scholarly journals VP39.07: Neonatal morbidity of cephalic/non‐cephalic uncomplicated monochorionic twins delivered by breech extraction

2021 ◽  
Vol 58 (S1) ◽  
pp. 267-267
Author(s):  
E. Choi ◽  
S. Lee ◽  
J. Kim ◽  
S. Kim ◽  
Y. Jung ◽  
...  
Keyword(s):  
Neonatal Morbidity ◽  
Monochorionic Twins ◽  
Breech Extraction

Twin Anemia-Polycythemia Sequence: Perinatal Management and Outcome

2015 ◽  
Vol 40 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Eran Ashwal ◽  
Yoav Yinon ◽  
Michal Fishel-Bartal ◽  
Abraham Tsur ◽  
Benjamin Chayen ◽  
...  
Keyword(s):  
Gestational Age ◽  
Neonatal Morbidity ◽  
Control Group ◽  
Monochorionic Twins ◽  
Monochorionic Twin ◽  
Gestational Age At Delivery ◽  
Perinatal Management ◽  
Intrauterine Blood Transfusion ◽  
And Control ◽  
Twin Pregnancies

Objective: To determine the perinatal outcome of monochorionic twin pregnancies complicated by twin anemia-polycythemia sequence (TAPS). Methods: All monochorionic twins diagnosed with TAPS between 2011 and 2014 were included. Each twin pair with TAPS (study group) was compared with 2 uncomplicated monochorionic twin pairs who were matched for gestational age at delivery (control group). Neonatal morbidity and mortality were evaluated. Results: During the study period, 179 monochorionic twins were followed at our center, of whom 46 underwent laser ablation due to twin-to-twin transfusion syndrome. TAPS was diagnosed in 10 cases; 8 of them were spontaneous, and 2 occurred following laser surgery. Out of 7 patients diagnosed prenatally with TAPS, 5 cases were managed expectantly, and 2 cases were treated with intrauterine blood transfusion. The rates of severe and mild central nervous system lesions on postnatal ultrasound were similar in the TAPS group and control group (5.0 vs. 2.5%, p = 0.61, and 5.0 vs. 12.5%, p = 0.25, respectively). Additionally, severe neonatal morbidity was comparable between the groups. All neonates were alive at 1 month of age. Conclusion: The neonatal outcome of monocohorionic twins affected by TAPS is favorable and comparable to gestational age-matched uncomplicated monochorionic twins.

scholarly journals A prospective observational study of foetal outcome in twin pregnancy delivering at a tertiary health care center of South Gujarat

2021 ◽  
Vol 10 (3) ◽  
pp. 905
Author(s):  
Heny K. Jariwala ◽  
Falguni B. Patel ◽  
Minal R. Chaudhari ◽  
Anjani Shrivastava
Keyword(s):  
Twin Pregnancy ◽  
Care Center ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
P Value ◽  
Monochorionic Twins ◽  
Health Care Center ◽  
Increased Risk ◽  
Labour Room ◽  
Second Twin

Background: Worldwide increased incidence of twin gestation. The rates of twin gestation have a direct effect on the rates of preterm birth and its co-morbidities. Importantly, this increased risk applies to each fetus and is not simply the result of more foetuses.Methods: This prospective study was carried out in department of obstetrics and gynaecology. 100 consecutive subjects fulfilling inclusion criteria   admitted to labour room and obstetrics intensive care enrolled over a period of around 1 year.Results: In this study twin delivery accounted for 1.3% of all delivery at our institute. On analysing neonatal morbidities Prematurity was commonest 65%, VLBW (23% first twin, 30% second twin), RDS (9% first twin, 13% second twin), birth asphyxia (7% first twin, 12% second twin), neonatal hyperbilirubinemia (7% first twin, 8% second twin). 34% of first twin and 40% of second twin required NICU admission. Early neonatal death observed in 6% of first twin and 8% of second twin. It was observed that proportion of neonatal complications was more in MCDA as compared to DCDA and in un-booked subjects as compared to booked subjects. This difference is statistically significant among both twin (p value<0.05).Conclusions: Twin pregnancy is associated with high perinatal morbidity. Specialized obstetrics and Intensive Neonatal care can decrease neonatal morbidity and mortality in twin gestation. We need to be extra vigilant in monochorionic twins and twin pregnancy with inadequate antenatal care.

Neonatal Morbidity in Growth-Discordant Monochorionic Twins: Comparison Between the Larger and the Smaller Twin

2012 ◽  
Vol 15 (4) ◽  
pp. 541-546 ◽  
Author(s):  
Enrico Lopriore ◽  
Carolien Sluimers ◽  
Suzanne A. Pasman ◽  
Johanna M. Middeldorp ◽  
Dick Oepkes ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Neonatal Morbidity ◽  
Fetal Lung ◽  
Cerebral Lesions ◽  
Lung Maturation ◽  
Monochorionic Twins ◽  
Increased Risk ◽  
Fetal Lung Maturation

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.

A report of dizygotic monochorionic twins complictated with twin-to-twin transfusion syndrome

2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
AMA Diemert ◽  
W Diehl ◽  
P Glosemeyer ◽  
K Held ◽  
K Hecher
Keyword(s):  
Monochorionic Twins

Smaller twins are not at risk of neonatal morbidity compared to their larger co-twins

2008 ◽  
Vol 29 (S 2) ◽  
Author(s):  
KJ Oh ◽  
JH Lee ◽  
JH Kang ◽  
CW Park ◽  
JS Park ◽  
...  
Keyword(s):  
At Risk ◽  
Neonatal Morbidity ◽  
Not At Risk

SIGNIFICANCE OF PLACENTAL HISTOPATHOLOGICAL FINDINGS IN PRETERM/TERM BIRTH

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Monika Kushwaha ◽  
Sanjeev Narang
Keyword(s):  
Preterm Birth ◽  
Comparative Study ◽  
Pregnancy Outcome ◽  
Neonatal Morbidity ◽  
Research Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Chorionic Villi ◽  
Term Birth ◽  
Medical College

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.

Prediction of Severe Neonatal Morbidity in Preterm Infants

2019 ◽  
Author(s):  
Tesfaye S Mengistu ◽  
Jane Fox ◽  
Christopher Flatley ◽  
Sailesh Kumar
Keyword(s):  
Preterm Infants ◽  
Neonatal Morbidity

Toll-like Receptor-4: A New Target for Preterm Labour Pharmacotherapies?

2018 ◽  
Vol 24 (9) ◽  
pp. 960-973 ◽  
Author(s):  
Sarah A. Robertson ◽  
Hanan H. Wahid ◽  
Peck Yin Chin ◽  
Mark R. Hutchinson ◽  
Lachlan M. Moldenhauer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Platelet Activating Factor ◽  
Neonatal Morbidity ◽  
Ischaemic Injury ◽  
E Coli ◽  
Normal Term ◽  
Inflammatory Activation ◽  
Cervical Disease ◽  
Term Labour

Inflammatory activation, a major driver of preterm birth and subsequent neonatal morbidity, is an attractive pharmacological target for new preterm birth therapeutics. Inflammation elicited by intraamniotic infection is causally associated with preterm birth, particularly in infants delivered ≤34 weeks’ gestation. However, sterile triggers of PTB, including placental ischaemic injury, uterine distention, cervical disease, or imbalance in the immune response, also act through inflammatory mediators released in response to tissue damage. Toll-like Receptors (TLRs) are critical upstream gate-keepers controlling the inflammatory activation that precedes preterm delivery, as well as in normal term labour. In particular, TLR4 is implicated for its capacity to sense and integrate a range of disparate infectious and sterile pro-inflammatory triggers, and so acts as a point-ofconvergence through which a range of infectious and sterile agents can activate and accelerate the parturition cascade. Recent studies point to the TLR4 signalling complex as a tractable target for the inhibition of fetal, placental & intraamniotic inflammatory cytokine production. Moreover, studies on mice show that novel small molecule antagonists of TLR4 signalling are highly effective in preventing preterm birth induced by bacterial mimetic LPS, heat-killed E. coli or the TLR4-dependent pro-inflammatory lipid, Platelet Activating Factor (PAF). In this review, we discuss the role of TLR4 in regulating the timing of birth and the potential utility of TLR4 antagonists as novel therapeutics for preterm delivery.

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