we would like to emphasize that long bone fractures can happen with cesarean section also. To prevent such untoward complications, during delivery of the baby the surgeon should be very careful, avoid energetic traction and should plan his incisions. Appropriate relaxation of the uterus must be achieved. Clavicles and other long bones should be palpated after a difficult delivery. However, it is important to note that long bone fractures in children heal rapidly without the need for any major intervention.

  14. Clinic observation on effecting of chorionic nature in twin pregnancy on pregnancy complications and perinatal outcome%双胎妊娠绒毛膜性质对孕妇妊娠期并发症及围生儿预后的影响

    Institute of Scientific and Technical Information of China (English)

    袁秀红

    2014-01-01

    Objective :To investigate the effects with chorionic nature in twin pregnancy and pregnancy complications .Methods :102 cases with twins were retrospectively analyzed .According to chorionic nature ,cases were divided into two groups :observation group (monochorionic) and control group (double chorion) .Results :There were no difference in gestational hypertension ,intrahepatic cholestasis of pregnancy ,polyhydramnios ,prema-ture rupture of membranes and preterm birth rate between Observation group and control group .But compared with observation group ,the rat of neonatal asphyxia and perinatal mortality in control group was significantly higher . Conclusions :Compared with double chorion twin pregnancies ,monochorionic twin pregnancies has a higher risk .It should be accurately determine about the chorionic nature ,to improve the level of care in monochorionic twin preg-nancies .%目的:探讨双胎妊娠绒毛膜性质对孕妇妊娠期并发症及围生儿预后的影响。方法:选取定期产检并分娩的双胎产妇102例,根据双胎绒毛膜性质分为观察组(单绒毛膜)和对照组(双绒毛膜),分析两组孕妇妊娠期并发症发生率及围生儿预后情况。结果:观察组妊娠期高血压、妊娠期肝内胆汁淤积症、羊水过多、胎膜早破、早产发生率与对照组比较无明显差异。新生儿窒息发生率、围生儿病死率均显著高于对照组。结论:单绒毛膜双胎妊娠比双绒毛膜双胎妊娠对围生儿具有更高的危险,故在孕早期应及时对双胎妊娠孕妇的绒毛膜性质进行准确判断,提高对单绒毛膜双胎妊娠孕妇和胎儿的整体监护水平。

  15. Emergency separation of a xipho-omphalopagus twin in a developing country

    Directory of Open Access Journals (Sweden)

    Shukla R

    2010-01-01

    Full Text Available Female conjoined twins (thoraco-omphalopagus were delivered by emergency caesarean section in a private nursing home. On examination, one of the twins was dead and was threatening the survival of the surviving twin (twin A. An emergency separation was performed to salvage the surviving twin.

  16. 超声诊断双胎妊娠并单脐动脉胎儿异常分析%Analysis of Fetal Malformations of Twin Pregnancy with Single Umbilical Artery Diagnosed by Ultrasound

    Institute of Scientific and Technical Information of China (English)

    陈肖侠; 解丽梅

    2013-01-01

    Objective To investigate ultrasound diagnosis of fetal malformations of twin pregnancy combined single umbilical artery (SUA).Methods A retrospective analysis was performed,SUA prenatal ultrasonographic results,chromosome check results and the follow up fetal outcomes were found from 36 cases of twin pregnancy.Results Among the 36 cases of twin fetus with SUA,there were 23 cases of single umbilical and fetal malformations (63.9%).Chromosome examination was performed in 15 cases,and 6 cases showed chromosomal abnormalities.There were 22 cases of fetal birth,of which 8 cases were born with twin reverse arterial perfusion (including 5 cases of low birth weight infants),the other 14 cases were born with single umbilical artery fetal (including 7 cases of low birth weight infants).Conclusion It is necessary to follow up twin pregnancy with SUA fetal outcome,summarize the patterns of fetal malformations and explore the relationship with chromosome and fetal outcome,so as to provide rationalization proposal for SUA antenatal consultation.%目的 探讨超声检查双胎妊娠合并单脐动脉(SUA)的胎儿异常情况.方法 回顾36例双胎妊娠合并SUA病例的产前超声检查结果及染色体检测结果,随访胎儿妊娠结局.结果 36例双胎妊娠合并SUA胎儿中,单脐动脉合并胎儿异常23例(63.9%),15例进行胎儿染色体检查,共检查出胎儿染色体异常6例.胎儿出生22例,其中双胎反向动脉灌注序列征者出生8例,5例为低出生体质量儿.其余合并单脐动脉胎儿出生14例,7例为低出生体质量儿.结论 通过对双胎合并SUA胎儿的随访,总结合并SUA胎儿畸形类型、与染色体关系及胎儿结局,为单脐动脉产前咨询提供合理化建议.

  17. Pregnancy after uterine arterial embolization

    Directory of Open Access Journals (Sweden)

    Cláudio E. Bonduki

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter. Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2, and 87.5% were successful live births (n = 14. The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54. One of the pregnancies resulted in twins. The newborn weights (n = 14 ranged from 2.260 to 3.605 kg (mean, 3.072 kg. One (7.1% was considered to have a low birth weight (2.260 kg. There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%], one case of premature rupture of the membranes (PRM (6.3%, and one case of preeclampsia (6.3%. All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  18. A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble VEGF receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small-for-gestational-age neonate

    Science.gov (United States)

    Romero, Roberto; Nien, Jyh Kae; Espinoza, Jimmy; Todem, David; Fu, Wenjiang; Chung, Hwan; Kusanovic, Juan Pedro; Gotsch, Francesca; Erez, Offer; Mazaki-tovi, Shali; Gomez, Ricardo; Edwin, Sam; Chaiworapongsa, Tinnakorn; Levine, Richard J.; Karumanchi, Ananth

    2008-01-01

    Introduction Accumulating evidence suggests that an imbalance between pro-angiogenic [i.e. vascular endothelial growth factor (VEGF) and placental growth factor (PlGF)] and anti-angiogenic factors [i.e. soluble VEGF receptor-1 (sVEGFR-1, also referred to as sFlt1) is involved in the pathophysiology of preeclampsia (PE). Endoglin is a protein that regulates the pro-angiogenic effects of transforming growth factor β, and its soluble form has been recently implicated in the pathophysiology of PE. The objective of this study was to determine if changes in maternal plasma concentration of these angiogenic and anti-angiogenic factors differ prior to development of disease among patients with normal pregnancies, and those destined to develop PE (preterm and term) or to deliver an SGA neonate. Methods This longitudinal nested case-control study included 144 singleton pregnancies in the following groups: 1) patients with uncomplicated pregnancies who delivered appropriate for gestational age (AGA) neonates (n=46); 2) patients who delivered an SGA neonate but did not develop PE (n=56); and 3) patients who developed PE (n=42). Longitudinal samples were collected at each prenatal visit, which was scheduled at four-week intervals from the first or early second trimester until delivery. Plasma concentrations of soluble endoglin (s-Eng), sVEGFR-1 and PlGF were determined by specific and sensitive ELISA. Results 1) Patients destined to deliver an SGA neonate had higher plasma concentrations of s-Eng throughout gestation than those with normal pregnancies; 2) patients destined to develop preterm PE and term PE had significantly higher concentrations of s-Eng than those with normal pregnancies at 23 and 30 weeks, respectively (for preterm PE: p<0.036 and for term PE: 0=0.002); 3) patients destined to develop PE (term or preterm) and those who delivered an SGA neonate had lower plasma concentrations of PlGF than those with normal pregnancy throughout gestation, and the maternal

  19. Plasma concentrations of four pregnancy proteins in complications of pregnancy.

    Science.gov (United States)

    Lin, T M; Halbert, S P; Spellacy, W N; Berne, B H

    1977-08-01

    Toxemia of pregnancy was associated with an elevation of the pregnancy-associated plasma protein (PAPP)-A concentration, as compared to the level in normal pregnancy in the last month of gestation. The other pregnancy proteins measured were not altered in toxemia. In twin pregnancies, the PAPP-A, PAPP-C, and human placental lactogen levels were all increased, particularly PAPP-A. On the other hand, pregnancy zone protein was not affected by twinning. Pregnancy with diabetes showed normal levels of these proteins.

  20. 双胎妊娠之一胎死宫内原因及处理17例临床分析%Clinical Analysis of 17 Cases of Twin Pregnancy with One Fetal Intrauterine Death

    Institute of Scientific and Technical Information of China (English)

    赵国斌; 左莉; 陈翊; 郑玲; 郭华

    2011-01-01

    Objective To study the cause, clinical treatment, and prognosis of twin pregnancy with one fetal intrauterine death. Methods 17 cases of twin pregnancy with one fetal intrauterine death from February 1995 to May 2009 in Panyu Central Hospital were analyzed. Results The rate of twin pregnancy with one fetal intrauterine death was 2.99% ( 17/568 ). Of the 17 cases, 3 patients were found one fetal death within 28 weeks of pregnancy; their pregnancy were terminated after averagely 102.8 days of expectant treatment; average termination time were 36 +5 weeks. 12 patients were found intrauterine death after 28 weeks of pregnancy deal with expectant treatment; their pregnancy were terminated after averagely 13.2 days; average termination time was 35 +1 weeks. Only 1 premature delivery cases had mild asphyxia. Of the 17 cases, no coagulation disturbance occurred. The most common complications were the premature birth and preeclampsia and premature rupture of membranes. Congenital malformation was the main reason to the intrauterine fetal death. Conclusion On condition that the intrauterine surviving fetal and maternal coagulation function were watched and maternal complications and accompanying diseases were dealt with, expectant treatment was an effective way of treating twin pregnancy with one fetal intrauterine death.%目的 探讨双胎妊娠之一胎死宫内的原因、临床处理及预后.方法 回顾性分析1995年2月-2009年5月广州番禺中心医院双胎妊娠之一胎死宫内的病例共17例临床资料.结果 双胎一胎宫内死亡的发生率为2.99%.孕28周前发现一胎宫内死亡者3例,平均期待治疗102.8 d,平均分娩孕周为36+5周;孕28周后发现一胎宫内死亡者期待治疗12例,平均期待治疗13.2 d,平均分娩孕周为35+1周.仅1例新生儿发生轻度窒息.无一例孕妇发生凝血功能障碍.早产、子痫前期和胎膜早破发生率高.胎儿畸形是胎死宫内的重要原因.结论 双胎妊娠一胎宫

  1. The TRAP (twin reversed arterial perfusion) sequence - case presentation.

    Science.gov (United States)

    Mărginean, Claudiu; Mărginean, Maria Oana; Mureşan, Daniel; Zahiu, LuminiŢa; Horváth, Emőke

    2016-01-01

    We present a particular case of TRAP (twin reversed arterial perfusion) syndrome, which has a very rarely association of the simultaneous existence of a rudimentary malformed heart and brain, and also other malformations like abdominal wall abnormality, absent bladder with present kidneys, and absence of the lungs, which appear only in a few cases on the receptor twin from this sequence, malformations incompatible with life. A Caucasian 26-year-old pregnant woman, at the first pregnancy, with a monochorionic-diamniotic pregnancy, 26 weeks of gestation was referred to our hospital, for polyhydramnios. The patient delivered a living female newborn, weighing 950 g, with an Apgar score of 2 at one minute - the donor fetus and a second female newborn with multiple malformations, no signs of life and who weighed 2300 g - the receptor fetus. The anatomopathological examination confirmed the TRAP sequence associated with severe facial dysmorphism, bilateral phocomelia and cardiac malformations (rudimentary hypoplastic, univentricular) and a vascular anastomosis between the two umbilical cords. Anemia and cardiac complications which can lead to cardiac failure, appear early during pregnancy and caused the death of the pumping twin. We emphasize that in our case of TRAP sequence, the ultrasound examination established the diagnosis of the syndrome with high accuracy. Therefore, we can conclude that the existence of a rudimentary heart and a vascular anastomosis between the two umbilical cords supports the apparition of TRAP sequence. The early diagnosis of this pathology, the observation of the pregnancy with the help of weekly ultrasounds and the intrauterine interventions can increase the survival chances of the donor fetus from the TRAP sequence.

  2. 产前超声在双胎妊娠中胎儿心脏复杂畸形中的应用%Application of Prenatal Ultrasound in Fetal Cardiac Complex Malformation in Twin Pregnancy

    Institute of Scientific and Technical Information of China (English)

    丁凤霞

    2016-01-01

    目的:分析产前超声在双胎妊娠中胎儿心脏复杂畸形中的临床价值。方法:回顾性分析我院于2012年1月~2015年1月期间经产前超声检查的双胎妊娠孕妇16例,至少有1例孕妇合并心脏复杂畸形,对孕妇产前、产后超声结果进行总结,并分析其产前漏诊原因。结果:经产后超声检查,证实本组16例孕妇均合并心脏复杂畸形的双胎,其中有11例为单绒毛膜囊双胎,有5例为双绒毛膜囊双胎。有14例孕妇经产前超声检查明确诊断,且由产后随访检查证实;有1例A型主动脉弓离断,其心脏复杂畸形多与心外畸形共存;有1例右室双出口出现漏诊,经产前诊断为室间隔缺损。结论:通过产前超声筛查,可有效诊断单绒毛膜囊双胎合并心脏复杂畸形的发生率明显高于双绒毛膜囊双胎,其具有良好的临床价值。%Objective: to analyze the clinical value of prenatal ultrasound in fetal cardiac complex malformation in twin pregnancy.Methods:a retrospective analysis of our hospital in 2012 January 2015 period in January by prenatal ultrasound examination of twin pregnancy in 16 cases, at least 1 cases of pregnant women with complex heart malformation, the prenatal and postnatal ultrasound results are summarized and and analysis of prenatal reasons for misdiagnosis.Results: multiparous after ultrasound examination, confirmed that this group of 16 cases of pregnant women were associated with cardiac malformation complex twins, of which 11 cases for sac properties of monochorionic twins, 5 cases of cystic nature of dichorionic twin pregnancy. With 14 cases pregnant women by prenatal ultrasound diagnosis and confirmed by postnatal follow-up examination;1 case of type A aortic arch interruption, the complex heart malformation with extracardiac malformations coexist; 1 case of right ventricular double outlet of missed diagnosis and prenatal diagnosis for ventricular septal defect

  3. Comparison of Naturally Conceived and IVF-DZ Twins in the Netherlands Twin Registry: A Developmental Study

    Directory of Open Access Journals (Sweden)

    Catharina E. M. van Beijsterveldt

    2011-01-01

    Full Text Available In a large set of twin pairs, we compared twins born after IVF to naturally conceived twins with respect to birth characteristics, growth, attainment of motor milestones, and emotional and behavioral problems. Twin families were registered with the Netherlands Twin Register. We included 1534 dizygotic (DZ twins born after IVF, 5315 naturally conceived (NC DZ twins, and 1504 control NC DZ twins who were matched to the IVF twins based on maternal age, maternal educational level, smoking during pregnancy, gestational age, and offspring sex. Data were obtained by longitudinal surveys sent to fathers, mothers, and teachers at ages 1, 2, 3, 7, 10, and 12 years. Results showed no differences in growth, in attainment of motor milestones, and in behavioral development between IVF and matched NC twins. It can be concluded that for nearly all aspects, development in IVF and NC children is similar.

  4. Clinical Study on the Mode of Delivery and Pregnancy Outcome in Twin Pregnancy%双胎妊娠的分娩方式与妊娠结局的临床研究分析

    Institute of Scientific and Technical Information of China (English)

    陈丽花

    2014-01-01

    目的:探讨双胎妊娠的不同分娩方式与其妊娠结局的关联。方法:将2009年3月~2013年3月我院产科收治的双胎妊娠孕妇80例随机均分为2组,各40例,其中一组行剖宫产,另一组行阴道产,观察比较两种分娩方式的妊娠结局。结果:(1)两种分娩方式孕妇产后出血机率比较无显著差异(P>0.05);剖宫产组孕周≥37周有29例(72.5%),明显高于阴道分娩组17例,42.5%(P0.05),但在第二胎儿中阴道分娩组窒息率达到27.5%,剖宫产组为7.5%,比较差异有统计学意义(P15min时第二例胎儿窒息发生率明显高于≤15min出生者(P0.05);The pregnant week and birth weight of cesarean section group was significantly greater than the vaginal delivery group. (2)There were no differences about incidence of neonatal asphyxia in first fetal between two groups (P>0.05), but the incidence of neonatal asphyxia of second fetal in vaginal delivery group was higher than that in cesarean section group (P<0.05).(3)The incidence of neonatal asphyxia of second fetal at≥15 minutes was higher than that of at<15 minutes(P<0.05). Conclusion:For twin pregnancy pregnant, making a right choice for the mode of delivery can lower the incidence of neonatal asphyxia.

  5. 双胎妊娠生长不一致对新生儿甲状腺功能的影响%Effects of growth-discordant twin pregnancies on thyroid function of neonates

    Institute of Scientific and Technical Information of China (English)

    陈怡博; 余颀; 陈志央; 庄丹燕; 潘婕文; 王飞; 卢文波

    2016-01-01

    性甲低的概率较大.%Objective To investigate the effects of growth-discordant twin pregnancies on neonatal thyroid stimulating hormone (TSH) level and congenital hypothyroidism (CH).Methods A total of 3 444 live-birth twin neonates born between January 1,2012 and December 30,2014 in Ningbo City were enrolled.Blood samples via heel puncture were collected and tested.Incidence of CH in singleton and twin neonates was compared.Deviation of birth weight larger than 25% in twin neonates was set as the criteria for discordant growth.TSH and 17 α-hydroxylase levels in CH twins and normal twins,with or without discordant growth,were compared.Chi-square and non-parametric statistics were performed for data analysis.Results The incidence of CH in twin neonates was 0.56% (19/3 444),higher than that in singleton neonates [0.09% (203/225 712),x2=76.225,P<0.01].Among nineteen CH twins,CH occurred in both twins in eight cases (four twins) and in one of the twins in eleven cases.The gestational age at birth in the eight CH twins were less than 37 weeks,with four males and four females;five were low birth weight infants;one twin were dichorionic,and three twins were monochorionic.In the eleven cases of CH occurring in one of the twins,the gestational age was less than 37 weeks in nine cases,eight were low birth weight infants,six were male and five female;seven were monochorionic and four were dichoronic twins.Five cases of temporary hypothyroidism were all low birth weight infants among the growth-discordant twins.CH cases in growth-discordant group had lower birth weight than their normal twins [M(P25-P75),2 100 (1 800-2 600) vs 2 770 (2 530-2 960) g,Z=4.369],and a higher TSH level [15.4 (11.8-18.5) vs 6.4 (4.8-7.9) mU/L,Z=6.339] (both P<0.05).In normal twins with or without discordant growth,the neonates with a lower birth weight had a higher TSH level [3.6(2.5-4.7) vs 2.4(1.8-2.9) mU/L,Z=0.962] in weight consistent group,compared with 6.0(4.4-7.8) vs 3.4(1.9-4.1) mU/L in weight inconsistent group

  6. A healthy delivery of twins by assisted reproduction followed by preimplantation genetic screening in a woman with X-linked dominant incontinentia pigmenti.

    Science.gov (United States)

    Kim, Myung Joo; Lyu, Sang Woo; Seok, Hyun Ha; Park, Ji Eun; Shim, Sung Han; Yoon, Tae Ki

    2014-12-01

    The purpose of this study is to report a successful twin pregnancy and delivery in a female patient with X-linked dominant incontinentia pigmenti (IP) who underwent assisted reproductive technology followed by preimplantation genetic screening (PGS). A 29-year-old female with IP had a previous history of recurrent spontaneous abortion. A molecular analysis revealed the patient had a de novo mutation, 1308_1309insCCCCTTG(p.Ala438ProfsTer26), in the inhibitor of the kappa B kinase gamma gene located in the Xq28 region. IVF/ICSI and PGS was performed, in which male embryos were sexed using array-based comparative genomic hybridization (aCGH). After IVF/ICSI and PGS using aCGH on seven embryos, two euploid male blastocysts were transferred with a 50% probability of a viable male pregnancy. The dizygotic twin pregnancy was confirmed and the amniocentesis results of each twin were normal with regard to the mutation found in the mother. The patient delivered healthy twin babies during the 37th week of gestation. This case shows the beneficial role of PGS in achieving a successful pregnancy through euploid male embryo gender selection in a woman with X-linked dominant IP with a history of multiple male miscarriages.

  7. The effect of chorionicity and twin-to-twin delivery time interval on short-term outcome of the second twin

    DEFF Research Database (Denmark)

    Hjortø, Sofie; Nickelsen, Carsten; Petersen, Janne;

    2013-01-01

    Abstract Objectives: To investigate the effect of chorionicity and twin-to-twin delivery time interval on short-term outcome in the second twin. Additionally, to investigate predictors of adverse outcome in both twins. Methods: Data included vaginally delivered twins (≥ 36 weeks) from Copenhagen...... University Hospitals (2001-09). The association between delivery interval and adverse outcome parameters were compared for monochorionic (MC) and dichorionic (DC) twins by multiple linear regression. Predictors were studied by logistic regression. Results: There were 554 twin pairs: 57 MC and 485 DC. We...... found no difference in the decrease of pH (p = 0.912) and Apgar (p = 0.609) in relation to increasing time interval. Neonatal unit (NICU) admissions did not differ (p = 0.167). Apgar ≤ 7 (p twin, whereas first (p = 0.001) or second (p twin Apgar...

  8. Predictive value on premature delivery of fFN combined with cervical canal length in twin pregnancy%fFN联合宫颈管长度对双胎妊娠早产的预测价值

    Institute of Scientific and Technical Information of China (English)

    梁梅芬; 石雪金

    2016-01-01

    目的:研究胎儿纤维连接蛋白(fFN)联合宫颈管长度对双胎妊娠早产的预测价值。方法选择2014年9月~2015年9月在我院进行产检和住院安胎的双胎妊娠孕妇91例,入选孕妇在24~34周测定宫颈管长度(CL)和fFN,并追踪统计孕妇的妊娠结局。结果卡方检验结果表明在CL≤25mm的40例孕妇中, fFN阳性孕妇的早产率89.3%显著高于fFN阴性孕妇早产率50%(x2=7.431,P<0.05);在CL>25mm的51例孕妇中,fFN阳性孕妇早产率28.6%显著高于fFN阴性孕妇16.2%(x2=5.251,P<0.05)。fFN和宫颈管长度联合检测预测双胎妊娠早产的敏感性和特异度分别为89.3%和74.0%。结论 fFN联合宫颈管长度对双胎妊娠早产具有较高的预测价值,能够满足临床应用,值得在产科临床推广应用。%Objective To study the predictive value on premature delivery of fFN (fetal fibronectin) combined with cervical canal length in twin pregnancy.Methods 91 pregnant women with twin pregnancy, who were carried out prenatal examination and hospitalization miscarriage prevention in our hospital from September 2014 to September 2015, were selected to mensurate the cervical canal length(CL) and fFN at 24-34 weeks, to tracking statistics the pregnancy outcome of pregnant women.Results The Chi-square test result showed that, of the 40 pregnant women of CL≤25mm, the premature delivery rate of fFN in positive pregnant women(89.3%) was significantly higher than which in negative pregnant women (50%)(x2=7.431,P25mm, the premature delivery rate of fFN in positive pregnant women(28.6%) was significantly higher than which in negative pregnant women(16.2%)(x2=5.251,P<0.05). The sensitivity and specificity of fFN and cervical canal length joint detection and prediction on premature delivery in twin pregnancy were respectively 89.3% and 74.0%. Conclusion FFN combined with cervical canal length on premature delivery in twin pregnancy has higher predictive

  9. To Analysis Twin Pregnancy Outcome with Severe Preeclampsia and Nursing Strategy%双胎妊娠合并重度子痫前期的妊娠结局分析及护理策略

    Institute of Scientific and Technical Information of China (English)

    郭宗艳; 宋爱君; 李爱云

    2013-01-01

      目的:比较双胎妊娠合并重度子痫前期与单胎重度子痫前期的妊娠结局及护理策略。方法:收集2006年3月-2011年12月60例双胎妊娠合并重度子痫前期的孕妇资料(观察组)与60例单胎妊娠合并重度子痫前期孕妇资料(对照组)。分析比较两组孕妇的发病周数、分娩方式、终止妊娠时间、妊娠合并症发生率及围生儿结局等情况。结果:观察组与对照组的发病周数分别为(28.12±2.28)周、(33.23±2.17)周;终止妊娠周数为(34.13±2.36)周、(36.58±2.46)周;胎盘早剥发生率为6.7%、1.7%;剖宫产率为81.7%、68.3%;产后出血率为18.3%、11.7%;妊娠期脂肪肝发生率3.3%、1.7%;早产率为75.0%、53.3%;围生儿死亡率35.0%、5.0%,两组间比较差异均具有显著统计学意义(P<0.01)。结论:双胎妊娠合并重度子痫前期孕产妇及围生儿不良结局较单胎明显,临床上应予以重视并加强护理工作。%Objective: To compare pregnancy outcomes and nursing strategy between twin and singleleton pregnancy complicated with severe preeclampsia.Method: 60 cases of twin pregnancy and 60 cases of singleton with severe preeclampsia were collected from March 2006 to December 2012, respectively, divided into comparison group and control group. Perinatal outcomes and incidences of maternal complications of the two groups were compared and analyzed. Result: There was significant difference between the two groups in their onset gestational ages, terminating gestation’s time, and the ratio of placental abruption, cesarean section, postpartum hemorrhage, etc(P<0.01).Conclusion: It’s serious complication in twin pregnancy with severe preeclampsia. So it’s very significant and necessary to strengthen the nursing work in twin pregnancy with severe preeclampsia.

  10. Clinical characteristics of twin pregnancy with intrahepatic cholestasis%双胎妊娠合并妊娠期肝内胆汁淤积症临床特点分析

    Institute of Scientific and Technical Information of China (English)

    吴星光

    2012-01-01

    目的 分析双胎合并妊娠期肝内胆汁淤积症的临床特点.方法 我院产科诊治的双胎妊娠患者515例,其中双胎妊娠合并妊娠期肝内胆汁淤积症17例为观察组,随机选取18例未合并肝内胆汁淤积症的双胎妊娠患者为对照组.观察并比较两组患者围生儿预后情况、孕妇生产方式及并发症发生情况.结果 双胎妊娠合并妊娠期肝内胆汁淤积症的发病率为3.30%;观察组中发生胎儿窘迫、胎儿窒息及胎儿死亡的比例分别为41.2%、52.9%和35.3%,显著高于对照组的5.6%、11.1%和0(P< 0.05);观察组患者中剖宫产比例为70.6%,显著高于对照组的33.3%(P<0.05);观察组患者发生妊高症及产后出血并发症的比例分别为58.8%和41.2%,均明显高于对照组的16.7%和5.6%(P<0.05).结论 双胎妊娠合并妊娠期肝内胆汁淤积症发病率高,胎儿预后较差,孕妇并发症多,临床工作中应该积极应对.%Objective To analyze the clinical characteristics of the twin pregnancy with intrahepatic cholestasis. Methods Five hundred and fifteen patients of twin pregnancy were chosen. Seventeen of the patients complicated with intrahepatic cholestasis were chosen as the study group, and 18 of the patients without intrahepatic cholestasis were chosen as the control group. The prognosis, maternal mode of production and occurrence of complications were compared between the two groups. Results The incidence of twin pregnancy complicated with gestational intrahepatic cholestasis were 3.30%. The occurrence of fetal distress, fetal asphyxia and fetal death in the study group were 41.2%, 52.9% and 35.3%, respectively, significantly higher than those in the control group (5.6%, 11.1% and 0%, respectively), P<0.05. The incidence of cesarean section, the pregnancy induced hypertension and postpartum hemorrhage of the study group were 70.6%, 58.8% and 41.2%, respectively, significantly higher than those in the

  11. Analysis on the factors causing neonatal weight difference in twin pregnancy%双胎妊娠新生儿体质量差异相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张岚

    2015-01-01

    Objective:To investigate the factors resulting in birth weight difference in twin pregnancies,and further define the adverse effects.Methods:192 cases of twin pregnancies in our hospital were included from 2004 to 2014.The birth weight was summarized,and the difference was analyzed regarding the maternal age,gestational age,nutritional status,pregnancy complications,preterm delivery and premature rupture of membranes,neonatal outcomes af-fected by prenatal,intrapartum or postpartum conditions.Results:Gestational hypertension and intrahepatic cholestasis of pregnancy ( ICP) had no obvious effect on the birth weight,and different sexes tended to increase the total fetal weight,yet reduce the difference of birth weight.The weight difference rate was linearly related to the gestational week.Premature rupture of membrane and poor neonatal outcomes were more likely in significantly increased neonatal weight.Overall weight was significantly lower in neonates with poor outcomes than that of the controls, and the weight difference was significant. Conclusion:Birth weight difference in twins are involved in gestational age and neonatal sexes,yet not affected by maternal age,complication of pregnancy and nutritional status of gravida.Nevertheless,increased weight differences between twins can lead to complications during delivery and increased incidence of adverse outcomes.%目的:探讨造成双胎新生儿出生体质量差异的相关因素及不良影响。方法:选取本院2004~2014年间192例双胎妊娠纳入研究,统计双胎体质量并计算其差异率,将双胎差异与孕妇年龄、孕周,营养状况,妊娠合并症,早产及胎膜早破,新生儿结局等产前、产时、产后因素进行统计分析。结果:妊娠期高血压及妊娠期肝内胆汁淤积症( ICP)对双胎妊娠体质量及其差异无显著影响;双胎不同性别可能增加胎儿总体质量,并能减少胎儿体质量显著差异的发生;孕周的增

  12. Management of Fetal Growth Arrest in One of Dichorionic Twins: Three Cases and a Literature Review

    Directory of Open Access Journals (Sweden)

    Shoji Kaku

    2015-01-01

    Full Text Available Progressive fetal growth restriction (FGR is often an indication for delivery. In dichorionic diamniotic (DD twin pregnancy with growth restriction only affecting one fetus (selective fetal growth restriction: sFGR, the normal twin is also delivered prematurely. There is still not enough evidence about the optimal timing of delivery for DD twins with sFGR in relation to discordance and gestational age. We report three sets of DD twins with sFGR (almost complete growth arrest affecting one fetus for ≥2 weeks before 30 weeks of gestation. The interval from growth arrest to delivery was 21–24 days and the discordance was 33.7–49.8%. A large-scale study showed no difference of overall mortality or the long-term outcome between immediate and delayed delivery for FGR, while many studies have identified a risk of developmental delay following delivery of the normal growth fetus before 32 weeks. Therefore, delivery of DD twins with sFGR should be delayed if the condition of the sFGR fetus permits in order to increase the gestational age of the normal growth fetus.

  13. The vanishing twin: a major determinant of infant outcome in IVF singleton births

    DEFF Research Database (Denmark)

    Pinborg, Anja; Lidegaard, Ojvind; Andersen, Anders Nyboe

    2006-01-01

    This article attempts to assess the frequency of vanishing twins in assisted reproductive and spontaneously conceived pregnancies, including in-vitro fertilization (IVF), and its impact on the live-born surviving twin....

  14. Twin vaginal delivery: innovate or abdicate.

    Science.gov (United States)

    Easter, Sarah Rae; Taouk, Laura; Schulkin, Jay; Robinson, Julian N

    2017-02-07

    Neonatal safety data along with national guidelines have prompted renewed interest in vaginal delivery of twins, particularly in the case of the noncephalic second twin. Yet, the rising rate of twin cesarean deliveries, coupled with the national decline in operative obstetrics, raises concerns about the availability of providers who are skilled in twin vaginal birth. Providers are key stakeholders for increasing rates of twin vaginal delivery. We surveyed a group of practicing obstetricians to explore potential barriers to the vaginal birth of twins with a focus on delivery of the noncephalic second twin. Among 107 responding providers, only 57% would deliver a noncephalic second twin by breech extraction. Providers who preferred breech extraction had a higher rate of maternal-fetal medicine subspecialty training (26.2% vs 4.3%; P30 sets of twins annually (57.4% vs 34.8%; P=.02). Most providers (54.2%) were familiar with the findings from the recent randomized trial that demonstrated the safety of twin vaginal birth. However, knowledge of the trial was not associated statistically with a preference for breech extraction (62.3% vs 43.5%; P=.05). Providers who preferred breech extraction were more likely to agree with recent society guidelines that encourage the vaginal birth of twins (86.9% vs 63.0%; Pinnovation. Without novel provider-focused strategies, we may relinquish passively the requisite skills for not only our patients but also for future generations of obstetricians.

  15. Acardiac Twinning (Twin Reversed Arterial Perfusion Sequence: A Review of Prenatal Management

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2005-06-01

    Full Text Available Acardiac twinning, or the twin reversed arterial perfusion (TRAP sequence, occurs in 1% of monozygotic twins, or 1 in 35,000 births. It is caused by the development of arterioarterial vascular anastomoses between the umbilical arteries of monozygotic twins early in embryogenesis. The pump twin may be associated with congenital anomalies and chromosomal abnormalities. Therefore, it is recommended that prenatal genetic testing be offered whenever pregnancy is complicated by acardiac twinning. The treatment options for acardiac twinning include observation, medical management, amniodrainage, and invasive treatment such as hysterotomy with selective delivery of the acardiac twin, intrafetal ablation of the acardiac twin by alcohol, laser, thermocoagulation or radiofrequency, fetoscope-guided funicular occlusion by ligation, laser or thermocoagulation, and ultrasound-guided funicular occlusion by ligation, cord compression, thermocoagulation or intrafunicular embolization with foreign bodies. If invasive treatment is indicated, the simplicity, safety, and efficacy of the chosen technique should be considered. An intrafetal approach has been shown to be superior to a funicular occlusion approach. Ultrasound-guided intrafetal laser ablation or radiofrequency ablation is believed to be the treatment of choice based on currently available data. This review emphasizes the necessity to carefully search for any possible associated anomaly in the pump twin by both genetic testing and sonographic examination, and to prudently consider invasive treatment only in pregnancies which would potentially benefit from the prenatal intervention.

  16. Detection of chromosomal abnormalities, congenital abnormalities and transfusion syndrome in twins

    DEFF Research Database (Denmark)

    Sperling, Lene; Kiil, C; Larsen, L U;

    2007-01-01

    by assisted reproduction. The incidence of TTTS was 23% from 12 weeks until delivery, and all those monochorionic twin pregnancies that miscarried had signs of TTTS. CONCLUSION: Twin pregnancies have an increased risk of congenital malformations and one out of four monochorionic pregnancies develops TTTS...

  17. The vanishing twin: a major determinant of infant outcome in IVF singleton births

    DEFF Research Database (Denmark)

    Pinborg, Anja; Lidegaard, Ojvind; Andersen, Anders Nyboe

    2006-01-01

    This article attempts to assess the frequency of vanishing twins in assisted reproductive and spontaneously conceived pregnancies, including in-vitro fertilization (IVF), and its impact on the live-born surviving twin.......This article attempts to assess the frequency of vanishing twins in assisted reproductive and spontaneously conceived pregnancies, including in-vitro fertilization (IVF), and its impact on the live-born surviving twin....

  18. Effect of pregnant week and delivery route on neonatal asphyxia in twin pregnancy%双胎妊娠分娩孕周及分娩方式对新生儿窒息的影响

    Institute of Scientific and Technical Information of China (English)

    何辉

    2011-01-01

    目的 探讨双胎妊娠的孕周及分娩方式与新生儿窒息的关系.方法 对101例双胎分娩的产妇分别按孕周及胎位各分为两组,对其资料进行回顾性分析.结果 0.05),而非头-头位的阴道产组新生儿窒息率显著高于剖宫产组(P<0.05),第二出生新生儿中阴道产组的窒息率显著高于剖宫产组(P<0.05).结论 正确选择双胎妊娠的分娩方式,将有助于降低新生儿窒息率.%Aim To explore the relationship between pregnant week and delivery route and neonatal asphyxia in twin pregnancy. Methods 101 cases of twin pregnancy women were divided into two groups from pregnant week and fetal presentation, and were analyzed retrospectively. Results The incidence of neonatal asphyxia of women with pregnant week shorted than 34 weeks was higher than those longer than 34 weeks( P < 0.05 ). When the fetal presentation were head head, no significant difference was shown in neonatal asphyxia of cesarean section or vaginal delivery( P > 0.05 ), however, when the fetal presentation was not head-head, the incidence of neonatal asphyxia of vaginal delivery was higher than that of cesarean section( P < 0.05 ). The incidence of neonatal asphyxia of second neonatal in vaginal delivery was higher than that in cesarean section( P < 0.05 ). Conclusion The right route of delivery can lower the incidence of neonatal asphyxia.

  19. Renal failure of the surviving fetus after intrauterine death of the co-twin.

    Science.gov (United States)

    Giannantonio, Carmen; Semeraro, Carla Maria; Fioretti, Maria; Molisso, Anna; Lio, Alessandra; Gallini, Francesca; Papacci, Patrizia; Romagnoli, Costantino

    2012-10-01

    Twin pregnancies are considered at a higher risk for fetal mortality than singleton pregnancies. The antenatal death of one of the twins is associated with an increasing rate of cerebral impairment and lesions in other organs in the surviving fetus, especially if the pregnancy is monochorionic. We describe a case of isolate renal failure becoming evident gradually after birth in a surviving twin after the antenatal death of the co-twin. Considering the deleterious effects of vascular disruption in a surviving twin, our findings suggest careful investigation of renal function, even if no intrauterine signs of diminished renal function were previously detected.

  20. The effect of chorionicity and twin-to-twin delivery time interval on short-term outcome of the second twin.

    Science.gov (United States)

    Hjortø, Sofie; Nickelsen, Carsten; Petersen, Janne; Secher, Niels Jørgen

    2014-01-01

    To investigate the effect of chorionicity and twin-to-twin delivery time interval on short-term outcome in the second twin as well as to investigate the predictors of adverse outcome in both twins. Data included vaginally delivered twins (≥36 weeks) from Copenhagen University Hospitals (2001-2009). The association between delivery interval and adverse outcome parameters was compared for monochorionic (MC) and dichorionic (DC) twins by multiple linear regression. Predictors were studied by logistic regression. There were 554 twin pairs, of which 57 were MC and 485 DC. We found no difference in the decrease of pH (p = 0.912) and Apgar (p = 0.609) in relation to increasing time interval. Neonatal unit (NICU) admissions did not differ (p = 0.167). Apgar ≤7 (p < 0.001) and pH ≤ 7.20 (p = 0.002) increased first twin risk of NICU admission, whereas first (p = 0.001) or second (p < 0.001) twin Apgar ≤7 and second twin pH ≤7.00 (p = 0.003) increased second twin risk of NICU admission. Increasing delivery interval was associated with a significant decrease in pH and Apgar, but there was no difference between MC and DC twins. Low Apgar of the first twin increased the risk of second twin NICU admission.

  1. 产前超声监测对双胎妊娠并发症的诊断及治疗选择的价值%The Value of Prenatal Ultrasound Monitoring in the Diagnosis and Management of Twins Pregnancy Complications

    Institute of Scientific and Technical Information of China (English)

    刘新秀; 辜秋阳; 庄勇; 陈玲; 陈晓宇; 甘玲; 许翔; 叶真

    2014-01-01

    目的:探讨双胎妊娠的产前超声监测方法对双胎并发症的诊断及治疗选择的价值。方法回顾性分析81例双胎妊娠孕妇的临床资料和超声监测方法,综合评估是否出现双胎输血综合征(TTTS)、选择性胎儿生长受限(sIUGR)等单绒毛膜双胎(MC双胎)特有的并发症,进行相应分期、分型和监测;随访至妊娠终止。结果81例双胎妊娠中双绒毛膜双羊膜囊双胎(DCDA )40例出现双胎之一宫内死亡1例,双胎生长不一致1例;38例单绒毛膜双羊膜囊双胎(MCDA)出现TTTS 4例,sIUGR 2例,双胎之一唇腭裂畸形1例,双胎之一宫内死亡1例;3例单绒毛膜单羊膜囊双胎(MCMA)并发双胎之一无心畸形1例,联体双胎1例。DCDA并发症明显小于MC双胎并发症(P<0.05)。DCDA双胎丢失率1/80(胎),MC双胎丢失率11/82(胎)。DCDA胎儿丢失率明显低于MC双胎胎儿丢失率( P<0.05)。产前超声监测与终止妊娠结果100%符合。结论早孕期诊断双胎妊娠的绒毛膜性具有重要的临床意义;对<26孕周的 MC双胎每2周监测1次,可早期诊断并发症;对≥26孕周的 TTTS及sIUGR在超声严密监测下选择分娩时机,可提高MC双胎围生儿生存率。%Objective To explore the value of prenatal ultrasound monitoring in the diagnosis and the treatment of the twin pregnancy complications . Methods The clinical data and ultrasound follow up medical files of 81 pregnant women with twin pregnancies were retrospectively analyzed during the study period (March 2011~ April 2014) . Twin to twin transfusion syndrome (TTTS) and selective intra-uterine growth restriction(sIUGR) and other complications were comprehensively assessed ,classified and moni-tored . All the cases were followed-up until pregnancy has been terminated . Results Among 81 cases of twins pregnancy ,forty cases were dichorionic-diamniotic twins pregnancies (DCDA) in which

  2. 17例双胎之一宫内死亡的母儿监测及护理分析%Analysis on monitoring and nursing for twin pregnancy with intrauterine single fetal death

    Institute of Scientific and Technical Information of China (English)

    符白玲; 蒋凤菊; 肖志群; 罗燕琴; 孟会

    2009-01-01

    目的 探讨双胎妊娠孕早、中期1胎死亡后期待治疗过程中的母儿监测及护理方法 .方法 回顾性分析2003年7月至2008年7月,本院收治的17例孕早、中期经B超确诊双胎妊娠1胎宫内死亡病例的期待治疗结果 及新生儿的转归.结果 期待治疗时间为3~147天,平均80天,平均分娩孕周为35周,无一例出现明显凝血功能障碍.羊水过少和胎膜早破是常见并发症,胎盘因素是胎死宫内的重要原因.结论 孕早、中期双胎之一胎死宫内后采取期待疗法,严密监测母儿的各项相关指标和并发症的条件下,配合积极的护理措施,可以尽可能延长存活胎儿在宫内生长的时间,提高存活胎儿的生存质量.%Objective To investigate the monitoring and nursing for twin pregnancy with intrauterine single fetal death. Methods The expectant management and neonatal outcome of 17 cases of intrauterine death of twin which were diagnosed by ultrasonography from July 2003 to July 2008 were analyzed retrospectively. Results The period of expectant management was 3-147days. The average period was 80 days. The average delivery pregnancy week was 35 weeks. No one case developed blood coagulation dysfunction. The common complications were oligohydramnios and premature ruptures of membrane, the important reasons of intrauterine death was placental factor Conclusions Taking expectant management, comprehensive monitoring the related indexes and complication of pregnant and fetal of intrauterine death of twin and nursing measures can prolong the time of intrauterine growth of survival fetal and improve the quality of life of neonatal.

  3. Twin Baryogenesis

    CERN Document Server

    Farina, Marco; Shin, Chang Sub

    2016-01-01

    In the context of Twin Higgs models, we study a simple mechanism that simultaneously generates asymmetries in the dark and visible sector through the out-of-equilibrium decay of a TeV scale particle charged under a combination of baryon and twin baryon number. We predict the dark matter to be a 5 GeV twin baryon, which is easy to achieve because of the similarity between the two confinement scales. Dark matter is metastable and can decay to three quarks, yielding indirect detection signatures. The mechanism requires the introduction of a new colored particle, typically within the reach of the LHC, of which we study the rich collider phenomenology, including prompt and displaced dijets, multi-jets, monojets and monotops.

  4. 不同受孕方式妊娠双胎儿围生期相关情况的研究%Maternal and neonatal complications of twin pregnancy in different modes of conception

    Institute of Scientific and Technical Information of China (English)

    张晓蕊; 曾超美; 刘捷

    2014-01-01

    婴围生期并发症概率高于IVF-ET技术及自然受孕,应重视及加强对单纯促排卵技术妊娠双胎母婴围生期的保健及新生儿救治,避免出现严重并发症.%Objective To explore the differences in maternal and neonatal complications of twin pregnancies in different modes of conception.Methods Retrospective analysis was performed to compare the differences in mother's gestation history,childbirth and neonatal complications among 102 cases of in vitro fertilization-embryo transfer(IVFET) pregnancy twins,16 cases of simple ovulation induction(OI) pregnancy twins and 96 cases of spontaneous conception(SC) pregnancy twins.Results 1.The maternal age[(32.51 ±4.03) years vs (31.25 ±3.38) years vs (30.20 ± 4.13) years,F =8.061,P < 0.05] and birthrate of full-term infants (21.5 % vs 0 vs 10.4%,x2 =7.566,P < 0.05) of IVF-ET group were significantly higher than that of OI group and SC group.The body weight at birth of OI group was significantly lower than that of IVF-ET group and SC group [(1 918.1 ±516.4) g vs (2 228.3 ±4542) g vs (2 164.4 ±442.5) g,F =3.293,P <0.05].The birthrate of late preterm infant(87.5% vs 51.0% vs 64.6%,x2 =9.322,P < 0.05) and the incidence of twin discordance (50.0% vs 21.6% vs 18.8%,x2 =7.781,P < 0.05) of OI group were significantly higher than that of IVF-ET group and SC group,while the incidence of monozygotic twins of SC group was significantly higher than that of IVF-ET group and OI group(52.1% vs 5.9% vs 0,x2 =58.016,P < 0.05).2.The incidence of pregnancy induced hypertension of OI group was significantly higher than those of IVF-ET group and SC group(50.0% vs 17.6% vs 22.9%,x2 =8.344,P < 0.05).The incidence of gestational diabetes mellitus of OI group and spontaneous group was significantly higher than that of IVF-ET group(12.5% vs 14.6% vs 3.9%,x2 =6.838,P <0.05).3.The incidence of twin transfusion syndrome of SC group was significantly higher than that of the

  5. Nursing Experience of 1 Case of Twin Pregnancy Acute Fatty Liver combined with DIC%双胎妊娠期急性脂肪肝合并DIC 1例的护理体会

    Institute of Scientific and Technical Information of China (English)

    陶园; 潘爱红; 李业桂; 胡晓鸥; 满萌; 贾金丽

    2014-01-01

    To review the treatment and nursing care of acute fatty liver with DIC in 1 cases of twin pregnancy experience.the late pregnant women pay attention to AFLP,doctors with the rapid termination of pregnancy,at the same time, disseminated intravascular Coagulation (DIC) treatment and nursing and postpartum hemorrhage, strengthen the treatment of artificial liver (plasma exchange) and first aid care,can significantly improve the prognosis.%回顾1例双胎妊娠期急性脂肪肝合并弥散性血管内凝血(DIC)的抢救与护理体会。通过对妊娠晚期孕妇急性脂肪肝(AFLP)配合医生迅速终止妊娠,同时做好DIC及产后出血的抢救与护理,加强人工肝治疗(血浆置换)的急救与护理,预后可明显改善。

  6. Pregnancy outcome after fetoscopic laser photocoagulation for twin-twin transfusion syndrome: experience of an emerging center from China%选择性胎儿镜下激光凝固术治疗双胎输血综合征的临床效果和围产儿结局

    Institute of Scientific and Technical Information of China (English)

    孙路明; 邹刚; 杨颖俊; 周奋翮; 梁德杨; 刘子建; Greg Ryan; 段涛

    2014-01-01

    Objective To evaluate pregnancy outcomes after selective fetoscopic laser photocoagulation (SFLP) for twin-to-twin transfusion syndrome (TTTS).Methods A total of 33 cases of TTTS were treated by SFLP in Shanghai First Maternity and Infant Hospital from January 2012 to August 2013.Clinical data on perinatal outcomes,fetaland maternalcomplicationswere recorded and retrospectively analyzed.Results (1) The mean gestational age for SFLP was (22.0 ± 2.3) weeks,the mean time for SFLP was (86 ± 32) minutes,the mean gestational age for delivery was 33 +6 weeks,the gestational age between SFLP and delivery was (9 ± 5) weeks.(2) The perinatal survival rate 28 days after the delivery was 70% (46/66).The survival rate was 52% (17/33) for both twins,36% (12/33) for one twin,88% (29/33) for at least one twin.Of all the survival twins,there were 21 donor twins (64%,21/33) with the mean birth weight at delivery was (1 805 ± 523) g and 25 recipient twins (76%,25/33) with the mean birth weight (2 214 ±600) g.(3) There were 4 cases at TTTS stage Ⅰ,9 at TTTS stage Ⅱ,11 at TTTS stage Ⅲ,9 at TTTS stage Ⅳ ;the survival number for at least one twin was 4,7,10,8 respectively; the total survival rate was 7/8,12/18,68% (15/22),12/18 respectively.(4) Four cases had both twins demises.3 fetuses had special fetal complications with 2 of them developing twin anemia-polycythemia sequence (TAPS).Two cases had preterm premature rupture of membrane (PPROM) within 3 weeks after SFLP.(5)Placental injections were performed in 7 cases with SFLP after delivery.Residual anastomosis was identified in one case.Conclusion As an emerging center,our study demonstrated favorable fetal outcomes with less maternal complications after SFLP for TTTS.%目的 探讨选择性胎儿镜下激光凝固(FLP)术治疗双胎输血综合征(TTTS)的临床效果和围产儿结局.方法 回顾性分析2012年1月-2013年8月同济大学附属第一妇婴保健院胎儿医学

  7. Unequal but monozygous: a history of twin-twin transfusion syndrome.

    Science.gov (United States)

    Obladen, Michael

    2010-03-01

    Twin-twin transfusion is the major cause of mortality and morbidity in monochorionic twins. Its pathogenesis has been gradually elucidated over the last three centuries. Among obstetricians, there was a long-lasting controversy on the existence of placental anastomoses and whether or not to tie the placental end of the firstborn infant's cord. However, a twin pregnancy practically never could be excluded. Stalpart van der Wiel described a twin-twin vessel connection in 1687. Studies on interfetal anastomoses using injection of placental vessels were published by Smellie in 1752, Osiander in 1781, and Brachet in 1821. Different types of anastomoses, and their associated fetal disorders were classified by Schatz in a series of papers at the end of the 19(th) century. With the advent of ultrasound and laser techniques, prenatal diagnosis and treatment became available in the last decade of the 20(th) century.

  8. Ultrasound measurement of cervical length in patients with twin pregnancies after assisted reproductive techniques and its effect on pregnancy outcome%超声测量辅助生殖技术后双胎妊娠患者宫颈长度及其对妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    靳瑾; 张国伟; 钟梅

    2013-01-01

    Objective:To explore the cervical length in second trimester of ART twin pregnancy patients and its impact on pregnancy outcome.Methods:Retrospective analysis of 118 patients of ART twin pregnancy received examination in our hospital from January 2006 to December 2010.Among them 25 cases were normal delivery group,30 cases were preterm group,23 cases were threatened premature labor group and 8 cases were late abortion group.We compared the cervical length of different groups and analysied the relationship of the cervical length and pregnancy outcome.Results:The incidence of preterm birth was negatively correlated with cervical length and was significantly increased when the cervical length < 2.5cm; The patients with dilated cervix more than 5mm were prone with threatened preterm labor or preterm birth.The patients with dilated cervix less than 5mm can effectively extend the gestational age by treating with aggressive tocolysis.Conclusions:It is necessary to get the cervical ultrasound examination of ART twin pregnancy in second trimester.The active and effective treatment is an important way to lower miscarriage rate of late abortion and premature delivery rates of ART twin pregnancy patients.%目的 探讨ART双胎妊娠患者中孕时宫颈长度及内口宽度对妊娠结局的影响.方法 回顾性分析我院2006年1月至2010年11月在我院妇产科门诊产检的IVF术后双胎妊娠的孕妇的临床资料,其中正常分娩组共25例,早产组共30例,先兆早产组共23例,晚期流产组8例,分析其中孕宫颈长度与妊娠结局的关系.结果 早产的发生与宫颈长度呈负相关,当宫颈长度<2.5cm时早产率显著增加;有宫颈内口扩张的患者来说易出现先兆早产或早产,当宫颈内口扩张>5mm者流产率及早产率明显增高,宫颈内口扩张<5mm者通过积极的保胎治疗后可有效延长孕周.结论 ART双胎妊娠患者孕中期的宫颈超声检查是必要的,积极有效的保胎治疗是

  9. The twin children of Auschwitz-Birkenau: conference on Nazi medicine.

    Science.gov (United States)

    Segal, Nancy L

    2013-06-01

    The twin children who survived the Holocaust and the horrific medical experiments conducted by Nazi doctors are sometimes overlooked in the relevant literature. This topic and more were discussed as part of an annual conference hosted by students from Yeshiva University's Medical Ethics Society in October 2012. A selective summary of this meeting is followed by summaries of recent twin studies concerning genetic influences on twinning, in vitro fertilization versus spontaneous twin pregnancies, gender identity disorder, and royal support for twin registries. Several human interest stories are also worth noting. They include identical twin school principals, twin loss at Sandy Hook Elementary School, timely twin documentaries, new twin and twin-like reunions, and the passing of two prominent twins.

  10. Twin birth order, birthweight and birthweight discordance: any relationship

    Directory of Open Access Journals (Sweden)

    Onyiriuka A.N.

    2010-12-01

    Full Text Available Background: It is widely believed that in twin pairs, at birth, the first-born weigh more than the second-born but this concept has been challenged. Objective: To assess the truthfulness of this common concept that first-born twins are usually heavier than their second-born siblings at birth. Methods: In a series of 104 sets of live-born twins, the birth weights of first-born twins were compared with those of their second-born siblings, after controlling for gender. Their intra-pair birthweight differences were determined and twin pairs whose birthweight difference was 15% or more were designated as discordant. Results: Twin I was heavier than Twin II in 61.5% of cases while Twin II was heavier than Twin I in 28.9% of cases. Twins I and II had equal birthweights in 9.6% of cases. Comparing the mean birthweight of the first-born-male twin with that of second-born- male twin, it was 2515+427g (95% Confidence Interval, CI=2402-2628 versus 2432 +435g (95% CI=2321-2543 p>0.05. The mean birthweight of first-born-female twin was 2326+445g (95% CI=2214-2439 while that of the second-born-female twin was 2325+501g (95% CI=2197-2453 p>0.05. When the birthweight difference exceeded 750g, the probability that Twin I will be heavier than Twin II was 83.3% (5 of 6. Conclusion: Although the first-born twin was more often heavier than their second-born siblings, either could weigh more or less at birth. The larger the birthweight difference between growth-discordant twin pair, the greater the probability that the heavier twin would be delivered first

  11. Twin trisomies-Edward and Patau syndromes.

    Science.gov (United States)

    Massiah, Nadine; Griffiths, Emma; Bamigboye, Vincent

    2008-11-01

    To report the rare occurrence of dichorionic diamniotic twins with dissimilar aneuploidies. Case report. District general hospital. A 36-year-old woman conceived by in vitro fertilization. Dichorionic diamniotic twins were found to have elevated nuchal translucencies and cystic hygromas. Intrauterine deaths occurred at 13 and 17 weeks gestation. Medical termination of pregnancy. Karyotypes. Cytogenetic studies confirmed Edward's and Patau's syndromes. The aetiology is unknown but maternal age and in vitro fertilization may be linked since the incidence of aneuploidy rises with maternal age and the incidence of twins' increases with assisted reproductive techniques. This case highlights the need for obstetricians to have good communication and counselling skills.

  12. Undiagnosed xiphopagus twins: a perinatal malady

    Directory of Open Access Journals (Sweden)

    Gowri Dorairajan

    2012-02-01

    Full Text Available Conjoined twins are a very rare entity. It is associated with poor survival rate in the presence of vital organ sharing. The entity can be diagnosed as early as the first trimester. A conjoined twin diagnosed late in labor is a malady with high perinatal mortality and maternal morbidity. We present one such case of xiphopagus twins. The management of a case diagnosed late in labor can be very challenging. Such obstetric challenges can be avoided by a meticulous early scan with a high index of suspicion, especially in the absence of separating membrane while scanning multiple pregnancies.

  13. Conjoined omphalopagus twins: a casereport

    Directory of Open Access Journals (Sweden)

    Sheila Yadira Gómez-Murillo

    2014-11-01

    Full Text Available Multiple pregnancies are 3% of the total. The most frequent are dizygotic females, however, a small group of them are of monozygotic conjoined twins in some anatomical area. This attracts the attention of physicians because of the rarity of the condition and the difficulties as well as the ethical dilemmas for their treatment. We report a case of male Siamese omphalopagus. They were separated surgically at seven weeks of age. One of them lived six months.

  14. A case report of spontaneous opening of congenitally fused labia in a female common marmoset (Callithrix jacchus) followed by pregnancy and birth of twins.

    Science.gov (United States)

    Wedi, E; Nayudu, P L; Michelmann, H W

    2011-10-01

    A first case of spontaneous opening of congenitally fused labia (CFL phenotype) in a captive common marmoset followed by pregnancy and birth is presented here. The occurrence of this phenotype has been previously published in captive marmosets, but so far the etiology is unknown.

  15. 自然妊娠和促排卵技术妊娠双胎的母婴围生期预后%Perinatal outcomes of twin pregnancies among cases of natural conception and ovulation induction

    Institute of Scientific and Technical Information of China (English)

    李伟伟; 曹红旭

    2014-01-01

    目的:对自然妊娠和促排卵技术妊娠双胎的母婴围生期预后进行探讨。方法回顾性分析本院妇产科随访的143例产妇,其中促排卵组65例,自然妊娠组78例,比较两组母婴围生期预后情况。结果自然妊娠组和促排卵组在产妇并发症发生方面比较无显著差异(P>0.05),同时两组在新生儿并发症方面无显著差异(P>0.05)。结论促排卵组和自然分娩组母婴围生期预后无显著差异,因此促排卵技术妊娠双胎是安全的。%Objective To explore the perinatal outcomes of twin pregnancies among cases of natural conception and ovulation induction. Method A follow-up of third-grade class our hospital obstetrics and gynecology were retrospectively analyzed 143 cases of maternal, which ovulation induction group 65 examples, the natural conception group 78 examples, to compare two groups of perinatal outcomes. Result Natural conception group and ovulation induction group had no significant differences in maternal complications (P>0.05), at the same time two groups had no signiifcant differences in infant complications (P > 0.05). Conclusion Ovulation induction and natural conception group no significant differences in perinatal outcomes, thus ovulation induction technology to fertility twins is safe.

  16. MR findings and comparative study of MR sequences in several twin pregnancy with comorbidities%常见双胎妊娠合并症的脑部 MR 征象分析及序列对比研究

    Institute of Scientific and Technical Information of China (English)

    刘颖; 袁慧书

    2014-01-01

    Objective To compare the applications of half-Fourier acquisition single-shot turbo spin-echo(HASTE)sequence and true fast imaging with steady state precession(True FISP)sequence for the delineation of structures and diseases in several twin pregnancy with comorbidities and to explore the clinical value of two series of fast imaging for MRI of fetus.Methods 27 twin preg-nancy women with comorbidities were imaged with HASTE and True FISP sequences.All images were statistically analyzed in re-spect of imaging qualities and artifacts.MR signs of fetal brain were analysized.Results There were abnormal changes in brains in 7 of 27 cases.Both sequences could demonstrate the structures and lesions of the fatus.Imaging quality scores of HASTE were higher than that of True FISP,but with more respiratory blurring.Conclusion There might be varying abnormalities in central nervous system in twin pregnancy with comorbidities.Combining the demonstration abilities of HASTE and True FISP is needed when de-tecting fetus lesions,especially the brain.%目的:通过半傅立叶采集单次激发快速自旋回波(HASTE)序列和真实稳态进动快速成像(True FISP)序列对常见的几种双胎妊娠合并症进行脑部 MR 征象分析,并比较2种快速成像序列在双胎 MRI 中的应用价值。方法27例双胎妊娠合并症的孕妇行 HASTE 和 True FISP 序列扫描,对2个序列的图像质量、图像伪影进行分析,比较其在双胎结构和病变的显示能力,并分析胎儿脑部的 MR 征象。结果27例中7例出现脑部结构异常。2种序列均可以显示胎儿的解剖和病变,HASTE 序列较 True FISP序列评分均值高,呼吸伪影比 True FISP 序列明显。结论在双胎妊娠合并症的胎儿中,可能出现不同程度的神经系统病变,结合HASTE 和 True FISP 序列对胎儿病变特别是颅脑病变的显示非常重要。

  17. Maternal 25-hydroxyvitamin d and preterm birth in twin gestations.

    LENUS (Irish Health Repository)

    Bodnar, Lisa M

    2013-07-01

    To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24-28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies.

  18. Clinical aspects of multiple pregnancy

    NARCIS (Netherlands)

    J.G. Santema

    1996-01-01

    textabstractThe natural wonder of multiple pregnancy and birth has fascinated mankind since ancient times and twins figure prominently in legends, folktales and myths. One of the best known traditional stories is that of Romulus and Remus, the twins who were abandoned on the banks of the Tiber and s

  19. Clinical aspects of multiple pregnancy

    NARCIS (Netherlands)

    J.G. Santema

    1996-01-01

    textabstractThe natural wonder of multiple pregnancy and birth has fascinated mankind since ancient times and twins figure prominently in legends, folktales and myths. One of the best known traditional stories is that of Romulus and Remus, the twins who were abandoned on the banks of the Tiber and

  20. Magnetic Resonance Imaging of the Feto-Placentar Unit after Fetoscopic Laser Coagulation for Twin-to-Twin Transfusion Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, T.A.G.M. [Univ. Children' s Hospital Zuerich (Switzerland). Dept. of Diagnostic Imaging; Lewi, L.; Willi, U.V.; Deprest, J. [Univ. Hospital Gasthuisberg, Leuven (Belgium). Dept. of Obstetrics-Gynaecology; Zimmermann, R. [Univ. Hospital Zurich (Switzerland). Dept. of Obstetrics

    2005-05-01

    Twin-to-twin transfusion syndrome (TTTS) is a severe complication in monochorionic twin pregnancies that results from a hemodynamical imbalance of placentar vascular anstomoses that connect the circulation of both fetuses. In TTTS, a poly/oligohydramnios sequence with high fetal morbidity and mortality rates occurs. Fetoscopic laser coagulation of the placentar anastomoses can limit or prevent fetal injury. The purpose of this report is to present and discuss fetal magnetic resonance imaging as a postoperative imaging tool after fetoscopic laser coagulation.

  1. Complete mole in a dichorionic twin pregnancy after intracytoplasmic sperm injection Mola hidatiforme completa em gravidez bicoriônica após injecção intracitoplasmática de espermatozoides

    Directory of Open Access Journals (Sweden)

    Tiago José Santos de Matos Ferraz

    2013-01-01

    Full Text Available A dichorionic twin pregnancy with complete hydatidiform mole and coexistent fetus is a rare and challenging situation, whose pathogenesis has not been yet fully understood. We present a case of a 39-year-old woman who underwent intracytoplasmic sperm injection with two embryos transfer. The 12-week gestation ultrasound examination revealed normal fetus and placenta with features of hydatidiform mole, leading to pregnancy termination. Autopsy and histological examinations diagnosed a complete mole coexisting with a normal fetus, and the genetic analysis showed a diploid fetus with biparental genome and molar tissue with paternal diploidy. This case highlighted that complete molar pregnancies may still occur even though pregnancy is achieved after intracytoplasmic sperm injection. A review of the literature was performed by collecting data from the few similar reported cases and by commenting on the pathogenesis of this rare condition.Uma gravidez bicoriônica com mola hidatiforme completa e feto normal é uma situação rara e desafiadora, cuja patogênese não foi ainda totalmente compreendida. Apresenta-se o caso de uma mulher de 39 anos submetida à injeção intracitoplasmática de espermatozoides com transferência de dois embriões. Na ecografia pré-natal realizada na 12ª semana de gestação, foi identificado um embrião morfologicamente normal e uma placenta com características molares. Esta situação resultou na terminação eletiva da gravidez. A autópsia e o estudo histológico permitiram o diagnóstico definitivo de uma mola hidatiforme completa coexistindo com feto normal. A análise genética mostrou feto diploide com genoma biparental e tecido molar com diploidia paterna. Este caso ressaltou que as gestações com mola hidatiforme completa poderão ainda ocorrer, mesmo que a gravidez seja realizada após uma injeção intracitoplasmática de espermatozoides. Foram realizadas uma revisão dos raros casos descritos na literatura

  2. Successful birth of South India's first twins after preimplantation genetic screening of embryos

    Directory of Open Access Journals (Sweden)

    Priya Selvaraj

    2016-01-01

    Full Text Available We report the first documented successful birth of twins following preimplantation genetic screening (PGS of cleavage stage embryos by array comparative genomic hybridization (CGH technology, in South India. The case was a 28-year-old woman with the previous history of preclinical pregnancy and a miscarriage in two attempted in vitro fertilization cycles. Day 3 cleavage stage embryos were generated by conventional long protocol with the use of a gonadotropin-releasing hormone analog and a combination of recombinant folliculotropins and human menopausal gonadotropins. Intracytoplasmic sperm injection of oocytes thus obtained was performed, and 10 selected embryos underwent PGS using the array CGH technique. Two normal blastocysts were transferred to the patient, and she conceived twins. She delivered at 35 weeks of gestation by elective cesarean on November 19, 2014. She delivered a healthy male and female baby weighing 2.19 kg and 2.26 kg, respectively. Postnatal evaluation of babies was also normal, and the hospital course was uneventful. PGS has a definitive indication in assisted reproductive technology programs and can be utilized to improve pregnancy rates significantly.

  3. Delayed Interval Delivery following Early Loss of the Leading Twin

    Directory of Open Access Journals (Sweden)

    P. C. Udealor

    2015-01-01

    Full Text Available This was a case of a nulliparous woman with reduced chance of conception following unilateral salpingectomy and years of infertility. She eventually conceived following ovulation induction resulting in twin pregnancy. She had miscarriage that led to loss of one of the twins at 17 weeks of gestational age. The pregnancy was however continued for 116 days following meticulous management with eventual delivery of a live female baby with good outcome.

  4. Cancer risk in opposite-sex and same-sex twins

    DEFF Research Database (Denmark)

    Juel Ahrenfeldt, Linda

    2015-01-01

    Twin pregnancies are characterized by simultaneous development of two fetuses that share the womb. An interest in opposite-sex (OS) twins, twin pairs consisting of one male and one female, comes from animal studies that showed that exposure to sex hormones is influenced by the position of the fetus...

  5. [Myasthenia gravis and pregnancy. Report on 13 cases].

    Science.gov (United States)

    Picone, O; Audibert, F; Gajdos, P; Fernandez, H

    2003-11-01

    To evaluate our experience of myasthenia during pregnancy. Retrospective study in a tertiary care university hospital including pregnant women affected by myasthenia gravis and who delivered in the obstetrical tertiary center. Medical and delivery reports were analyzed. Between 1994 and 2002, 12 women, age 31 (25-36), delivered 14 children. One women delivered twice, and there was one twin pregnancy. Clinical symptoms of myasthenia worsened in five. One was admitted twice to the intensive care unit during her pregnancy. Two were admitted to intensive care unit during the first month of post-partum. Gestational age at birth was 39.3 weeks (38-40.6), all birth weights were normal: 3329 g (2660-4520). Six women delivered vaginally, two by instrumental extraction and five by cesarean section. Apgar score was normal for all infants: 9/10. The level of anti-acetylcholine receptor antibodies (anti AchR) was high: 36.4 nM/L (0-46.8) (normal below 0.6 nM/L), but was not related to neonatal outcome. Three children presented neonatal myasthenia. We recommend obstetrical monitoring in tertiary centers for pregnant women with myasthenia gravis because of the risk of neonatal myasthenia. Measurement of anti-acetylcholine receptor antibodies may be useful. Pediatric and maternal observation is necessary in the first days of post partum.

  6. Effects of twinning on gestation length, retained placenta, and dystocia.

    Science.gov (United States)

    Echternkamp, S E; Gregory, K E

    1999-01-01

    Constraints to maximal productivity from twinning in beef cattle include increased incidence of dystocia and retained placenta, longer postpartum interval, and lower conception rate. Incidence and cause(s) of the shorter gestation length and of the increased retained placenta and dystocia associated with twinning were evaluated for 3,370 single and 1,014 twin births produced in a population of cattle selected for natural twin births. Gestation length was shorter for twin than for single pregnancies (275.6 vs. 281.3 d, P.10) by parity with twin births. Because of the shorter gestation length and the increased incidence of retained placenta and(or) dystocia, achievement of increased productivity with twinning in cattle necessitates intensive management of twin-producing dams and their calves during the calving season. Management of the increased dystocia can be facilitated by preparturient diagnosis of twin pregnancies, enabling timely administration of obstetrical assistance to facilitate delivery of twin calves and to increase their neonatal survival.

  7. Nutrition and multifetal pregnancy.

    Science.gov (United States)

    Brown, J E; Carlson, M

    2000-03-01

    Largely because of assisted reproduction, the rate of multifetal pregnancy is rising rapidly in the United States. Accordingly, dietitians are increasingly being called upon to provide nutrition services for these high-risk pregnancies. This article gives an overview of the incidence of and risks associated with multifetal pregnancy and reviews studies that contribute to our knowledge of nutrition and multifetal pregnancy. Practice guidelines for promoting healthy outcomes based on the best available scientific data are suggested. Guidelines for weight gain for twin and triplet pregnancy, dietary intake, and supplement use are included. Suggested practice guidelines for multifetal pregnancy include a positive rate of weight gain early in pregnancy, the use of prepregnancy weight status to determine total weight gain goals in twin pregnancy, a 50-lb weight gain goal for triplet pregnancy, and higher minimal number of servings of foods from several of the Food Guide Pyramid groups. The need for additional information on the effects of nutritional status on the course and outcome of multifetal pregnancy is critical. Preliminary evidence of the benefits of nutrition services suggests that both the incorporation of dietetics services into care programs and additional research on nutrition and multifetal gestation are warranted.

  8. Treatment of twin-twin transfusion syndrome by fetoscopic laser photocoagulation

    Institute of Scientific and Technical Information of China (English)

    劉子建; 梁德楊; 馮德源; 梁子昂

    2004-01-01

    @@ Twin-twin transfusion syndrome (TTTS) is a serious obstetric complication, occurring in about 15% of monochorionic (MC) twin pregnancies. If untreated, the prognosis is poor, with an overall perinatal mortality of 80%.1 It is now clear that TTTS is the result of an unbalanced unidirectional blood flow through placental arteriovenous anastomoses (also termed deep anastomoses) between the two fetal circulations.2 The donor twin progressively becomes anemic, and develops growth restriction, oliguria, and oligohydramnios/anhydramnios; whereas the recipient becomes plethoric and polyuric, and develops congestive heart failure, cardiomegaly, polyhydramnios and fetal hydrops. Preterm labor is common because of gross polyhydramnios, and further deteriorations will lead to intrauterine death of both twins.

  9. Successful Pregnancy and Delivery in a Woman With Panhypopituitarism

    Directory of Open Access Journals (Sweden)

    Barton D

    2007-01-01

    Full Text Available To The Editor: Pregnancy after a complete loss of hypophyseal function is rare. Lack of growth hormone (GH, adrenocorticotropin (ACTH and thyroid-stimulating hormone (TSH in childhood may result in malfunction of different organ systems, affecting fertility. Complete lack of ovarian stimulation by FSH and LH results in anovulation and ovarian atrophy. We present a patient with panhypopituitarism who has achieved pregnancy and delivered through in vitro fertilization (IVF and embryo transfer (ET. This 35 year-old woman underwent four trans-sphenoidal hypophysectomies at 12, 13, 23 and 26 years of age, for recurrent neuroectodermal cysts (embryonic remnant. Her second operation was complicated by panhypopituitarism with severe diabetes insipidus, treated with adequate doses of hydrocortisone, L-thyroxine and desmopressin. At age 21, cyclic substitution therapy with estrogen and progesterone was given for primary amenorrhea. Two years later, GH therapy was added. At age 33, she requested fertility treatment. GH, cyclic estrogen, and progesterone therapy were stopped, and she underwent ovulation induction, with gonadotropins, followed by IVF and ET, resulting in a successful dichorionic twin pregnancy. She was followed regularly at a combined antenatal clinic. No changes in steroid, desmopressin, or thyroxine doses were required, and the antenatal period was uneventful. An elective caesarean section was performed at 37 weeks gestation, and healthy twin boys (weighing 3.0 and 3.14 kg were delivered. Clinical course during puerperium was normal.Conception and uncomplicated pregnancy in patients with hypopituitiarism are rare [1,2]. Well-timed substitution of missing hormones enables normal physical development. Stimulation therapy with gonadotropins can induce adequate follicular maturation. IVF-ET may be a useful treatment for infertility in patients with hypopituitarism as it may reduce the incidence of multiple pregnancies associated with higher

  10. Maternal and fetal prognosis analyses in 13 cases of single intrauterine death in twin pregnancies%13例双胎之一胎儿宫内死亡病例的母儿预后分析

    Institute of Scientific and Technical Information of China (English)

    黄莺莺; 张燕菲; 张园; 王志坚

    2014-01-01

    Objective To investigate the perinatal outcome, maternal and fetal prognosis of single intrauterine death in twin pregnancy. Method 13 cases of single intrauterine death in twin pregnancies from June 2002 to December 2012 in Nanfang Hospital, Southern Medical University were analyzed retrospectively, then carried a follow-up investigation. Results (1) Time of fetal death was detected from 13 w+1 d to 36 w+5 d gestational weeks, average is 29 w gestational weeks. Birth weight of living fetus is 1130g~2890 g,average is 2220 g.(2) In 13 neonates, 1 case was severe asphyxia in newborn, 1 case was mild asphyxia neonatorum. The reasons of fetal death included torsion of umbilical cord, chromosome disorder, unchal cord, chorioamnionitis and placental abruption. 8 cases couldn't be found definite death cause. 2 cases showed ultrasound abnormal, one was fetal septum pellucidum, the other was FGR. (3) 2 puerperants suffered rheumatoid arthritis and chronic hypertension, the disease still present after delivery;1 puerpera suffered gestational diabetes mellitus her blood glucose was still abnormal after delivery. In 13 puerperants, 1 case happened postpartum hemorrhage, 1 case happened post partum chronicity DIC. Survivors’age are from 2 months to 10 years old. There is a 7 years old boy, his physical development is hysteresis compare with the same age children. 1 surviror was detected mild blood coagulation dysfunction. Conclusions Single intrauterine death in twin pregnancy raises up premature labor rate and uterine-incision delivery rate. It has greater influence on puerperants’s blood clotting function when fetal death happened in late pregnancy. Pregnancy outcome has no significant difference between normal labor and uterine-incision delivery. Survivors’prognosis is more related with gestational age, birth weight and asphyxia.%目的:探讨双胎之一胎儿宫内死亡的妊娠结局及母儿预后。方法回顾性分析2002年6月至2012年12月在南方医科

  11. A rare case report of cord entanglement in a post-dated monochorionic monoamniotic twins

    Directory of Open Access Journals (Sweden)

    Kasturi Donimath

    2016-01-01

    Full Text Available Monochorionic Monoamniotic (MCMA twin gestations have been associated perinatal mortality rates as high as 28 to 47%. Umbilical cord entanglements and knots, twin-to-twin transfusion syndrome, congenital anomalies, prematurity and intertwin locking during labour is responsible for their high perinatal morbidity and mortality. We report here a case of Cord entanglement in a post-dated MCMA twin pregnancy without any complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 230-231

  12. Thoracopagus conjoined twin: an unusual presentation

    Directory of Open Access Journals (Sweden)

    Rajesh Kumari

    2014-02-01

    Full Text Available Conjoined twins are among rare clinical conditions observed by obstetricians. Due to rare incidence of this condition there is general lack of knowledge among obstetricians, especially at primary care level which leads to missed diagnosis during antenatal period. The management of this condition is complex especially in cases where the diagnosis is not known before onset of labour. A 30 - year old Hindu lady was referred to us from other hospital with diagnosis of twin pregnancy and prolonged second stage of labour. Clinical examination revealed findings of ruptured uterus and foetal head of one baby and feet of second baby were outside the introitus. Emergency laparotomy was done which revealed conjoined twins. This article report clinical course of a thoracopagus conjoined twin. The relevant literature is also reviewed. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 245-247

  13. Perinatal risk factors and neonatal complications in discordant twins admitted to the neonatal intensive care unit

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-rui; LIU Jie; ZENG Chao-mei

    2013-01-01

    Background Many studies have shown a relationship between birth weight discordance and adverse perinatal outcomes.This study aimed to investigate the perinatal risk factors and neonatal complications of discordant twins who are admitted to the neonatal intensive care unit.Methods A total of 87 sets of twins were enrolled in this retrospective study,of which 22 sets were discordant twins and 65 sets were concordant twins.Binary Logistic regression analysis was used to identify the risk factors associated with the occurrence of discordant twins.The common neonatal complications of discordant twins were also investigated.Results Multivariate analysis showed that the use of assisted reproductive techniques,pregnancy-induced hypertension,and unequal placental sharing were risk factors for the occurrence of discordant twins.The incidence of small for gestational age infants and very low birth weight infants of discordant twins was significantly higher,while the birth weight of discordant twins was significantly lower than those of concordant twins.The duration of hospitalization of discordant twins was longer than that of concordant twins.The incidence of several neonatal complications,such as neonatal respiratory distress syndrome and intracranial hemorrhage,was higher in discordant twins than that in concordant twins.The percentage of those requiring pulmonary surfactant and mechanical ventilation was significantly higher in discordant twins than that in concordant twins.Conclusions Use of assisted reproductive techniques,pregnancy-induced hypertension,and unequal placental sharing are perinatal risk factors of discordant twins who are admitted to the neonatal intensive care unit.These infants are also much more likely to suffer from various neonatal complications,especially respiratory and central nervous system diseases.It is important to prevent the occurrence of discordant twins by decreasing these risk factors and timely treatment should be given to discordant

  14. The Qingdao Twin Registry

    DEFF Research Database (Denmark)

    Duan, Haiping; Ning, Feng; Zhang, Dongfeng;

    2013-01-01

    In 1998, the Qingdao Twin Registry was initiated as the main part of the Chinese National Twin Registry. By 2005, a total of 10,655 twin pairs had been recruited. Since then new twin cohorts have been sampled, with one longitudinal cohort of adolescent twins selected to explore determinants...... of metabolic disorders and health behaviors during puberty and young adulthood. Adult twins have been sampled for studying heritability of multiple phenotypes associated with metabolic disorders. In addition, an elderly twin cohort has been recruited with a focus on genetic studies of aging-related phenotypes...

  15. Twin Jet

    Science.gov (United States)

    Henderson, Brenda; Bozak, Rick

    2010-01-01

    Many subsonic and supersonic vehicles in the current fleet have multiple engines mounted near one another. Some future vehicle concepts may use innovative propulsion systems such as distributed propulsion which will result in multiple jets mounted in close proximity. Engine configurations with multiple jets have the ability to exploit jet-by-jet shielding which may significantly reduce noise. Jet-by-jet shielding is the ability of one jet to shield noise that is emitted by another jet. The sensitivity of jet-by-jet shielding to jet spacing and simulated flight stream Mach number are not well understood. The current experiment investigates the impact of jet spacing, jet operating condition, and flight stream Mach number on the noise radiated from subsonic and supersonic twin jets.

  16. [Peculiarities of multiple pregnancy: embryology].

    Science.gov (United States)

    Leszczyńska-Gorzelak, B; Oleszczuk, J J; Machin, G A; Sawulicka-Oleszczuk, H; Kiczyńska, A; Keith, L G

    2000-11-01

    Multiple pregnancies are not physiologic in humans and the understanding of the pathogenesis of this phenomenon is not fully established. Embriology of multiple pregnancy has been extensively investigated and this paper presents the phases of embrional development of monozygotic and dizygotic twins.

  17. Selective termination in dichorionic twins discordant for congenital defect.

    Science.gov (United States)

    Alvarado, Eugenia Antolín; Pacheco, Ricardo Pérez Fernández; Alderete, Francisco Gámez; Luís, Juán Antonio de León; de la Cruz, Angel Aguarón; Quintana, Luís Ortiz

    2012-03-01

    To evaluate the perinatal outcome of selective termination in dichorionic twins discordant for congenital defect, performed at the Hospital General Universitario Gregorio Marañon. Twenty-eight dichorionic twins with an anomalous fetus were included from May 2008 to February 2011. Intracardiac KCl (1-2 ml; 15 mEq/ml) under ultrasonographic guidance was used in all procedures. Congenital defect, gestational age at the procedure, incidence and perinatal outcome were retrieved. Selective termination was performed in 14 (50%) cases of structural defects with normal karyotype and in 14 (50%) cases of chromosomal abnormality, 13 of them (92.8%) trisomy 21. Median gestational age at the procedure was 17.8 weeks (range 14.5-24; SD 2.3), and 12 (42.8%) were performed before 18 weeks. The presenting fetus was terminated in 11 cases (39.3%). Selective termination was followed by the subsequent delivery of a viable infant in 27 out of 28 cases (96.4%). Fetal loss before 24 weeks occurred in 1 case (3.6%). Median gestational age at delivery was 38 weeks (range 24.1-40.1; SD 3.8). Twenty-four (88.9%) were delivered >34 weeks and 1 (3.7%) before 28 weeks. Selective termination in dichorionic twins discordant for congenital defect is a safe procedure with low risk of unintended fetal loss. This option is a reasonable alternative to expectant management or termination of the whole pregnancy. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. 乙型肝炎病毒携带孕妇双胎妊娠的结局分析%Twin pregnancy outcomes of maternal hepatitis B virus carrier state

    Institute of Scientific and Technical Information of China (English)

    芮燕京; 戴毅敏; 宋文英; 陈洁; 周乙华; 胡娅莉; 王志群

    2014-01-01

    目的:探讨乙型肝炎病毒(hepatitis B virus,HBV)携带对双胎妊娠结局的影响。方法2004年1月至2012年12月,在南京医科大学鼓楼临床医学院妇产科分娩的双胎妊娠孕妇共569例,其中32例妊娠前乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)阳性, e抗原阴性且肝功能正常,确诊HBV携带,作为HBsAg阳性组;另外537例孕妇HBsAg阴性,作为HBsAg阴性组。回顾性分析这些孕妇的妊娠结局。采用t检验及χ2检验比较2组间妊娠结局的差异,采用多元线性回归分析探讨影响新生儿出生体重的因素。结果 HBsAg阳性组孕妇发生肝功能损害(妊娠期丙氨酸转氨酶≥50 U/L)的比例明显高于HBsAg阴性组[18.8%(6/32)与5.8%(31/537),χ2=6.367,P=0.012]。HBsAg阳性组孕妇妊娠期糖尿病的发生率高于HBsAg阴性组,但差异无统计学意义[21.9%(7/32)与11.6%(62/537),χ2=2.132,P=0.144]。HBsAg阳性组妊娠期肝内胆汁淤积症、妊娠期高血压疾病、胎膜早破、前置胎盘、胎儿窘迫、产后出血、早产、剖宫产、胎儿脐带绕颈、羊水粪染、新生儿窒息发生率与HBsAg阴性组相比,差异均无统计学意义(P值均>0.05)。多因素分析显示,妊娠期糖尿病(β=67.869,95%CI:0.494~135.244, P=0.048)、孕妇年龄(β=6.592,95%CI:2.020~11.880,P=0.006)和分娩孕周(β=164.069,95%CI:154.426~173.712,P<0.01)对新生儿出生体重均有影响;而孕妇HBsAg阳性对新生儿出生体重的影响无统计学意义(β=78.864,95%CI:-16.950~174.678,P=0.107)。结论 HBV携带者双胎妊娠时易发生肝功能损害,但并不影响其他不良妊娠结局和新生儿疾病的发生风险。%To investigate the impact of maternal hepatitis B virus (HBV) carrier state on twin pregnancy outcomes. Methods From January 2004 to December 2012, 569 women with twin pregnancy were hospitalized in

  19. IVF for premature ovarian failure: first reported births using oocytes donated from a twin sister

    Directory of Open Access Journals (Sweden)

    Sills Eric

    2010-03-01

    Full Text Available Abstract Background Premature ovarian failure (POF remains a clinically challenging entity because in vitro fertilisation (IVF with donor oocytes is currently the only treatment known to be effective. Methods A 33 year-old nulligravid patient with a normal karyotype was diagnosed with POF; she had a history of failed fertility treatments and had an elevated serum FSH (42 mIU/ml. Oocytes donated by her dizygotic twin sister were used for IVF. The donor had already completed a successful pregnancy herself and subsequently produced a total of 10 oocytes after a combined FSH/LH superovulation regime. These eggs were fertilised with sperm from the recipient's husband via intracytoplasmic injection and two fresh embryos were transferred to the recipient on day three. Results A healthy twin pregnancy resulted from IVF; two boys were delivered by caesarean section at 39 weeks' gestation. Additionally, four embryos were cryopreserved for the recipient's future use. The sister-donor achieved another natural pregnancy six months after oocyte retrieval, resulting in a healthy singleton delivery. Conclusion POF is believed to affect approximately 1% of reproductive age females, and POF patients with a sister who can be an oocyte donor for IVF are rare. Most such IVF patients will conceive from treatment using oocytes from an anonymous oocyte donor. This is the first report of births following sister-donor oocyte IVF in Ireland. Indeed, while sister-donor IVF has been successfully undertaken by IVF units elsewhere, this is the only known case where oocyte donation involved twin sisters. As with all types of donor gamete therapy, pre-treatment counselling is important in the circumstance of sister oocyte donation.

  20. IVF for premature ovarian failure: first reported births using oocytes donated from a twin sister.

    LENUS (Irish Health Repository)

    Sills, Eric Scott

    2010-01-01

    BACKGROUND: Premature ovarian failure (POF) remains a clinically challenging entity because in vitro fertilisation (IVF) with donor oocytes is currently the only treatment known to be effective. METHODS: A 33 year-old nulligravid patient with a normal karyotype was diagnosed with POF; she had a history of failed fertility treatments and had an elevated serum FSH (42 mIU\\/ml). Oocytes donated by her dizygotic twin sister were used for IVF. The donor had already completed a successful pregnancy herself and subsequently produced a total of 10 oocytes after a combined FSH\\/LH superovulation regime. These eggs were fertilised with sperm from the recipient\\'s husband via intracytoplasmic injection and two fresh embryos were transferred to the recipient on day three. RESULTS: A healthy twin pregnancy resulted from IVF; two boys were delivered by caesarean section at 39 weeks\\' gestation. Additionally, four embryos were cryopreserved for the recipient\\'s future use. The sister-donor achieved another natural pregnancy six months after oocyte retrieval, resulting in a healthy singleton delivery. CONCLUSION: POF is believed to affect approximately 1% of reproductive age females, and POF patients with a sister who can be an oocyte donor for IVF are rare. Most such IVF patients will conceive from treatment using oocytes from an anonymous oocyte donor. This is the first report of births following sister-donor oocyte IVF in Ireland. Indeed, while sister-donor IVF has been successfully undertaken by IVF units elsewhere, this is the only known case where oocyte donation involved twin sisters. As with all types of donor gamete therapy, pre-treatment counselling is important in the circumstance of sister oocyte donation.

  1. Deformation twinning in monazite

    Energy Technology Data Exchange (ETDEWEB)

    Hay, R.S.; Marshall, D.B

    2003-10-20

    Polycrystalline monazite (LaPO{sub 4}) was deformed at room temperature by a spherical indenter. Deformation twins were identified by TEM in 70 grains. Five twin planes were found: (100) was by far the most common; (001) and (120) were less common; (122-bar)was rare, and kinks in (120) twins were identified as irrational '(483)' twin planes. The twinning modes on these planes were inferred from the expression of twinning shear at free surfaces, predictions of classical deformation twinning theory, and various considerations of twin morphology and crystal structure. Atomic shuffle calculations that allow formation of either a glide plane or a mirror plane at the twin interface were used to analyze twin modes. The inferred twin modes all have small atomic shuffles. For (001) twins, the smallest shuffles were obtained with a glide plane at the interface, with displacement vector R=((1)/(2))[010]. The results do not uniquely define a twin mode on (100), leaving open the possibility of more than one mode operating on this plane. Factors that may determine the operative deformation twinning modes are discussed. Crystal structure considerations suggest that the relative abundance of twinning modes may correlate with low shear modulus on the twin plane in the direction of twinning shear, and with a possible low-energy interface structure consisting of a layer of xenotime of one half-unit-cell thickness that could form at (100) and (001) twins. The three most common twins have low strains to low {sigma} coincidence site lattices (CSLs)

  2. The vanishing twin: morphologic and cytogenetic evaluation of an ultrasonographic phenomenon

    DEFF Research Database (Denmark)

    Rudnicki, M; Vejerslev, L O; Junge, Jette

    1991-01-01

    Twin pregnancy was observed by ultrasonographic examination in the 6th week of gestation. After singleton term delivery a thickening of the membranes opposite to the main placenta showed degenerated chorionic villi embedded between one layer of amnion and chorion; no fetal parts were observed. Vi....... Postconceptional nondisjunction leading to tetraploidy in one twin conceptus may explain demise in early pregnancy. Tetraploidy observed by chorionic villus biopsy must be confirmed by amniocentesis before interruption of the pregnancy is considered....

  3. The Norwegian Twin Registry.

    Science.gov (United States)

    Nilsen, Thomas S; Brandt, Ingunn; Magnus, Per; Harris, Jennifer R

    2012-12-01

    Norway has a long-standing tradition in twin research, but the data collected in several population-based twin studies were not coordinated centrally or easily accessible to the scientific community. In 2009, the Norwegian Twin Registry was established at the Norwegian Institute of Public Health (NIPH) in Oslo with the purpose of creating a single research resource for Norwegian twin data. As of today, the Norwegian Twin Registry contains 47,989 twins covering birth years 1895-1960 and 1967-1979; 31,440 of these twins consented to participate in health-related research. In addition, DNA from approximately 4,800 of the twins is banked at the NIPH biobank and new studies are continually adding new data to the registry. The value of the Norwegian twin data is greatly enhanced by the linkage opportunities offered by Norway's many nationwide registries, spanning a broad array of medical, demographic, and socioeconomic information.

  4. Prediction of preterm birth in twins.

    Science.gov (United States)

    Makrydimas, George; Sotiriadis, Alexandros

    2014-02-01

    About 13% of twins are born before 34 weeks and 7% before 32 weeks. The prediction of preterm birth in twins is based on the same tests as in singleton pregnancies. In twin pregnancies, the cut-off for short cervix at the second trimester scan is less than 25 mm (compared with 15 mm in singletons); length less than 20 mm is associated with 42% risk for birth before 32 weeks and cervical length less than 25 mm is associated with 28% risk for birth before 28 weeks. The measurement of cervical length in pregnancies with symptoms of preterm labour may have limited accuracy in predicting preterm birth. In asymptomatic women, a positive fetal fibronectin test seems to be associated with 35% risk for birth before 32 weeks and 40% risk for birth less than 34 weeks, whereas a negative test decreases the risk to 6% and 17%, respectively. The differences in the predictive value of tests between twins and singletons reflect the diverse pathophysiology of preterm birth between the two groups.

  5. Rate and Outcomes of Pulmonary Stenosis and Functional Pulmonary Atresia in Recipient Twins with Twin-Twin Transfusion Syndrome.

    Science.gov (United States)

    Ortiz, Javier U; Masoller, Narcís; Gómez, Olga; Bennasar, Mar; Eixarch, Elisenda; Lobmaier, Silvia M; Crispi, Fàtima; Gratacos, Eduard; Martinez, Josep María

    2017-01-01

    To evaluate the rate of pulmonary stenosis and functional pulmonary atresia (PS/PA) in recipient twins prior to fetal surgery for twin-twin transfusion syndrome (TTTS) and their pre- and postnatal outcomes. We carried out a prospective study including 260 cases of TTTS. Echocardiography was performed before laser surgery to detect the presence of PS/PA. The outcomes of recipients with and without PS/PA were compared. The need of postnatal cardiac interventions and the survival rate at 6 months of age were also evaluated. PS was observed in 16/260 (6.2%) of recipient twins and PA in 12/260 (4.6%). After fetal surgery, 10/28 (35.7%) recipients died, 9/28 (32.1%) showed in utero regression, and 9/28 (32.1%) had persistence of PS/PA. Postnatally, seven recipients underwent percutaneous balloon pulmonary valvuloplasty, one required surgical valvotomy and one palliative surgery. Pregnancies with recipient twins with PS/PA had lower survival of at least one twin (67.9 vs. 83.6%, p = 0.045) and lower overall survival (57.1 vs. 72.8%, p = 0.015) at 6 months of age. PS and PA were observed in 10.8% of recipients. Among these, about one third showed persistence of pulmonary valve pathology after delivery, which stresses the need for strict follow-up. © 2016 S. Karger AG, Basel.

  6. Comparison of triple serum marker level and MoM between singleton and twin pregnancy in second trimester%孕中期三联筛查单双胎妊娠孕妇血清结果和MoM值比较

    Institute of Scientific and Technical Information of China (English)

    林铿; 钟明; 刘艳霞

    2012-01-01

    Objective: AFP, β - hCG and uE3 serum levels were tested and MoM was calculated and adjusted according to previous study. Comparison of triple serum marker level and MoM between singleton and twin pregnancy was studied to determine if the adjustment factor in previous study was fit for our laboratory. Methods: Second trimester (GA 14 week - 21 week) serum from twin - pregnant women was taken and tested by immunoassay platform. Risk was assessed according to pregnancy demographics and pregnancy result was checked. There were total 109 cases of twin pregnant women and 10829 cases of singleton pregnant women involved in this study. Results: The median of adjusted MoM were 0.92, 1.01 and 0.98 for AFP, hCG and uE3. The median of adjusted AFP MoM was not expected and the median of adjusted hCG and uE3 were fine. Conclusion: Since twin pregnancy is low prevalence , the adjustment factor can be used according to previous study. But when the laboratory has enough twin pregnancy samples, they should check if the median MoM of twin pregnancy is well - adjusted. If it's not, they should derive their own adjustment factor.%目的:检测孕中期双胎妊娠孕妇血清甲胎蛋白(AFP)、人绒毛膜促性腺激素β亚基(β-hCG)和游离雌三醇(uE3)的浓度,通过文献上的校正方法得到校正后MoM值[1],计算唐氏征和神经管缺陷风险,通过与单胎标本的比较,评判该方法是否适合本实验室.方法:收集双胎妊娠109例,孕中期(14周~21周)采集孕妇静脉血,用化学发光免疫分析技术测定血清AFP、hCG和uE3的浓度,结合孕妇信息计算风险,并于分娩后随访,确定胎儿妊娠结局.以同期正常单胎妊娠的10829例作对照组.结果:校正后109例双胎妊娠孕妇血清的MoM中值是AFP 0.92,hCG 1.01,uE3 0.98,AFP的校正结果与文献上略有差异,hCG和uE3基本吻合.结论:鉴于双胎妊娠的发生概率较小,可以采用文献上校正参数,但当累积的样本足够多时,可以适当调整该参数.

  7. Imperfect twinning: a clinical and ethical dilemma

    Science.gov (United States)

    Denardin, Daniela; Telles, Jorge Alberto B.; Betat, Rosilene da Silveira; Fell, Paulo Renato K.; da Cunha, André Campos; Targa, Luciano Vieira; Zen, Paulo Ricardo G.; Rosa, Rafael Fabiano M.

    2013-01-01

    OBJECTIVE To review the history, epidemiology, etiology, gestational aspects, diagnosis and prognosis of imperfect twinning. DATA SOURCES Scientific articles were searched in PubMed, SciELO and Lilacs databases, using the descriptors "conjoined twins", "multiple pregnancy", "ultrasound", "magnetic resonance imaging" and "prognosis". The research was not delimited to a specific period of time and was supplemented with bibliographic data from books. DATA SYNTHESIS: The description of conjoined twins is legendary. The estimated frequency is 1/45,000-200,000 births. These twins are monozygotic, monochorionic and usually monoamniotic. They can be classified by the most prominent fusion site, by the symmetry between the conjoined twins or by the sharing structure. The diagnosis can be performed in the prenatal period or after birth by different techniques, such as ultrasound, magnetic resonance imaging and echocardiography. These tests are of paramount importance for understanding the anatomy of both fetuses/children, as well as for prognosis and surgical plan determination. CONCLUSIONS Although imperfect twinning is a rare condition, the prenatal diagnosis is very important in order to evaluate the fusion site and its complexity. Hence, the evaluation of these children should be multidisciplinary, involving mainly obstetricians, pediatricians and pediatric surgeons. However, some decisions may constitute real ethical dilemmas, in which different points should be discussed and analyzed with the health team and the family. PMID:24142323

  8. Imperfect twinning: a clinical and ethical dilemma.

    Science.gov (United States)

    Denardin, Daniela; Telles, Jorge Alberto B; Betat, Rosilene da Silveira; Fell, Paulo Renato K; Cunha, André Campos da; Targa, Luciano Vieira; Zen, Paulo Ricardo G; Rosa, Rafael Fabiano M

    2013-09-01

    OBJECTIVE To review the history, epidemiology, etiology, gestational aspects, diagnosis and prognosis of imperfect twinning. DATA SOURCES Scientific articles were searched in PubMed, SciELO and Lilacs databases, using the descriptors "conjoined twins", "multiple pregnancy", "ultrasound", "magnetic resonance imaging" and "prognosis". The research was not delimited to a specific period of time and was supplemented with bibliographic data from books. The description of conjoined twins is legendary. The estimated frequency is 1/45,000-200,000 births. These twins are monozygotic, monochorionic and usually monoamniotic. They can be classified by the most prominent fusion site, by the symmetry between the conjoined twins or by the sharing structure. The diagnosis can be performed in the prenatal period or after birth by different techniques, such as ultrasound, magnetic resonance imaging and echocardiography. These tests are of paramount importance for understanding the anatomy of both fetuses/children, as well as for prognosis and surgical plan determination. CONCLUSIONS Although imperfect twinning is a rare condition, the prenatal diagnosis is very important in order to evaluate the fusion site and its complexity. Hence, the evaluation of these children should be multidisciplinary, involving mainly obstetricians, pediatricians and pediatric surgeons. However, some decisions may constitute real ethical dilemmas, in which different points should be discussed and analyzed with the health team and the family.

  9. Imperfect twinning: a clinical and ethical dilemma

    Directory of Open Access Journals (Sweden)

    Daniela Denardin

    2013-09-01

    Full Text Available OBJECTIVE To review the history, epidemiology, etiology, gestational aspects, diagnosis and prognosis of imperfect twinning. DATA SOURCES Scientific articles were searched in PubMed, SciELO and Lilacs databases, using the descriptors "conjoined twins", "multiple pregnancy", "ultrasound", "magnetic resonance imaging" and "prognosis". The research was not delimited to a specific period of time and was supplemented with bibliographic data from books. DATA SYNTHESIS: The description of conjoined twins is legendary. The estimated frequency is 1/45,000-200,000 births. These twins are monozygotic, monochorionic and usually monoamniotic. They can be classified by the most prominent fusion site, by the symmetry between the conjoined twins or by the sharing structure. The diagnosis can be performed in the prenatal period or after birth by different techniques, such as ultrasound, magnetic resonance imaging and echocardiography. These tests are of paramount importance for understanding the anatomy of both fetuses/children, as well as for prognosis and surgical plan determination. CONCLUSIONS Although imperfect twinning is a rare condition, the prenatal diagnosis is very important in order to evaluate the fusion site and its complexity. Hence, the evaluation of these children should be multidisciplinary, involving mainly obstetricians, pediatricians and pediatric surgeons. However, some decisions may constitute real ethical dilemmas, in which different points should be discussed and analyzed with the health team and the family.

  10. Reduction of multifetal gestation to twins: is it always possible to attain natural outcomes?

    Directory of Open Access Journals (Sweden)

    Tuncay Yuce

    2016-09-01

    Material and Methods: Women with multifetal gestation whose pregnancies were reduced to twins were compared with spontaneous twins and assisted reproduction twins. The main outcome measures were the duration of pregnancy, premature labor and delivery rates, complication rates during pregnancy, birth weight, APGAR scores, neonatal intensive care unite admission rates, and delivery routes. Results: 380 twin deliveries followed up at our institution between years 2007-2014 were enrolled. All data concerning perinatal outcomes were compared among three groups. twins conceived spontaneously (group 3, n=165 and via IVF (group 1, n=117 along with IVF conceived high order pregnancies wherein embryo reduction was implemented (group 2, n=49. The duration of pregnancy, the rate of premature and the rate of overall pregnancy associated complications were all favorable in group 1 rather than group 2. As well, the mean birth weight and APGAR scores at 1st and 5th minutes were all found to be lower in group 2 than in group 1. Conclusion: The results emphasize embryo reduction should be acknowledged as a salvage procedure due to high risk of complications in embryo reduced high-order pregnancies. Embryo reduction yields results comparable to twins conceived via IVF yields poorer results compared to spontaneously conceived twins. [Cukurova Med J 2016; 41(3.000: 485-490

  11. Twin anemia polycythemia sequence: a single center experience and literature review.

    Science.gov (United States)

    Moaddab, Amirhossein; Nassr, Ahmed A; Espinoza, Jimmy; Ruano, Rodrigo; Bateni, Zhoobin H; Shamshirsaz, Amir A; Mandy, George T; Welty, Stephen E; Erfani, Hadi; Popek, Edwina J; Belfort, Michael A; Shamshirsaz, Alireza A

    2016-10-01

    Twin anemia polycythemia sequence (TAPS) is defined by significant intertwin hemoglobin discordance without the amniotic fluid discordance that characterizes twin-twin-transfusion syndrome (TTTS) in monochorionic twin pregnancies. TAPS is an uncommon condition which can either occur spontaneously, or following fetoscopic laser ablation for TTTS. This complication is thought to result from chronic transfusion through very small placental anastomoses; however, the pathogenesis of TAPS remains unknown. Consequently, there is no consensus in the management of TAPS. In this article, three cases of TAPS are described and we review the literature on this uncommon pregnancy complication.

  12. The Danish Twin Register

    DEFF Research Database (Denmark)

    Kyvik, K O; Christensen, Kaare; Skytthe, A;

    1996-01-01

    BACKGROUND: Population based twin registers represent a valuable tool for genetic epidemiological research, since twin studies aim at separating the effect of genes and environment for complex traits. The Danish Twin Register's history, size, ascertainment and completeness of data, as well as data...... accessibility and availability are described. RESULTS: The Danish Twin Register comprises 14,051 twin pairs born 1870-1930, representing all twins surviving to age six years, and 20,888 twin pairs born 1953-1982, representing 75% of those born 1953-1967 and 95% of those born 1968-1982. The birth cohorts 1931......-1952 og 1983-1993 are being ascertained at the moment. The register is available for research given certain conditions are fulfilled. CONCLUSION: This register will in a few years be the most comprehensive twin register in the world. It is a very valuable Danish research resource....

  13. The Danish Twin Register

    DEFF Research Database (Denmark)

    Kyvik, K O; Christensen, Kaare; Skytthe, A

    1996-01-01

    BACKGROUND: Population based twin registers represent a valuable tool for genetic epidemiological research, since twin studies aim at separating the effect of genes and environment for complex traits. The Danish Twin Register's history, size, ascertainment and completeness of data, as well as data...... accessibility and availability are described. RESULTS: The Danish Twin Register comprises 14,051 twin pairs born 1870-1930, representing all twins surviving to age six years, and 20,888 twin pairs born 1953-1982, representing 75% of those born 1953-1967 and 95% of those born 1968-1982. The birth cohorts 1931......-1952 og 1983-1993 are being ascertained at the moment. The register is available for research given certain conditions are fulfilled. CONCLUSION: This register will in a few years be the most comprehensive twin register in the world. It is a very valuable Danish research resource....

  14. The correlation of fecundability among twins: Evidence of a genetic effect on fertility?

    DEFF Research Database (Denmark)

    Christensen, Kaare; Kohler, Hans-Peter; Basso, Olga;

    2003-01-01

    born 1953-1982. Fecundability was assessed as the waiting time to pregnancy at the first attempt to achieve a pregnancy. RESULTS: The reported time to pregnancy for males was slightly shorter than for females but there were no sex differences in intrapair similarity. We found an intrapair correlation......BACKGROUND: Numerous rare genetic conditions are known to influence fecundability in both males and females. It is less clear to what extent more subtle genetic differences influence fecundability on a population level. METHODS: In 1994 a population-based survey was conducted among Danish twins...... in time to pregnancy for 645 monozygotic twin pairs (r = 0.22; 95% confidence interval = 0.12 to 0.32), but no intrapair correlation for 826 like-sex dizygotic twin pairs (r = 0.00; 95% confidence interval = -0.09 to 0.10). CONCLUSIONS: The correlation in time to pregnancy for monozygotic twins suggests...

  15. Detection and Significance of Brain Natriuretic Peptide Level in Normal Late Pregnant Women with Twin Pregnancy%正常双胎晚期妊娠孕妇氨基末端脑钠肽前体水平的检测及意义∗

    Institute of Scientific and Technical Information of China (English)

    游一平; 李晨辉; 唐雅兵; 王诗章

    2014-01-01

    目的探讨正常双胎晚期妊娠孕妇氨基末端脑钠肽前体(NT-proBNP)水平的正常值范围,为临床应用提供指导。方法用免疫电化学发光法测定本院758例正常双胎晚期妊娠孕妇血清 NT-proBNP水平,并根据孕周不同进一步将758例正常双胎晚期妊娠孕妇分为3个亚组,即 A组(孕28~31+6周)、B组(32~35+6周)、C组(≥孕36周),并比较三组NT-proBNP水平。结果正常双胎晚期妊娠孕妇NT-proBNP水平为(60.44±42.02)pg/mL,A、B、C三组血清NT-proBNP值分别为(29.55±25.49)pg/mL、(86.28±54.25)pg/mL、(66.69±31.44)pg/mL,A组与B、C组比较,A组血清NT-proBNP水平明显低于B组与C组,且差异有显著性(P0.05)。结论本组测得正常双胎晚期妊娠孕妇 NT-proBNP水平,样本量较大,其结果可以初步确立正常双胎晚期妊娠孕妇NT-proBNP参考值的范围。%Obj ective]To explore normal value range of brain natriuretic peptide(amino terminal pro-brain natriuretic peptide,NT-proBNP)level in normal late pregnant women with twin pregnancy so as to provide the guidance for clinical application.[Methods]Serum NT-proBNP level in 758 normal twin pregnant women of our hospital was determined by immune electrochemical luminescence method.According to gestational weeks,758 normal late pregnant women with twin pregnancy were further divided into 3 subgroups including group A(28~31+6 gestational weeks),group B(32~35+6 gestational weeks)and group C(≥36 gestational weeks).The levels of NT-proBNP among 3 groups were compared.[Results]The levels of NT-proBNP in normal late preg-nant women with twin pregnancy were (60.44±42.02)pg/mL,and those in group A,B and C were (29.55± 25.49)pg/mL,(86.28±54.25)pg/mL and (66.69±31.44)p/mL,respectively.The levels of NT-proBNP in group A were obviously lower than those in group B and C,and there was significant difference(P 0.05).[Conclusion]In this group, NT-proBNP level in normal late pregnant women with twin pregnancy is determined

  16. 胎儿纤维连接蛋白联合宫颈长度检测对双胎妊娠早产的预测价值%Study on the predictive value of fetal fibronectin combined with measurement of cervical length in detection of premature birth of twin ;pregnancy

    Institute of Scientific and Technical Information of China (English)

    郝静; 李彦军

    2016-01-01

    Objective To explore the predictive value of combined detection of fetal fibronectin( fFN)and measurement of length of cer-vical tube( CL)in detecion of premature birth of twin pregnancy. Methods The clinical data of 64 cases of twin pregnancy in pregnant women with vaginal fornix secretion for detection of fetal fibronectin( fFN)during 26 to 32 weeks,and color Doppler ultrasound had been applied for de-tection of length of cervical tube in this hospital were collected and their outcomes of pregnancy were predicted. The sensitivity,specificity and pos-itive predictive value of fFN and CL were observed and combined with prediction of preterm delivery in twin pregnancy. Results In the positive predictive value of fFN and CL in twin pregnancy and preterm delivery,its sensitivity was 73. 33%,specificity was 65. 31%,and positive predic-tive value was 39. 29%. The significance of length of cervical tube equal to or less than 25 mm had been applied for prediction of premature birth of twin pregnancy and its sensitivity for preterm delivery was 68. 42%,its specificity was 62. 22% and its positive predictive value was 43. 33%. The sensitivity of combination detection was 84. 62%,its specificity was 94. 74%,and its positive predictive value was 91. 67%,and the differ-ence in sensitivitty of detection with combination of positive fFN and CL≤25 was not significant,and the difference in specificity and positive pre-dictive value was statistically significant( P ﹤0. 05). Conclusion For twin pregnancy,the specificity and positive predictive value of fFN detec-tion combined with ultrasound measurement of length of cervical tube have been applied for prediction of premature birth of twin pregnancy,al-though the difference in sensitivity is not significant,but their specificity and positive predictive value in prediction of preterm delivery have statisti-cal difference and clinical significance in application for prediction of preterm delivery. of twin pregnancy.%目的:探

  17. Heterotopic pregnancy following ovulation induction by Clomiphene and a healthy live birth: a case report

    Directory of Open Access Journals (Sweden)

    Honarbakhsh Abbas

    2008-12-01

    Full Text Available Abstract Introduction A heterotopic pregnancy is defined as the presence of a combined intrauterine and ectopic pregnancy. Its estimated incidence is accepted as between 1/7000 and 1/30,000 pregnancies. It is also reported to be as high as 1% after the use of assisted reproductive technology, but Clomiphene Citrate which increases the rate of twinning, could be associated with a heterotopic pregnancy rate of 1/900, which is much less than using assisted reproductive technology. Heterotopic pregnancies are diagnostic and therapeutic challenges for obstetricians. If they continue without diagnosis, a life-threatening situation may occur even when surgical intervention with laparotomy is performed. Case presentation We present the case of a 22-year-old Iranian woman who developed a simultaneous extra -and intrauterine pregnancy after the induction of ovulation with Clomiphene. In this case, there was a delay in the detection of the ectopic pregnancy component resulting in an emergency laparotomy being performed. Fortunately after the laparotomy, the intrauterine pregnancy was not affected and it progressed satisfactorily until 37 weeks. A healthy male baby was delivered by caesarean section. Conclusion This case suggests that a heterotopic pregnancy must always be considered in patients presenting with pelvic pain even in a confirmed intrauterine pregnancy, particularly after the induction of ovulation by Clomiphene Citrate or assisted reproductive technology. Every clinician treating women of reproductive age should keep this diagnosis in mind. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.

  18. Monozygotic Monochorionic Twins Discordant for Trisomy 21: A Reason to Evaluate Both Fetuses: A Case Report.

    Science.gov (United States)

    Macatangga, Monica; De la Calle, Maria; Torres, Maria Luisa; Bartha, Jose Luis

    2016-01-01

    The occurrence of a discordant chromosomal abnormality in monozygotic twins is an extremely rare condition. We report the prenatal sonographic findings and cytogenetic studies in a monochorionic twin pregnancy discordant for severe fetal anomalies. Amniocentesis was normal for both twins. The pregnancy was managed conservatively, resulting in the delivery of discordant twins at 28 weeks. Cytogenetic analysis performed on cultured lymphocytes from peripheral blood revealed a mosaic 47XY+21 (in 2% of the cells)/46XY (in 98%) in the structurally normal twin, and a mosaic 47XY+21 (4%)/46XY (96%) for the abnormal twin. The abnormal neonate died shortly after delivery. The structurally normal twin survived without sequelae and had a normal karyotype 2 years later. This report adds to the literature a case of a monochorionic twin pregnancy with a mosaic fetus who gives his co-twin trisomic cells through placental vascular anastomoses, this twin being a chimera, highlighting the necessity of performing molecular genetics with polymorphic DNA markers to differentiate chimerism from mosaicism and define the origin of cell lines.

  19. Prenatal diagnosis and clinical management of a twin pregnancy consisting of a complete mole and coexisting fetus%双胎之一完全性葡萄胎的产前诊断及处理

    Institute of Scientific and Technical Information of China (English)

    戚庆炜; 向阳; 郝娜; 刘俊涛; 徐蕴华; 杨秀玉; 孙念怙

    2003-01-01

    目的探讨双胎之一完全性葡萄胎(a twin pregnancy consisting of a complete mole and coexisting fetus,CMCF)的产前诊断及处理.方法回顾性分析2例CMCF的临床资料.结果第1例患者在孕10周时,B超发现胎儿与葡萄胎胎盘共存,患者要求终止妊娠,刮宫物间期细胞荧光原位杂交(fluorescent in situ hybridization,FISH)和核型分析提示,胎儿与葡萄胎均为二倍体,证实为CMCF.第2例患者在孕21周时,B超发现胎儿与葡萄胎胎盘共存,B超引导下经腹壁绒毛活组织检查(活检)和羊膜腔穿刺,葡萄胎和羊水的间期细胞FISH和核型分析提示,胎儿与葡萄胎均为二倍体,证实为CMCF双胎之一完全性葡萄胎,患者继续妊娠,在孕28周时胎膜早破,因继发感染而行剖宫产终止妊娠,胎儿存活,胎盘、新生儿外周血的核型分析结果与产前诊断相符.结论产前一旦发现胎儿与葡萄胎胎盘共存,应立即进行CMCF和部分性葡萄胎(partial hydatidiform mole,PHM)的鉴别,如果绒毛和羊水行间期细胞FISH和核型分析为二倍体,则为CMCF,是否继续妊娠,需采取个体化原则;如果为三倍体,则为部分性葡萄胎,应及时终止妊娠.

  20. Lesão vascular da placenta condicionando RCIU e hidropisia fetal não imune em gestação gemelar Placental vascular lesion as cause of IUGR and nonimmune fetal hydrops in twin pregnanc

    Directory of Open Access Journals (Sweden)

    Nuno Ricardo Gonçalves Baptista Pereira

    2011-12-01

    Full Text Available As lesões vasculares da placenta constituem um grupo de entidades distintas, mas inter-relacionadas, em que se incluem os corioangiomas e a corangiomatose multifocal difusa. O corioangioma é uma lesão nodular expansiva com incidência de cerca de 1%. A corangiomatose multifocal difusa é rara (0,2% e predominante em placentas em idade gestacional inferior a 32 semanas. Os autores apresentam um caso de gestação gemelar monocoriônica/biamniótica, no qual um dos fetos, à 26ª semana de gestação, apresentou quadro de restrição de crescimento intrauterino, hidropisia e anemia associado à formação tumoral da placenta com vascularização aumentada verificada pela doplervelocimetria. O estudo anatomopatológico da placenta permitiu o diagnóstico de corangiomatose multifocal difusa. Este raro caso de corioangiomatose multifocal difusa com forma de apresentação pré-natal mimetizando a de um corioangioma comprova que a detecção ultrassonográfica de um tumor da placenta com vascularização aumentada deve suscitar outras hipótese diagnóstica, além do corioangioma.Placenta vascular lesions are a group of distinct yet related entities that include chorangiomas and diffuse multifocal chorangiomatosis. Chorangioma is an expansive nodular lesion with an incidence of about 1%. Diffuse multifocal chorangiomatosis is rare (0.2% and mostly seen in placentas before the 32nd gestational week. The authors present a case of a monochorionic/biamniotic twin pregnancy, in which, at the 26th gestational week, one fetus developed intrauterine growth restriction (IUGR, hydrops, and anemia associated with a tumor of the placenta with increased vascularization in the Doppler study. Pathological examination of the placenta diagnosed diffuse multifocal chorangiomatosis. This rare case report of diffuse multifocal chorangiomatosis with prenatal manifestations resembling those of a chorangioma proves that prenatal ultrasound detection of a placenta tumor

  1. Blood Chimerism in Dizygotic Monochorionic Twins During 5 Years Observation.

    Science.gov (United States)

    Dziegiel, M H; Hansen, M H; Haedersdal, S; Barrett, A N; Rieneck, K; Main, K M; Hansen, A T; Clausen, F B

    2017-04-19

    Dizygotic monochorionic twin pregnancies can result in blood chimerism due to in utero twin-to-twin exchange of stem cells. In this case, we examined the proportion of allogeneic red blood cells by flow cytometry and the proportion of allogeneic nucleated cells by digital polymerase chain reaction at 7 months and again at 5 years. We found an increase in the proportion of allogeneic cells from 63% to 89% in one twin, and a similar increase in autologous cells in the other twin from 57% to 84%. A paradigm for stem cell therapy could be modeled on this case: induction of tolerance and chimerism by antenatal transfusion of donor stem cells. The procedure would hold the promise of transplantation and tolerance induction without myeloablative conditioning for inheritable benign hematological diseases such as sickle cell disease and thalassemia. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. Oclusão da artéria umbilical como opção terapêutica em gestações com gêmeo acárdio Umbilical artery occlusion as a therapeutic option in pregnancy with acardiac twin

    Directory of Open Access Journals (Sweden)

    Júlio César de Faria Couto

    2004-07-01

    Full Text Available Gestação gemelar com gêmeo acárdio é um evento raro que se caracteriza pela presença de uma anastomose placentária entre o gêmeo doador, morfologicamente normal, e o gêmeo acárdio, levando à perfusão contra-corrente de um dos gêmeos. As principais complicações encontram-se associadas à prematuridade e insuficiência cardíaca do gêmeo normal secundária à sobrecarga circulatória. Várias modalidades terapêuticas têm sido propostas, mas não há consenso em relação aos resultados observados. A oclusão intra-fetal da artéria umbilical do gêmeo acárdio tem se mostrado um método de baixo custo, fácil execução e alta eficácia no controle da sobrecarga circulatória. Apresentamos dois casos com ablação intra-fetal e boa evolução. Uma gestação trigemelar na qual se realizou a ablação intra-fetal com 29 semanas, evoluindo com parto prematuro e nascimento de um recém-nascido em boas condições. Uma gestação gemelar cuja ablação foi realizada com 31 semanas e que evoluiu com rotura prematura de membranas e parto prematuro com nascimento de uma criança saudável.Twin pregnancy with an acardiac twin is a rare event characterized by the presence of a placentary arterial anastomosis between the pump twin, morfologically normal, and the acardiac twin, causing a reverse circulation in one of the twins. The major complications are associated with cardiac failure in the normal twin, which is due to circulatory overload and prematurity. Many therapeutic options have been proposed, but there is no consensus about which one is the best therapy. However, intrafetal ablation of the umbilical artery of the acardiac fetus proved to be an inexpensive method that is easy to perform and highly efficient in controlling circulatory overload. We presented two cases of intra-fetal ablation and good evolution. A triplet pregnancy in which the intra-fetal ablation was done in a 29-week-old fetus that evolved to premature delivery of

  3. Psychological vulnerability of singleton children after the 'vanishing' of a co-twin following assisted reproduction.

    Science.gov (United States)

    De Pascalis, Leonardo; Monti, Fiorella; Agostini, Francesca; Fagandini, Piergiuseppina; La Sala, Giovanni B; Blickstein, Isaac

    2008-02-01

    We test the hypothesis that parents who conceived twins by assisted reproduction technology (ART), but experienced loss of one twin, have a different parental-child relationship compared with ART parents following a singleton pregnancy. We used the 1994-2005 ART database of the Centre for Infertility of the Arcispedale Santa Maria Nuova in Reggio Emilia, Italy to identify families of 53 singleton births after the 'vanishing' twin syndrome. The controls comprised 106 families who conceived and delivered singletons, matched for gestational age (>or= 28 or= 32 or= 37 weeks), maternal age (or= 35 40 years), child's age (1-3, 4-6, and 7-11 years) and child's gender. We completed 3 tests: a sociodemographic questionnaire, the QUIT - Italian Questionnaires of Temperament - motor scale, and the Child Vulnerability Scale. We found that children in the study had significantly more difficulties at the beginning of nursery school (p = .002) and kindergarten (p = .0005), with more frequent anxiety of separation from the parents (nursery school, p = .009; kindergarten, p = .001). We found a lower mean QUIT motor score for the 7- to 11-year-old children when compared to the general Italian normative values, suggesting that parents perceived their children as having more motor difficulties. In contrast, analysis of the Child Vulnerability Scale showed that significantly more parents (15.1%) from the controls perceived their child as vulnerable compared to those from the study group (3.8%), p = .034. We conclude that despite the perceived motor difficulties and the difficulties in the process of individuation-separation that appear at the beginning of the different educational circumstances, parents of singletons following the 'vanishing' twin syndrome perceive their children as 'invincible', and thus less vulnerable compared to controls.

  4. Analysis outcomes and complications of twin pregnancy by in vitro fertilization-embryotransfer and intracytoplasmic sperm injection%体外受精-胚胎移植与单精子卵胞浆内注射受孕双胎妊娠并发症及结局的比较

    Institute of Scientific and Technical Information of China (English)

    谢涛; 郑剑兰; 张小琼; 付景丽; 赵本华

    2013-01-01

    Objective:To investigate the outcomes and complications of twin pregnancy by in vitro fertilization-embryotransfer (IVF-ET) and intracytoplasmic sperm injection (ICSI).Methods:A retrospective study was carried out to measure premature rupture of membrane,placental abruption,pregnancy-induced hypertension,intrahepatic cholestasis of pregnancy and abortion,437 twin pregnant women who achieved pregnancy by IVF-ET or ICSI in our hospital from February,2004 to May,2011 had participated the study.Results:Incidences of premature rupture of membrane and placental abruption in IVF-ET group were significant higher than in ICSI group (x2 =5.93,6.01 ; P < 0.05) ; Ratios of pregnancy-induced hypertension and intrahepatic cholestasis of pregnancy between IVF-ET and ICSI group were no significant differences (x2 =2.68,1.37 ; P > 0.05) ; Ratio of abortion in IVF-ET group was significant higher than that in ICSI group (x2 =5.09; P < 0.05).Conclusion:The risk of twin pregnancy by IVF-ET is higher than by ICSI,IVF-ET and ICSI maybe are not the main cause of pregnancy-induced hypertension and intrahepatic cholestasis of pregnancy.%目的 比较体外受精-胚胎移植(IVF-ET)与单精子卵胞浆内注射(ICSI)受孕双胎妊娠围生期并发症及结局.方法 回顾性分析我院2004年2月~ 2011年5月437例IVF-ET、ICSI受孕双胎的并发症(如胎膜早破、胎盘早剥、妊娠期高血压疾病、妊娠期肝内胆汁淤积症)及妊娠结局(流产发生率).结果 IVF-ET受孕双胎组胎膜早破及胎盘早剥发生率高于ICSI受孕双胎组(x2=5.93,6.01;P<0.05);IVF-ET受孕双胎组与ICSI受孕双胎组妊娠期高血压疾病、妊娠期肝内胆汁淤积症发生率无统计学差异(x2=2.68,1.37; P>0.05); IVF-ET受孕双胎组较ICSI受孕双胎组流产率高,差异有统计学差异(x2 =5.09; P<0.05).结论 IVF-ET较ICSI受孕双胎妊娠风险较高,IVF-ET与ICSI本身可能不是导致妊娠期高血压疾病、妊娠期肝内胆汁淤积症的因素.

  5. 双(多)胎儿发生脑瘫的相关因素调查分析及早期干预对预后的影响%Related factor analysis of cerebral palsy in twin or multiple pregnancies and the effect of early intervention on prognosis

    Institute of Scientific and Technical Information of China (English)

    刘振玲; 何爽; 陈芳; 覃京; 黄秀丽

    2013-01-01

    Objective To explore the related factors of cerebral palsy in twin or multiple pregnancies ,and the effect of early intervention on prognosis .Methods One hundred and fifty nine cases of twin or multiple pregnancy from 86 families in the perinatal period were investigated by retrospective investigation and analysis method , and as-sessed them by Gesell scale at the same time, the results were comprehensively analyzed .Results There were 106 cases of cerebral palsy in 159 cases twin or multiple pregnancies , the cerebral palsy rate was 66.7%(106/159). There were 94 cases of cerebral palsy among 143 babies of twin or multiple pregnancies , the cerebral palsy rate was 65.7%(94/143).After the rehabilitation treatment, the cerebral palsy rate was 14.5%(23/159), There were many high risk factors of cerebral palsy , which in turn was premature birth, low birth weight, hyperbilirubinemia, hypoxic ischemic encephalopathy, asphyxia, neonatal pneumonia, hypoglycemia, gestational diabetes, in-vitro fertilization and cesarean section.Conclusion Twin or multiple pregnancies are prong to premature birth; there were positive correlation between infantile cerebral palsy and their high risk factors .But early intervention could significantly re-duce the incidence of cerebral palsy , and the smaller age of rehabilitation therapy , the better results, and the optimal treatment time window was before 6 months age.%目的探讨双(多)胎儿发生脑瘫的相关因素及早期干预对预后的影响。方法采用回顾性调查分析的方法,对86个家庭的159例双胎或多胎患儿进行围产期调查,同时给予Gesell测评,并对结果进行综合分析。结果159例多(双)胎儿中诊断脑瘫106例,脑瘫发生率为66.7%,其中婴儿脑瘫94例(65.7%),康复治疗后治愈83例,最终脑瘫发生率为14.5%(23/159)。脑瘫的高危因素依次为早产、低出生体重、高胆红素血症、缺氧缺血性脑病、窒息、新生

  6. Successful pregnancy following medical management of heterotopic pregnancy

    Directory of Open Access Journals (Sweden)

    R Lavanya

    2009-01-01

    Full Text Available We present a case of sonographic demonstration of quadruplet heterotopic pregnancy consisting of twin intrauterine (IU pregnancy and a twin adnexal pregnancy after ovulation induction (OI with clomiphene citrate (CC and timed intercourse (TI. Both heterotopic pregnancy and spontaneous twinning are frequent after OI, this combination although extremely rare must be kept in mind. The role of early transvaginal sonography and serum beta human chorionic gonadotrophin after missed periods helps in early diagnosis. It gives us an opportunity for medical management, saving the patient the agony of surgery along with loss of pregnancy. The management of heterotopic pregnancy is controversial. This patient did not have a viable IU pregnancy and both the sacs in the adnexa were small. Thus, we treated her successfully by medical management with systemic methotrexate, with regular follow-up. This patient successfully conceived after 6 months with OI and TI, with ovulation occurring from the same side of the previous ectopic. She had a viable IU gestation corresponding to 12 weeks.

  7. Multiple Pregnancy

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Multiple Pregnancy Home For Patients Search FAQs Multiple Pregnancy Page ... Multiple Pregnancy FAQ188, July 2015 PDF Format Multiple Pregnancy Pregnancy How does multiple pregnancy occur? What are ...

  8. Pregnancy Complications

    Science.gov (United States)

    ... To receive Pregnancy email updates Enter email Submit Pregnancy complications Complications of pregnancy are health problems that ... pregnancy. Expand all | Collapse all Health problems before pregnancy Before pregnancy, make sure to talk to your ...

  9. Cancer risk in opposite-sex and same-sex twins

    DEFF Research Database (Denmark)

    Juel Ahrenfeldt, Linda

    2015-01-01

    Twin pregnancies are characterized by simultaneous development of two fetuses that share the womb. An interest in opposite-sex (OS) twins, twin pairs consisting of one male and one female, comes from animal studies that showed that exposure to sex hormones is influenced by the position of the fetus...... in the womb. Studies in rodents have shown that female fetuses developing between males are masculinized in several anatomical, physiological and behavioral traits....

  10. Feto-maternal outcome in twin pregnancy

    Directory of Open Access Journals (Sweden)

    Amiben V. Gajera

    2015-12-01

    Conclusions: Most of the complications in multiple gestations are preventable. High risk units in the obstetric ward and well developed NICU set up would reduce the maternal, perinatal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1836-1839

  11. Malaysian Twin Registry.

    Science.gov (United States)

    Jahanfar, Shayesteh; Jaffar, Sharifah Halimah

    2013-02-01

    The National Malaysian Twin Registry was established in Royal College of Medicine, Perak, University Kuala Lumpur (UniKL) in June 2008 through a grant provided by UniKL. The general objective is to facilitate scientific research involving participation of twins and their family members in order to answer questions of health and wellbeing relevant to Malaysians. Recruitment is done via mass media, poster, and pamphlets. We now have 266 adult and 204 children twins registered. Several research projects including reproductive health study of twins and the role of co-bedding on growth and development of children are carried out. Registry holds annual activities for twins and seeks to provide health-related information for twins. We seek international collaboration.

  12. The Brazilian Twin Registry.

    Science.gov (United States)

    Ferreira, Paulo H; Oliveira, Vinicius C; Junqueira, Daniela R; Cisneros, Lígia C; Ferreira, Lucas C; Murphy, Kate; Ordoñana, Juan R; Hopper, John L; Teixeira-Salmela, Luci F

    2016-12-01

    The Brazilian Twin Registry (BTR) was established in 2013 and has impelled twin research in South America. The main aim of the initiative was to create a resource that would be accessible to the Brazilian scientific community as well as international researchers interested in the investigation of the contribution of genetic and environmental factors in the development of common diseases, phenotypes, and human behavior traits. The BTR is a joint effort between academic and governmental institutions from Brazil and Australia. The collaboration includes the Federal University of Minas Gerais (UFMG) in Brazil, the University of Sydney and University of Melbourne in Australia, the Australian Twin Registry, as well as the research foundations CNPq and CAPES in Brazil. The BTR is a member of the International Network of Twin Registries. Recruitment strategies used to register twins have been through participation in a longitudinal study investigating genetic and environmental factors for low back pain occurrence, and from a variety of sources including media campaigns and social networking. Currently, 291 twins are registered in the BTR, with data on demographics, zygosity, anthropometrics, and health history having been collected from 151 twins using a standardized self-reported questionnaire. Future BTR plans include the registration of thousands of Brazilian twins identified from different sources and collaborate nationally and internationally with other research groups interested on twin studies.

  13. Preterm delivery after fetoscopic laser surgery for twin-twin transfusion syndrome: etiology and risk factors.

    Science.gov (United States)

    Malshe, A; Snowise, S; Mann, L K; Boring, N; Johnson, A; Bebbington, M W; Moise, K J; Papanna, R

    2017-05-01

    Preterm delivery after fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS) is a major complication. The causative factors leading to preterm delivery continue to be elusive and a better understanding of the risk factors could reduce complications. The objective of this study was to determine the etiology of preterm delivery after FLS for TTTS and its associated risk factors. This was a secondary analysis of a prospective study of 203 patients with TTTS who underwent FLS at a single center between September 2011 and December 2014. Preoperative, operative, postoperative, delivery and neonatal data were reviewed. Preterm delivery was categorized according to etiology into three groups: spontaneous (SPT), indicated (IND) and elective (ELC). Comparisons between groups were performed by ANOVA. Kaplan-Meier survival analysis was performed to compare the procedure-to-delivery interval between groups. To identify risk factors for preterm delivery, logistic regression, with calculation of relative risks (RR), was performed, with P preterm prelabor rupture of membranes (iPPROM) occurred in 39% of cases. SPT preterm delivery occurred in 97 (48%) patients, IND preterm delivery in 65 (32%) and ELC preterm delivery in 41 (20%). In the IND group, 30 (46%) patients delivered for fetal indications, 31 (48%) for maternal indications and four (6%) for combined fetal and maternal indications. The overall chorioamnionitis rate was 6.4%; of these, nine (9%) were in the SPT group and four (6%) were in the IND group, with no case occurring in the ELC group. There was a significant difference in procedure-to-delivery interval between groups (P preterm delivery were iPPROM (RR, 16.2 (95% CI, 4.5-57.7)), preoperative cervical length (RR, 0.96 (95% CI, 0.92-0.998)) and number of anastomoses (RR, 1.14 (95% CI, 1.02-1.27)). Significant risk factors for IND preterm delivery were iPPROM (RR, 9.6 (95% CI, 2.6-35.0)) and number of ablated anastomoses (RR, 1.13 (95% CI, 1

  14. Spontaneous reduction of advanced twin embryos: its occurrence and clinical relevance in dairy cattle.

    Science.gov (United States)

    López-Gatius, F; Hunter, R H F

    2005-01-01

    Twin pregnancies represent a management problem in dairy cattle since the risk of pregnancy loss increases, and the profitability of the herd diminishes drastically as the frequency of twin births increases. The aim of this study was to monitor the development of 211 twin pregnancies in high producing dairy cows in order to determine the best time for an embryo reduction approach. Pregnancy was diagnosed by transrectal ultrasonography between 36 and 42 days after insemination. Animals were then subjected to weekly ultrasound examination until Day 90 of gestation or until pregnancy loss. Viability was determined by monitoring the embryonic/fetal heartbeat until Day 50 of pregnancy, and then by heartbeat or fetal movement detection. Eighty-six cows (40.8%) bore bilateral and 125 (59.2%) unilateral twin pregnancies. Embryo death was registered in one of the two embryos in 35 cows (16.6%), 33 of them at pregnancy diagnosis. Pregnancy loss occurred in 22 of these cows between 1 and 4 weeks later. Thus, 13 (6.2% of the total animals) cows, carrying one dead of the two embryos, maintained gestation. Total pregnancy loss before Day 90 of pregnancy (mean 69 +/- 14 days) was registered in 51 (24.2%) cows: 7 (8%) of bilateral pregnancies and 44 (35.2%) of unilateral pregnancies, and it was higher (P = 0.0001) for both right (32.4%, 24/74) and left (39.2%, 20/51) unilateral than for bilateral (8.1%, 7/86) twin pregnancies. The single embryo death rate was significantly (P = 0.02) lower for cows with bilateral twins (9.3%, 8/86) than for total cows with unilateral twins (21.6%, 27/125). By way of overall conclusion, embryo reduction can occur in dairy cattle, and the practical perspective remains that most embryonic mortality in twins (one of the two embryos) occurs around Days 35-40 of gestation, the period when pregnancy diagnosis is generally performed and when embryo reduction could be tried.

  15. Successful fetoscopic laser coagulation for twin-to-twin transfusion syndrome under local anaesthesia.

    LENUS (Irish Health Repository)

    Cooley, S

    2011-06-01

    A review of the efficacy and outcome of fifteen fetoscopic laser ablations under local anaesthesia for twin to twin transfusion syndrome (TTTS) in the National Maternity Hospital Dublin was undertaken. The mean gestation at laser was 19.7 weeks (range 16-25 weeks) with a mean gestation at delivery of 29.1 weeks (range 20-35 weeks). The overall liveborn birth rate was 79% (22 infants) and one pregnancy was still ongoing. There were four neonatal deaths secondary to complications of prematurity. The surviving eighteen infants (64%) undergo regular paediatric review. The procedure was performed successfully in all cases with local anaesthesia. In no case was there maternal discomfort that warranted the procedure to be abandoned and good visual access of the vascular anastamoses was obtained in all cases. Local anaesthesia therefore offers a safe effective anaesthetic option for fetoscopic laser coagulation in monochorionic pregnancies complicated by TTTS.

  16. Prenatal diagnosis of heterokaryotypic mosaic twins discordant for fetal sex.

    Science.gov (United States)

    Schmid, O; Trautmann, U; Ashour, H; Ulmer, R; Pfeiffer, R A; Beinder, E

    2000-12-01

    The presence of a monozygotic twin gestation with discordant sex of the twins is a very rare constellation, which is referred to as heterokaryotypic monozygotic pregnancy. This constellation can develop either due to a chromosomal aberration after twinning or is - as in the following case - due to a mitotic error before twinning and an unequal distribution of mosaicism in both embryos. So far the diagnosis of heterokaryotypic monozygotic pregnancy has always been made postnatally, with only one exception (Gonsoulin et al., 1990). In this case we suspected the presence of monozygotic twins ultrasonically because of the chorionic and amniotic membrane characteristics. Surprisingly the sex of the fetuses was discrepant. As one of them had hydrops and a structural heart defect, we carried out an amniocentesis, which revealed mosaicism [45,X/46,X,i(Y)(p10)] of both fetuses. The female fetus with a predominant 45,X set of chromosomes and the typical intrauterine signs of the Ullrich-Turner syndrome (massive hygroma colli, hydrops fetalis and multiple cardiac defects) died during the 25th week of gestation due to cardiac decompensation. The other fetus appeared to be male with a predominance of a 46,X,i(Y)(p10) set of chromosomes and was born a few days after the intrauterine death of the hydropic fetus. In conclusion, our observation shows that ultrasonic evidence of discordant fetal sex in twins does not necessarily exclude monozygosity. Copyright 2000 John Wiley & Sons, Ltd.

  17. Twin anemia polycythemia sequence

    NARCIS (Netherlands)

    Slaghekke, Femke

    2014-01-01

    In this thesis we describe that Twin Anemia Polycythemia Sequence (TAPS) is a form of chronic feto-fetal transfusion in monochorionic (identical) twins based on a small amount of blood transfusion through very small anastomoses. For the antenatal diagnosis of TAPS, Middle Cerebral Artery – Peak Syst

  18. The Danish Twin Registry

    DEFF Research Database (Denmark)

    Skytthe, Axel; Ohm Kyvik, Kirsten; Vilstrup Holm, Niels

    2011-01-01

    Introduction: The Danish Twin Registry is a unique source for studies of genetic, familial and environmental factors on life events, health conditions and diseases. Content: More than 85,000 twin pairs born 1870-2008 in Denmark. Validity and coverage: Four main ascertainment methods have been emp...

  19. Twin anemia polycythemia sequence

    NARCIS (Netherlands)

    Slaghekke, Femke

    2014-01-01

    In this thesis we describe that Twin Anemia Polycythemia Sequence (TAPS) is a form of chronic feto-fetal transfusion in monochorionic (identical) twins based on a small amount of blood transfusion through very small anastomoses. For the antenatal diagnosis of TAPS, Middle Cerebral Artery – Peak

  20. Twin-to-twin transfusion syndrome: an anti-angiogenic state?

    Science.gov (United States)

    KUSANOVIC, Juan Pedro; ROMERO, Roberto; ESPINOZA, Jimmy; NIEN, Jyh Kae; KIM, Chong Jai; MITTAL, Pooja; EDWIN, Sam; EREZ, Offer; GOTSCH, Francesca; MAZAKI-TOVI, Shali; THAN, Nandor G.; SOTO, Eleazar; CAMACHO, Natalia; GOMEZ, Ricardo; QUINTERO, Ruben; HASSAN, Sonia S.

    2008-01-01

    Objective An imbalanced chronic blood flow between the donor and recipient twin through placental vascular anastomoses is the accepted pathophysiology of twin-to-twin transfusion syndrome (TTTS). Vascular endothelial growth factor receptor-1 (VEGFR-1) mRNA is overexpressed only in the syncytiotrophoblast of the donor twin in some cases of TTTS. This study was conducted to determine maternal plasma concentrations of placental growth factor (PlGF), soluble VEGFR-1, and soluble endoglin (s-Eng) in monochorionic-diamniotic pregnancies with and without TTTS. Study design This case-control study included monochorionic-diamniotic pregnancies between 16–26 weeks with and without TTTS. Maternal plasma concentrations of PlGF, sVEGFR-1 and s-Eng were determined with ELISA. A p-value <.05 was considered statistically significant. Results Patients with TTTS had higher median plasma concentrations of s-Eng [14.8 ng/ml vs. 7.8 ng/ml; p<0.001] and sVEGFR-1 [6383.1 pg/ml vs. 3220.1 pg/ml; p<0.001]; and lower median plasma concentrations of PlGF [115.5 pg/ml vs. 359.3 pg/ml; p=0.002] than those without TTTS. Conclusions We propose that an anti-angiogenic state may be present in some cases of TTTS. PMID:18395032

  1. Risk of hypertensive disorders in pregnancies following assisted reproductive technology

    DEFF Research Database (Denmark)

    Opdahl, S; Henningsen, A A; Tiitinen, A

    2015-01-01

    STUDY QUESTION: Is the risk of hypertensive disorders in pregnancies conceived following specific assisted reproductive technology (ART) procedures different from the risk in spontaneously conceived (SC) pregnancies? SUMMARY ANSWER: ART pregnancies had a higher risk of hypertensive disorders......, in particular following cryopreservation, with the highest risk seen in twin pregnancies following frozen-thawed cycles. WHAT IS KNOWN ALREADY: The risk of hypertensive disorders is higher in ART pregnancies than in SC pregnancies. The increased risk may be partly explained by multiple pregnancies...... twin pregnancies (46 674). We used logistic regression to estimate adjusted odds ratios and risk differences for hypertensive disorders in pregnancies following IVF, ICSI and fresh or frozen-thawed cycles. We also compared fresh and frozen-thawed cycles within mothers who had conceived following both...

  2. Impact of Monochorionicity and Twin to Twin Transfusion Syndrome on Prenatal Attachment, Post Traumatic Stress Disorder, Anxiety and Depressive Symptoms.

    Science.gov (United States)

    Beauquier-Maccotta, Berengere; Chalouhi, Gihad E; Picquet, Anne-Laure; Carrier, Aude; Bussières, Laurence; Golse, Bernard; Ville, Yves

    2016-01-01

    Monochronioric (MC) twin pregnancies are considered as high-risk pregnancies with potential complications requiring in-utero interventions. We aimed to assess prenatal attachment, anxiety, post-traumatic stress disorder (PTSD) and depressive symptoms in MC pregnancies complicated with Twin-To-Twin-transfusion syndrome (TTTS) in comparison to uncomplicated monochorionic (UMC) and dichorionic pregnancies (DC). Auto-questionnaires were filled out at diagnosis of TTTS and at successive milestones. Prenatal attachment, PTSD, anxiety and perinatal depression were evaluated respectively by the Prenatal Attachment Inventory (PAI) completed for each twin, the Post-traumatic Checklist Scale (PCLS), the State-Trait Anxiety Inventory (STAI) and the Edinburgh Perinatal Depression Scale (EPDS). There was no significant difference in the PAI scores between the two twins. In the DC and UMC groups, PAI scores increased throughout pregnancy, whilst it didn't for TTTS group. TTTS and DC had a similar prenatal attachment while MC mothers expressed a significantly higher attachment to their fetuses and expressed it earlier. At the announcement of TTTS, 72% of the patients present a score over the threshold at the EPDS Scale, with a higher score for TTTS than for DC (p = 0.005), and UMC (p = 0.007) at the same GA. 30% of mothers in TTTS group have PTSD during pregnancy. 50% of TTTS- patients present an anxiety score over the threshold (STAI-Scale), with a score significantly higher in TTTS than in UMC (pPTSD, high level of anxiety and an alteration of the prenatal attachment. These results should guide the psychological support provided to these patients.

  3. Twin Reversed Arterial Perfusion (TRAP Sequence; Characteristic Gray-Scale and Doppler Ultrasonography Findings

    Directory of Open Access Journals (Sweden)

    Buyukkaya

    2015-07-01

    Full Text Available Twin reversed arterial perfusion (TRAP sequence is a syndrome with poor prognosis, seen only in monochorionic monozygotic twin pregnancies. The incidence is one in 35.000 births and one in 100 monozygotic twin pregnancies. It is characterized with a recipient fetus exhibiting lethal anomalies including acardia and a pump fetus. Mortality is usually due to heart failure or premature labor caused by polyhydramnios of pump fetus. Herein, we report a case of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in the diagnosis and management of TRAP sequence.

  4. Twin Reversed Arterial Perfusion (TRAP) Sequence; Characteristic Gray-Scale and Doppler Ultrasonography Findings.

    Science.gov (United States)

    Buyukkaya, Ayla; Tekbas, Guven; Buyukkaya, Ramazan

    2015-07-01

    Twin reversed arterial perfusion (TRAP) sequence is a syndrome with poor prognosis, seen only in monochorionic monozygotic twin pregnancies. The incidence is one in 35.000 births and one in 100 monozygotic twin pregnancies. It is characterized with a recipient fetus exhibiting lethal anomalies including acardia and a pump fetus. Mortality is usually due to heart failure or premature labor caused by polyhydramnios of pump fetus. Herein, we report a case of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in the diagnosis and management of TRAP sequence.

  5. Delayed interval delivery after intrauterine infection and immature birth of twin 1--a case report and literature review.

    Science.gov (United States)

    de Jong, M W; Pinas, I M; van Eijck, J

    1995-11-01

    We report a case of delayed interval delivery in a twin pregnancy complicated by rupture of membranes, intrauterine infection and birth of one twin at 21 weeks gestation. Tocolysis combined with antibiotics and corticosteroids successfully prolonged pregnancy for 73 days, allowing the second twin to mature and reach viability. At 31.5 weeks gestation, a 1890 g healthy male neonate was born with good Apgar scores. His postnatal course was uneventful. A literature review of several other cases of delayed interval delivery is presented. When multifetal pregnancies are complicated by immature birth of one fetus, delayed interval delivery may offer survival chances and favourable outcome for the remaining fetus(es).

  6. 胎儿纤维连接蛋白联合宫颈长度在双胎妊娠早产的诊断价值%The value of fetal fibronectin combined with cervical length detection in diagnosis of preterm birth in twin pregnancy

    Institute of Scientific and Technical Information of China (English)

    李光莲; 陈丹玲

    2015-01-01

    目的:探讨胎儿纤维连接蛋白(fFN)与宫颈长度(CL)联合检测对双胎妊娠早产的预测价值。方法选择我院2013年10月1日~2014年9月30日期间收治的80例双胎妊娠孕妇的资料进行研究,患者在孕中期20~32周之间定期进行阴道超声 CL 测量,同时在孕22~30周之间定期联合测定 fFN,观察并分析 fFN 联合 CL 检测对预测早产的价值。结果以宫颈长度≤25 mm 为异常,80例双胎妊娠孕妇中,共38例孕妇的宫颈长度≤25 mm,其中 fFN(+)25例, fFN(-)13例,fFN(+)组共23例于孕37周前分娩,早产率高达92.00%,而 fFN(-)组仅6例于孕37周前分娩,早产率为46.15%,fFN(+)组与 fFN(-)组早产率比较差异具有统计学意义(P <0.05)。结论 fFN 联合 CL 检测是一种客观、有效的双胎妊娠早产预防方法,具有较高的早产预测价值,值得在临床上推广使用。%Objective To evaluate the value of fetal fibronectin (fFN)combined with cervical length (CL) detection for predicting preterm birth in twin pregnancies. Methods The data analysis was done for 80 cases of twin pregnancy pregnant women cared at our hospital from October 1,2013 to September 30,2014,patients in the mid 20~32 weeks of pregnancy received a regular vaginal ultrasound cervical length measurement,at the same time during 22 to 30 weeks received regular combined fFN determination.Observed and analyzed the val-ue of combination detection of fFN and CL in predicting preterm birth. Results The abnormal criteria was cervical length ≤25 mm.Thirty-eight of 80 cases of twin pregnancy in pregnant women had cervical length ≤25 mm,including 25 fFN (+)cases,13 fFN (-)cases.In the fFN (+)group,23 cases had childbirth before 37 weeks ,premature birth rate was as high as 92.00%,and in the fFN (-)group only 6 cases had childbirth before 37 weeks,premature birth rate was 46.15%,compared of premature birth rate between fFN (+)group and fFN (-)group yielded statistically significant difference (P < 0

  7. Digitalization of the mother in treating hydrops fetalis in monochorionic twin with Ebstein's anomaly. Case report.

    Science.gov (United States)

    Koike, T; Minakami, H; Shiraishi, H; Ogawa, S; Matsubara, S; Honma, Y; Sato, I

    1997-01-01

    Hydrops fetalis thought to be due to Ebstein's anomaly was seen at 22 weeks' gestation in one of two fetuses with a monochorionic placenta. Hydrops was treated with maternal digitalization and resolved by the 28th week of gestation. Hydrops did not recur while maternal digitalization continued. A clinical diagnosis of twin-to-twin transfusion syndrome required termination of the pregnancy at 33 weeks of gestation. The twin with Ebstein's anomaly died 22 hours after birth. The other twin survived and was normal at 19 months of age. Thus, administration of digitalis to the mother controlled hydrops fetalis in one fetus, and ultimately led to the survival of the healthy infant.

  8. Dicephalus parapagus conjoined twins discordant for anencephaly: a case report

    Directory of Open Access Journals (Sweden)

    Udo Jacob J

    2010-02-01

    Full Text Available Abstract Introduction Cases of conjoined twins occur so rarely that it is important to learn as much as possible from each case. Case presentation We present a case of 9-hour-old, female, Nigerian dicephalus parapagus conjoined twins discordant for anencephaly diagnosed only after the birth of the twins. The anencephalic twin was stillborn while the normal one died within 9 hours of birth from cardiopulmonary failure. Conclusion Many congenital defects of interest can now be detected before birth. A severe lesion such as that found in our index case, which is incompatible with postnatal life, requires counselling. If detected early enough during a properly monitored antenatal care, it may indicate termination of pregnancy.

  9. Infertility, infertility treatment and twinning: the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten

    2007-01-01

    BACKGROUND: We have previously observed that an increasing time to pregnancy (TTP) is associated with a reduced frequency of twin deliveries in couples not receiving infertility treatment. By using updated information, we assessed the frequencies of dizygotic (DZ) and monozygotic (MZ) twin...... deliveries as a function of infertility (TTP > 12 months), as well as infertility treatment. METHODS: From the Danish National Birth Cohort (1997-2003), we identified 51 730 fertile couples with TTP 12 months and 5163 infertile couples who conceived after treatment. Information on zygosity, available...... for part of the cohort (1997-2000), was based on standardized questions on the similarities between the twins at the age of 3-5 years. RESULTS: Compared with fertile couples, the frequency of DZ twin deliveries was lower for infertile couples conceiving naturally (odds ratio 0.4, 95% confidence interval 0...

  10. Fetal echocardiographic screening in twins for congenital heart diseases

    Institute of Scientific and Technical Information of China (English)

    LI Hui; MENG Tao; SHANG Tao; GUAN Yun-ping; ZHOU Wei-wei; YANG Guang; BI Li-hua

    2007-01-01

    Background Congenital heart disease (CHD) is the most common congenital disorder at birth. Yagel and colleagues's method of heart examination has been proved valuable in finding CHD prenatally in single pregnancies. The aim of this study was to analyze the frequency of CHD in twin pregnancies and the sensitivity of the method.Methods A total of 1103 pregnant women with twins were enrolled in this study, including 127 cases with high-risk for CHD. Five transverse ultrasound measurements were used for fetal heart examination, including the upper abdomen view, four-chamber view, five-chamber view, pulmonary artery bifurcation view, and three-vessel view. In the fetuses who were diagnosed with CHD and whose parents requested termination of the pregnancy, autopsy of the fetal heart was performed after an abortion, and a blood sample was collected from the heart for chromosome evaluation. In the other fetuses, a close follow-up was conducted by echocardiography within one year after birth.Results Antenatally, CHD was found in 12 twins, of which 4 were from the high-risk group (3.15%), and 8 from the low-risk group (0.82%). In 2 pairs of the twins, the two fetuses had a same kind of CHD (one pair had tetralogy of Fallot (TOF), another pair had rhabdomyoma). Another pair had different types of anomaly (one fetus had TOF, and the other duodenal atresia with a normal heart). Termination of pregnancy was performed in these three pairs and the autopsy of the fetal heart confirmed the ultrasound findings. In the other 9 pairs, CHD was detected in one fetus, and a normal heart in the others. In the cases who received chromosome evaluation, 2 had abnormal chromosomes. During the follow-up after birth, heart examinations confirmed the prenatal diagnosis in 7 of the 9. The diagnosis of CHD was missed antenatally in 2 pairs of twins. In both the cases, one fetus was normal, and the other was confirmed as having CHD after birth (small ventricle septum defect in one, and persistent

  11. Term twin birth - impact of mode of delivery on outcome.

    Science.gov (United States)

    Ylilehto, Elina; Palomäki, Outi; Huhtala, Heini; Uotila, Jukka

    2017-05-01

    The main aims of this study were to compare maternal and neonatal outcomes in term twin birth according to the planned mode of delivery and to study the effects of chorionicity and inter-twin delivery time on neonatal outcome. A single-center cohort study of 495 women with twin deliveries at ≥37(+0) weeks of gestation. Term twin deliveries were divided into a trial of labor group (TOL, 69.3%) and a planned cesarean section (CS) group (30.7%). The primary outcomes were maternal and neonatal morbidity. 80.8% of women attempting TOL achieved vaginal birth. In the TOL group, mothers had less bleeding [median 500 mL (range 150-2700 mL) vs. 950 mL (range 150-3500 mL), p delivery time exceeded 30 min. TOL is a good option for women with twin pregnancy at term, regardless of chorionicity. Active management of labor for the second twin is important, also in DC births. Maternal outcomes were more favorable with TOL and although low Apgar scores and low umbilical blood pH may be more frequent after TOL - especially with the second twin - serious neonatal morbidity is rare and does not differ from that after planned CS. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. Prenatal x-ray exposure and childhood cancer in twins

    Energy Technology Data Exchange (ETDEWEB)

    Harvey, E.B.; Boice, J.D. Jr.; Honeyman, M.; Flannery, J.T.

    1985-02-28

    A case-control study was conducted to investigate the relation between prenatal exposure to x-rays and childhood cancer, including leukemia, in over 32,000 twins born in Connecticut from 1930 to 1969. Twins as opposed to single births were chosen for study to reduce the likelihood of medical selection bias, since twins were often exposed to x-rays to diagnose the twin pregnancy or to determine fetal positioning before delivery and not because of medical conditions that may conceivably pre-dispose to cancer. Each of 31 incident cases of cancer, identified by linking the Connecticut twin and tumor registries, was matched with four twin controls according to sex, year of birth, and race. Records of hospitals, radiologists, and private physicians were searched for histories of x-ray exposure and other potentially important risk factors. Documented prenatal x-ray exposures were found for 39 per cent of the cases (12 of 31) and for 26 per cent of the controls (28 of 109). No other pregnancy, delivery, or maternal conditions were associated with cancer risk except low birth weight: 38 per cent of the cases as compared with 25 per cent of the controls weighed under 2.27 kg at birth. When birth weight was adjusted for, twins in whom leukemia or other childhood cancer developed were twice as likely to have been exposed to x-rays in utero as twins who were free of disease (relative risk, 2.4; 95 per cent confidence interval, 1.0 to 5.9). The results, though based on small numbers, provide further evidence that low-dose prenatal irradiation may increase the risk of childhood cancer.

  13. IKAP模式护理干预对双胎妊娠妇女心理状态、分娩结局及满意度的影响%Effect of IKAP theory on twin pregnancy women′s psychological states, satisfaction and childbirth ;outcomes

    Institute of Scientific and Technical Information of China (English)

    贾曼; 廖碧珍

    2016-01-01

    Objective To evaluate the effect of IKAP(Information-Knowledge-Attitude-Practice) theory on twin pregnancy women′s psychological states, satisfaction and childbirth outcomes. Methods One hundred twin pregnancy women who had made registrations and antenatal examination were divided into the intervention group and the control group with 50 women in each group according to randorn digit table. The twin pregnancy women in the control group received routine antenatal examinations. In addition, the twin pregnancy women in the intervention group received a special health education with IKAP theory. The twin pregnancy women′s anxiety, depression, birth outcomes and satisfaction were measured and compared between the two groups. Results The score of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the intervention group was 27.64±2.86 and 26.53±2.96 one week after delivery, significantly lower than those upon admission, 44.18 ±2.53 and 47.42 ±4.82, the difference was statistically significant (t=5.41, 4.49, P0.05). In the intervention group the rate of cesarean section was 29.17% (14/48), and the score of satisfaction was (9.01±0.78), they were also significantly higher than those of the control group, 53.06%(26/49), (7.82±1.44), the difference was significant (χ2=7.701, t=4.806, P0.05). Conclusions The IKAP theory on twin pregnancy women can decrease the anxiety, depression and the rate of cesarean section, and increase patient satisfaction.%目的:探讨IKAP模式护理干预对双胎妊娠妇女焦虑抑郁状态评分、分娩结局及满意度的影响。方法将符合纳入标准的100例双胎妊娠妇女按随机数字表法分为干预组和对照组各50例。2组孕产妇除接受常规产检及一般护理外,对照组采用传统健康教育模式,干预组采用IKAP健康教育模式进行护理干预。比较2组在入组时、分娩后1周的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分情况,

  14. Decreased Brain and Placental Perfusion in Omphalopagus Conjoined Twins on Fetal MRI

    Directory of Open Access Journals (Sweden)

    Sureyya Burcu Gorkem

    2016-01-01

    Full Text Available The aim of this study is to evaluate perfusional changes in brain and placenta of omphalopagus conjoined twins and to compare them with singleton fetuses by using diffusion weighted imaging and apparent diffusion coefficient. Fetal MRIs of 28-week-old omphalopagus conjoined twins with a shared liver with two separate gallbladders and portal and hepatic venous systems and three singleton fetuses with unilateral borderline ventriculomegaly at the same gestational week as control group were enrolled retrospectively. There was a significant decrease in ADC values of brain regions (p=0.018 and placenta (p=0.005 of conjoined twins compared to the control group. The decreased ADC values in placenta and brain regions in conjoined twins might be due to decreased placental perfusion compared to singleton pregnancy. Our results would be a keystone for future studies which will compare larger group of monochorionic multiple pregnancies with singleton pregnancies.

  15. Birth size and age at menarche: a twin perspective.

    Science.gov (United States)

    Sørensen, Kaspar; Juul, Anders; Christensen, Kaare; Skytthe, Axel; Scheike, Thomas; Kold Jensen, Tina

    2013-10-01

    Do birthweight (BW) and co-twin sex influence the age at menarche in twins? BW, but not co-twin sex, was associated with age at menarche in twins. However, BW was not associated with age at menarche after controlling for genetics and shared rearing environment. Nutritional deprivation during critical developmental periods can trigger long-term effects on health. A small size at birth has been associated with early age at menarche in singletons. However, the relative influence of genetics and environmental factors on this association remains unresolved. In total, 2505 twin pairs were included in this cohort study. All participants were recruited from the Danish Twin Register. Data on the age at menarche were collected by questionnaire and combined with data on BW, birth length (BL) and gestational age (GA) from the Danish Medical Birth register. The BW for GA standard deviation score (BW-SDS) was calculated. BW-SDS [hazard ratio (HR) 0.96; 95% confidence interval (CI): 0.93-0.00], P = 0.04], but not BW, BL or GA (P ≥ 0.15), was positively associated with age at menarche in all twins after adjustment for zygosity and year of birth. However, BW-SDS was not associated with menarcheal age within twin pairs (HR 1.01; 95% CI: 0.91-1.12, P = 0.88). No differences were found in the age at menarche or birth size between twin girls from same sex and twin girls from opposite-sex pregnancies. Heritability of menarcheal age and BW were estimated to be 0.61 (95% CI: 0.38-0.84) and 0.27 (95% CI: 0.18-0.38), respectively. Both BW and menarcheal age were influenced by genetic and environmental factors. A limitation of this study is recall bias on the age at menarche. It is also not clear how these results should be extrapolated to the non-twin population. lower BW for GA is associated with earlier age at menarche in twin girls. However, the lack of within-pair differences in menarcheal age between even markedly BW-discordant twins indicates that this association is governed by

  16. Long-term neurodevelopmental outcome of monochorionic and matched dichorionic twins.

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    Karien E A Hack

    Full Text Available BACKGROUND: Monochorionic (MC twins are at increased risk for perinatal mortality and serious morbidity due to the presence of placental vascular anastomoses. Cerebral injury can be secondary to haemodynamic and hematological disorders during pregnancy (especially twin-to-twin transfusion syndrome (TTTS or intrauterine co-twin death or from postnatal injury associated with prematurity and low birth weight, common complications in twin pregnancies. We investigated neurodevelopmental outcome in MC and dichorionic (DC twins at the age of two years. METHODS: This was a prospective cohort study. Cerebral palsy (CP was studied in 182 MC infants and 189 DC infants matched for weight and age at delivery, gender, ethnicity of the mother and study center. After losses to follow-up, 282 of the 366 infants without CP were available to be tested with the Griffiths Mental Developmental Scales at 22 months corrected age, all born between January 2005 and January 2006 in nine perinatal centers in The Netherlands. Due to phenotypic (unalikeness in mono-or dizygosity, the principal investigator was not blinded to chorionic status; perinatal outcome, with exception of co-twin death, was not known to the examiner. FINDINGS: Four out of 182 MC infants had CP (2.2% - two of the four CP-cases were due to complications specific to MC twin pregnancies (TTTS and co-twin death and the other two cases of CP were the result of cystic PVL after preterm birth - compared to one sibling of a DC twin (0.5%; OR 4.2, 95% CI 0.5-38.2 of unknown origin. Follow-up rate of neurodevelopmental outcome by Griffith's test was 76%. The majority of 2-year-old twins had normal developmental status. There were no significant differences between MC and DC twins. One MC infant (0.7% had a developmental delay compared to 6 DC infants (4.2%; OR 0.2, 95% 0.0-1.4. Birth weight discordancy did not influence long-term outcome, though the smaller twin had slightly lower developmental scores than its

  17. SUSY Meets Her Twin

    CERN Document Server

    Katz, Andrey; Pokorski, Stefan; Redigolo, Diego; Ziegler, Robert

    2016-01-01

    We investigate the general structure of mirror symmetry breaking in the Twin Higgs scenario. We show, using the IR effective theory, that a significant gain in fine tuning can be achieved if the symmetry is broken hardly. We emphasize that weakly coupled UV completions can naturally accommodate this scenario. We analyze SUSY UV completions and present a simple Twin SUSY model with a tuning of around 10% and colored superpartners as heavy as 2 TeV. The collider signatures of general Twin SUSY models are discussed with a focus on the extended Higgs sectors.

  18. SUSY Meets Her Twin

    CERN Document Server

    Katz, Andrey; Pokorski, Stefan; Redigolo, Diego; Ziegler, Robert

    2017-01-01

    We investigate the general structure of mirror symmetry breaking in the Twin Higgs scenario. We show, using the IR effective theory, that a significant gain in fine tuning can be achieved if the symmetry is broken hardly. We emphasize that weakly coupled UV completions can naturally accommodate this scenario. We analyze SUSY UV completions and present a simple Twin SUSY model with a tuning of around 10% and colored superpartners as heavy as 2 TeV. The collider signatures of general Twin SUSY models are discussed with a focus on the extended Higgs sectors.

  19. SUSY Meets Her Twin

    CERN Document Server

    Katz, Andrey; Pokorski, Stefan; Redigolo, Diego; Ziegler, Robert

    2017-01-31

    We investigate the general structure of mirror symmetry breaking in the Twin Higgs scenario. We show, using the IR effective theory, that a significant gain in fine tuning can be achieved if the symmetry is broken hardly. We emphasize that weakly coupled UV completions can naturally accommodate this scenario. We analyze SUSY UV completions and present a simple Twin SUSY model with a tuning of around 10% and colored superpartners as heavy as 2 TeV. The collider signatures of general Twin SUSY models are discussed with a focus on the extended Higgs sectors.

  20. The natural history of prenatally diagnosed conjoined twins.

    Science.gov (United States)

    Mackenzie, Tippi C; Crombleholme, Timothy M; Johnson, Mark P; Schnaufer, Louise; Flake, Alan W; Hedrick, Holly L; Howell, Lori J; Adzick, N Scott

    2002-03-01

    Accurate prenatal diagnosis of complex anatomic connections and associated anomalies has only been possible recently with the use of ultrasonography, echocardiography, and fetal magnetic resonance imaging (MRI). To assess the impact of improved antenatal diagnosis in the management and outcome of conjoined twins, the authors reviewed their experience with 14 cases. A retrospective review of prenatally diagnosed conjoined twins referred to our institution from 1996 to present was conducted. In 14 sets of conjoined twins, there were 10 thoracoomphalopagus, 2 dicephalus tribrachius dipus, 1 ischiopagus, and 1 ischioomphalopagus. The earliest age at diagnosis was 9 weeks' gestation (range, 9 to 29; mean, 20). Prenatal imaging with ultrasonography, echocardiography, and ultrafast fetal MRI accurately defined the shared anatomy in all cases. Associated anomalies included cardiac malformations (11 of 14), congenital diaphragmatic hernia (4 of 14), abdominal wall defects (2 of 14), and imperforate anus (2 of 14). Three sets of twins underwent therapeutic abortion, 1 set of twins died in utero, and 10 were delivered via cesarean section at a mean gestational age of 34 weeks. There were 5 individual survivors in the series after separation (18%). In one case, in which a twin with a normal heart perfused the cotwin with a rudimentary heart, the ex utero intrapartum treatment procedure (EXIT) was utilized because of concern that the normal twin would suffer immediate cardiac decompensation at birth. This EXIT-to-separation strategy allowed prompt control of the airway and circulation before clamping the umbilical cord and optimized control over a potentially emergent situation, leading to survival of the normal cotwin. In 2 sets of twins in which each twin had a normal heart, tissue expanders were inserted before separation. Advances in prenatal diagnosis allow detailed, accurate evaluations of conjoined twins. Careful prenatal studies may uncover cases in which emergent

  1. First-trimester prenatal sonographic diagnosis of ectopia cordis in a twin gestation.

    Science.gov (United States)

    Barbee, Kristen; Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2009-01-01

    The 11-14-week ultrasound examination allows early pregnancy dating, detection of major anomalies and multiple gestations, and accurate chorionicity determination. We describe a rare case of first-trimester sonographic diagnosis of ectopia cordis in a dichorionic twin pregnancy, illustrating the benefits of early ultrasound in patient counseling and management.

  2. Fetal reduction by bipolar cord coagulation in managing complicated monochorionic multiple pregnancies: preliminary experience in China

    Institute of Scientific and Technical Information of China (English)

    HE Zhi-ming; FANG Qun; YANG Yong-zhong; LUO Yan-min; CHEN Jun-hong; CHEN Yong-zhen; ZHOU Yi; CHEN Min-ling

    2010-01-01

    Background Monochorionic multiple pregnancies (MMPs) are associated with higher rates of perinatal morbidity and mortality caused by interfetal vascular anastomoses in the monochorionic placenta, which can lead to fetal health interactions. In some circumstances, selective feticide of the affected fetus is necessary to save the healthy co-twin. We evaluated the effects and safety of our initial experiences using bipolar cord coagulation for the management of complicated MMPs. Methods Using ultrasound-guided bipolar cord coagulation, we performed selective feticide on 14 complicated MMPs (5 with twin-twin transfusion syndrome, 4 with acardia, 3 with discordant structural anomalies, and 2 with severe selective intrauterine growth restriction). One patient with monochorionic triplets received the procedure twice to terminate 2 affected fetuses for different indications. Data regarding the operations, complications and neonatal outcomes were analyzed. Results Cord occlusions were successfully performed in 13/14 (93%) cases. The failure happened in an acardiac fetus and the pregnancy was terminated by induction. The included cases delivered at a mean gestational age of 35.4 weeks with a perinatal survival rate of 11/13 (85%). Three operation-related complications occurred (21%), including membrane rupture of the terminated sac (1 case), preterm labor at 28 weeks gestation (1 case), and chorioamniotic membrane separation (1 case). Amnioinfusion was indicated in 11 procedures to expand the target sacs for entering the trocar and obtaining sufficient working space. However, in all 4 cases of acardia, the acardiac sacs showed extreme oligohydramnios and could not be well expanded by infusion; thus, the trocar had to be inserted from the sac of the preserved co-twin. Conclusions The application of bipolar cord coagulation in complicated MMPs is safe and improves the prognosis. Amnioinfusion is useful in helping to expand the target sac when the working space is limited.

  3. Twin-twin Transfusion Syndrome with a Single Ectopic Kidney in a Twin Donor. Case Presentation

    Directory of Open Access Journals (Sweden)

    Gerardo Rogelio Robaina Castellanos

    2016-10-01

    Full Text Available Twin-twin Transfusion Syndrome presents more frequently in diamniotic monochromic twins. In advanced stages and without prenatal intervention, is associated to high rates of peri natal mortality and neurological sequel in the survivors. It is presented a case of a pair of twins with severe depression at birth in which it was diagnosed a Twin-twin Transfusion Syndrome, later confirmed with the presence of anemia in the donor twin and polycythemia in the receptor twin. Both twins had an unfavourable evolution with an early neonatal death. Necropsy findings were comparable with secondary damage to the syndrome, with the particularity that both had evidences of pulmonary infection and a renal malformation in the donor twin which is not included in the proper malformations of this syndrome. The objective of this work is to point out the essential elements for the diagnosis and antenatal treatment for this disease through the peculiarities of the presented case.

  4. Fullerton Virtual Twin Study.

    Science.gov (United States)

    Segal, Nancy L

    2006-12-01

    Virtual twins (VTs; same-age unrelated siblings reared together from early infancy) have been studied at California State University (CSU), Fullerton since 1991. The current sample includes over 130 pairs. Past and current research have research have focused on siblings' similarities and differences in general intelligence and body size. Future research in these areas will continue as new pairs continue to be identified. These studies will be supplemented by analyses of personality, social relations and adjustment using monozygotic (MZ) twins, dizygotic (DZ) twins, full siblings and friends, as well as new VTs, who have participated in Twins, Adoptees, Peers and Siblings (TAPS), a collaborative project conducted between CSU Fullerton and the University of San Francisco, from 2002 to 2006.

  5. Asthma affects time to pregnancy and fertility

    DEFF Research Database (Denmark)

    Gade, Elisabeth J; Thomsen, Simon F; Lindenberg, Svend;

    2014-01-01

    Coexistence of infertility and asthma has been observed clinically. Therefore, we investigated the association between asthma and delayed pregnancy in a nationwide population-based cohort of twins. A cohort of 15 250 twins living in Denmark (aged 12-41 years) participated in a questionnaire study...... including questions about the presence of asthma and fertility. Differences in time to pregnancy and pregnancy outcome were analysed in subjects with asthma, allergy and in healthy individuals using multiple regression analysis. Asthma was associated with an increased time to pregnancy, the percentage...... in those >30 years of age (32.2% versus 24.9%, OR (95% CI) 1.44 (1.1-1.9); p=0.04). Untreated asthmatics had a significant increased risk of prolonged time to pregnancy compared to healthy individuals (OR (95% CI) 1.79 (1.20-2.66); p=0.004), while asthmatics receiving any kind of treatment for asthma...

  6. Craniofacial anomalies in twins.

    Science.gov (United States)

    Keusch, C F; Mulliken, J B; Kaplan, L C

    1991-01-01

    Studies of twins provide insight into the relative contribution of genetic and environmental factors in the causality of structural anomalies. Thirty-five affected twin pairs were identified from a group of 1114 patients with congenital craniofacial deformities evaluated from 1972 to 1989. Forty-three of these 70 twins exhibited one or more craniofacial anomalies; these were analyzed for dysmorphic characteristics, zygosity, concordance, and family history. The anomalies were categorized into two groups: malformations and deformations. The malformations (n = 36) included hemifacial microsomia (n = 10), cleft lip and palate (n = 8), cleft palate (n = 4), rare facial cleft (n = 2), craniosynostosis (n = 2), Binder syndrome (n = 2), Treacher Collins syndrome (n = 2), craniopagus (n = 2), CHARGE association (n = 1), frontonasal dysplasia (n = 2), and constricted ears (n = 1). The deformations (n = 7) included plagiocephaly (n = 5), hemifacial hypoplasia (n = 1), and micrognathia (n = 1). Twenty-one monozygotic and 14 dizygotic twin pairs were identified. The concordance rate was 33 percent for monozygotic twins and 7 percent for dizygotic twins.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Factors affecting spontaneous reduction of corpora lutea and twin embryos during the late embryonic/early fetal period in multiple-ovulating dairy cows.

    Science.gov (United States)

    López-Gatius, F; García-Ispierto, I; Hunter, R H F

    2010-02-01

    Spontaneous reduction of advanced twin embryos has been described in high-producing, Holstein-Fresian (Bos taurus) dairy herds. The first objective of the current study was to determine whether management and cow factors could have an effect on such a reduction in twin pregnancies during the early fetal period. Because loss of a corpus luteum was noted in cows suffering twin reduction, we expanded our study to include multiple-ovulating cows carrying singletons. Pregnancy was diagnosed and confirmed from Days 28 to 34 and 56 to 62 postinsemination. Sixty-nine (23.5%) of 293 pregnant cows with two corpora lutea carrying singletons and 132 (28.4%) of 464 twin pregnancies recorded on first pregnancy diagnosis subsequently lost one of the corpora lutea or one of the embryos, respectively. Thirty-four (25.8%) of the 132 twin pregnancies suffering embryo reduction lost one corpus luteum along with the embryo. Corpus luteum reduction always occurred in the ovary ipsilateral to the gravid horn suffering embryo reduction. Binary logistic regressions were performed considering corpus luteum and embryo reduction as dependent variables in single and twin pregnancies, respectively, and several management- and cow-related factors as independent variables. In cows carrying singletons, the risk of corpus luteum reduction was 14.3 (1/0.07) times lower for a given herd, whereas the interaction season by laterality significantly affected corpus luteum reduction such that in cows with two corpora lutea ipsilateral to the horn of pregnancy, the risk of reduction decreased during the winter period. In cows carrying twins, ipsilateral twin pregnancies were 3.45 (1/0.29) times more likely to undergo the loss of one embryo than bilateral twin pregnancies. As an overall conclusion, both corpora lutea and embryos were vulnerable to the effects of stress factors during the early fetal period in cows maintaining their pregnancies. A strong unilateral relationship between the corpus luteum and

  8. Pregnancy Tests

    Science.gov (United States)

    ... Us Home A-Z Health Topics Pregnancy tests Pregnancy tests > A-Z Health Topics Pregnancy test fact ... To receive Publications email updates Enter email Submit Pregnancy tests If you think you may be pregnant , ...

  9. Ultrasound pregnancy

    Science.gov (United States)

    Pregnancy sonogram; Obstetric ultrasonography; Obstetric sonogram; Ultrasound - pregnancy; IUGR - ultrasound; Intrauterine g