Outcome of two sequential singleton pregnancies and twin pregnancies among primiparous women at advanced age undergoing IVF

2020 ◽  
Vol 302 (5) ◽  
pp. 1113-1119
Author(s):  
Nizan Mor ◽  
Ronit Machtinger ◽  
Yoav Yinon ◽  
Shlomo Toussia-Cohen ◽  
Daphna Amitai Komem ◽  
...  
Keyword(s):  
Advanced Age ◽  
Twin Pregnancies ◽  
Primiparous Women ◽  
Singleton Pregnancies

Spontaneous loss of a co-twin and the risk of birth defects after assisted conception

2016 ◽  
Vol 7 (6) ◽  
pp. 678-684 ◽  
Author(s):  
M. J. Davies ◽  
A. R. Rumbold ◽  
M. J. Whitrow ◽  
K. J. Willson ◽  
W. K. Scheil ◽  
...  
Keyword(s):  
Birth Defects ◽  
Pregnancy Loss ◽  
Multiple Pregnancy ◽  
Fetal Loss ◽  
South Australia ◽  
Increased Risk ◽  
Study Population ◽  
Infertility Patients ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

The study of very early pregnancy loss is impractical in the general population, but possible amongst infertility patients receiving carefully monitored treatments. We examined the association between fetal loss and the risk of birth defects in the surviving co-twin in a retrospective cohort study of infertility patients within an infertility clinic in South Australia from January 1986 to December 2002, linked to population registries for births, terminations and birth defects. The study population consisted of a total of 5683 births. Births from singleton pregnancies without loss were compared with survivors from (1) pregnancies with an empty fetal sac at 6–8 weeks after embryo transfer, (2) fetal loss subsequent to 8-week ultrasound and (3) multiple pregnancy continuing to birth. Odds ratios (OR) for birth defects were calculated with adjustment for confounders. Amongst infertility patients, the prevalence of birth defects was 7.9% for all twin pregnancies without fetal loss compared with 14.6% in pregnancies in which there had been an empty sac at ultrasound, and 11.6% for pregnancies with fetal loss after 6–8 weeks. Compared with singleton pregnancies without loss, the presence of an empty sac was associated with an increased risk of any defect (OR=1.90, 95% confidence intervals (CI)=1.09–3.30) and with multiple defects (OR=2.87, 95% CI=1.31–6.28). Twin pregnancies continuing to birth without loss were not associated with an overall increased prevalence of defects. We conclude that the observed loss of a co-twin by 6–8 weeks of pregnancy is related to the risk of major birth defects in the survivor.

scholarly journals Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

2021 ◽  
Vol 11 ◽  
Author(s):  
Jill Hutton ◽  
Paul J. Rowan
Keyword(s):  
Vertical Transmission ◽  
Transmission Rate ◽  
Monozygotic Twin ◽  
Dizygotic Twin ◽  
Cmv Infection ◽  
Vertical Transmission Rate ◽  
Congenital Cmv Infection ◽  
Twin Pregnancies ◽  
Congenital Cmv ◽  
Singleton Pregnancies

ObjectiveThe objectives are to estimate the vertical transmission rate in twins relative to singleton pregnancies, to evaluate whether discordance within twin pairs is rare, and to characterize concordance within monozygotic and dizygotic twin pairs in relation to hereditability.MethodsWe first sought to estimate the vertical transmission rate of congenital CMV infection in twins by gathering cohort-based studies of congenital CMV in which vertical transmission in both singleton and twin pregnancies was reported. This also allowed us to compare singleton and twin infection rates. From the above studies and other large cohorts of congenitally infected infants, the percentage of discordantly infected twin pairs determined whether this is a rare phenomenon. Theorizing discordance is not rare, we then analyzed data from cases with twin outcomes for congenital CMV infection, according to whether the twins were monozygotic or dizygotic, and calculated their corresponding concordance rates to estimate the broad-sense heritability. Lastly, we described other factors that might affect vertical transmission.ResultsFrom five articles following at-risk pregnancies, the rate of vertical transmission in twin pregnancies is 58.7% (95% CI 43.3-72.3%) whereas in singleton pregnancies it is 31.4% (95% CI: 29.0-34.0%) p = 0.0002. Of ten studies of larger cohorts of infants with congenital CMV infection, 21 of 42 twin pairs with at least one twin infected were discordant for congenital CMV (50.0%, 95% CI: 34.4–65.6%) indicating discordance of congenital CMV infection in twin pairs is not rare. Of 28 studies covering 37 twin pairs where at least one twin had congenital CMV, and zygosity was known, eleven of thirteen monozygotic twin pairs (84.6%; 95% CI: 53.7-97.3%) were concordant for CMV infection, and nine of twenty-four dizygotic twin pairs (37.5%; 95% CI: 19.6-59.2%) were concordant for infection giving an estimated hereditability of 94.2%. Within these 37 twin pairs, factors such as primary or recurrent maternal infection, prematurity, growth discordance, and sex are described; however, in many of these cases these factors are unknown.ConclusionThe rate of vertical transmission of congenital CMV is higher for twins than singletons. Discordance of congenital CMV in twins is not rare and suggests a possible genetic susceptibility to congenital CMV.

scholarly journals Maternal serum sFlt-1/PlGF ratio in twin pregnancies with and without pre-eclampsia in comparison with singleton pregnancies

2015 ◽  
Vol 45 (3) ◽  
pp. 286-293 ◽  
Author(s):  
L. Dröge ◽  
I. Herraìz ◽  
H. Zeisler ◽  
D. Schlembach ◽  
H. Stepan ◽  
...  
Keyword(s):  
Maternal Serum ◽  
Twin Pregnancies ◽  
Plgf Ratio ◽  
Singleton Pregnancies

Maternal Nutrition in Twin Pregnancy

1982 ◽  
Vol 31 (3-4) ◽  
pp. 221-227 ◽  
Author(s):  
Doris M. Campbell ◽  
Ian MacGillivray ◽  
Sheena Tuttle
Keyword(s):  
Protein Intake ◽  
Twin Pregnancy ◽  
Maternal Nutrition ◽  
Dietary Zinc ◽  
Nitrogen Intake ◽  
The Relationship ◽  
Twin Pregnancies ◽  
Urinary Nitrogen ◽  
Singleton Pregnancies

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.

Singleton pregnancies are as affected by ovarian hyperstimulation syndrome as twin pregnancies

2004 ◽  
Vol 82 (6) ◽  
pp. 1691-1693 ◽  
Author(s):  
Diane De Neubourg ◽  
Kathelijne Mangelschots ◽  
Eric Van Royen ◽  
Miet Vercruyssen ◽  
Jan Gerris
Keyword(s):  
Ovarian Hyperstimulation Syndrome ◽  
Ovarian Hyperstimulation ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

Can Early hCG Levels be a Marker for Pregnancy Outcome in ART Cycles?

2009 ◽  
Vol 1 (3) ◽  
pp. 33-39 ◽  
Author(s):  
Mandakini Parihar
Keyword(s):  
Sensitivity And Specificity ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
High Sensitivity ◽  
Maternal Serum ◽  
Multiple Gestations ◽  
Adverse Result ◽  
Ultimate Outcome ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

ABSTRACT With advancing technology of assisted reproduction, physicians today have the ability to achieve conception in many couples who would have been totally incapable doing so only a few years ago. The anxiety and the uncertainty of pregnancy outcomes using ART procedures is widely accepted as one of the main psychological stresses the couples. The ability to predict outcome as soon as possible after assisted conception treatment is important for clinic staff and patients. The aim of this observational study is to highlight the importance of hCG values in predicting the outcome of ART cycle and counseling the patients in case of adverse result. The ultimate aim is to improve the take home baby rate and initial hCG value can help us counsel our patients towards the ultimate outcome. Embryo development in early pregnancy follows a preprogrammed-timing schedule and depends mainly on the embryonic age of the healthy, successfully implanted conceptus. The appearance of hCG in maternal serum is used to assess the time of clinically detectable implantation. bhCG has provided the best sensitivity and specificity for detection of normal and pathological pregnancies. After IVF, early pregnancy loss or multiple gestations may be predicted with high sensitivity and specificity by using cut-off values of serum hCG. The median HCG concentration was 116 IU/l in viable pregnancies and 31 IU/l in nonviable pregnancies. The median hCG concentration in twin pregnancies was almost double that in singleton pregnancies (201 IU/l vs 116 IU/l). Thus we can reassure normally pregnant patients as well as filter and manage those with nonviable outcomes more efficiently.

scholarly journals Perineal Distensibility Using Epi-no in Twin Pregnancies: Comparative Study with Singleton Pregnancies

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Juliana Sayuri Kubotani ◽  
Antonio Fernandes Moron ◽  
Edward Araujo Júnior ◽  
Miriam Raquel Diniz Zanetti ◽  
Vanessa Cardoso Marques Soares ◽  
...  
Keyword(s):  
Case Control Study ◽  
Abdominal Circumference ◽  
Third Trimester ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
The Third ◽  
Nulliparous Women ◽  
Twin Pregnancies ◽  
Control Study ◽  
Singleton Pregnancies

The aims of this study were to compare perineal distensibility between women with twin and singleton pregnancies and to correlate these women’s perineal distensibility with anthropometric data. This prospective cross-sectional case-control study was conducted among nulliparous women, of whom 20 were pregnant with twins and 23 with a single fetus. Perineal distensibility was evaluated in the third trimester by means of Epi-no, which was introduced into the vagina and inflated up to the maximum tolerable limit. It was then withdrawn while inflated and its circumference was measured. The unpaired Student’s t-test was used to compare perineal distensibility in the two groups and Pearson’s correlation coefficient (r) was used to correlate the pregnant women’s perineal distensibility with their anthropometric data. There was no difference in perineal distensibility between the twin group (16.51 ± 2.05 cm) and singleton group (16.13 ± 1.67 cm) (P=0.50). There was a positive correlation between perineal distensibility and abdominal circumference (r=0.36; P=0.01). The greater the abdominal circumference was, the greater the perineal distensibility was, regardless of whether the pregnancy was twin or singleton.

Human Placental Lactogen and dU-Estrogen Levels in Normal Twin Pregnancies

1985 ◽  
Vol 34 (1-2) ◽  
pp. 59-65 ◽  
Author(s):  
B. Kappel ◽  
K. Hansen ◽  
J. Moller ◽  
J. Faaborg-Andersen
Keyword(s):  
Sensitivity And Specificity ◽  
Reference Intervals ◽  
Placental Lactogen ◽  
Human Placental Lactogen ◽  
Normal Range ◽  
Intrauterine Growth ◽  
Two Parameters ◽  
Twin Pregnancies ◽  
Normal Twin ◽  
Singleton Pregnancies

AbstractReference intervals for human placental lactogen (hPL) and dU-estrogens (dU-E) in uncomplicated twin pregnancies are found to be higher than singleton pregnancies and considerably wider. Significantly more monozygotic than dizygotic pregnancies, and significantly more monoplacental than diplacental pregnancies showed hPL values below the median on the normal range curve. The same was not found for dU-E. Significantly more growth-retarded fetuses were found in monoplacental than diplacental pregnancies. The benefit of measuring the two parameters in order to identify the intrauterine growth retarded fetuses were evaluated in terms of sensitivity and specificity. Both parameters were found less suitable for the purpose.

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