Reduced fetal movements is twin pregnancies and the association with adverse neonatal outcomes

Objective: To evaluate vaginal birth safety by comparing the results of cesarean birth in twin pregnancies with the first twin in vertex presentation. Material and methods: A retrospective cohort study of vertex-presenting twin pregnancies between 32 weeks 0 days and 38 weeks 6 days of gestation was conducted at our hospital from January 2013 to December 2014. The study population was divided according to the mode of birth. The primary outcome was early neonatal mortality, and secondary outcomes related to maternal and perinatal clinical characteristics were analysed between the groups. Results: Of 45,166 births, 1.92% (n = 869) were twin pregnancies. Of the 295 pregnancies meeting the study criteria, 30.16% (n = 89) were in the vaginal birth group, while the remaining 69.84% (n = 206) were in the cesarean birth group. In the vaginal birth group, all the first twins were delivered via vaginal birth, while among the second twins, 82.03% (n = 73) were delivered via vaginal birth, and the remaining 17.97% (n = 16) were delivered via cesarean birth. In the vaginal birth group, the early neonatal mortality rate was 22.4‰ (n = 2), and it was 9.7‰ (n = 2) in the cesarean birth group. All of the deaths occurred in pregnancies under 37 weeks of gestation. Conclusion: The neonatal outcomes between the vaginal birth and cesarean birth groups were similar in term pregnancies with the first in twin vertex presentation, whereas adverse neonatal outcomes were increased in the vaginal birth group in preterm second twin pregnancies.

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Obstetric and perinatal outcomes of dizygotic twin pregnancies resulting from in vitro fertilization versus spontaneous conception: a retrospective study

PeerJ ◽

10.7717/peerj.6638 ◽

2019 ◽

Vol 7 ◽

pp. e6638 ◽

Cited By ~ 1

Author(s):

Hua Chen ◽

Ying Wan ◽

Haitao Xi ◽

Weijue Su ◽

Jing Cheng ◽

...

Keyword(s):

In Vitro Fertilization ◽

Perinatal Care ◽

Perinatal Outcomes ◽

Neonatal Outcomes ◽

Dizygotic Twin ◽

Vitro Fertilization ◽

Adverse Neonatal Outcomes ◽

Potential Risks ◽

Twin Pregnancies

This study was designed to to assess perinatal and neonatal outcomes of dizygotic twin pregnancies conceived naturally or by in vitro fertilization (IVF). After strict selection, the study included 470 dizygotic twin pregnancies. There were 249 resulting from IVF treatments and 221 conceiving spontaneously. After adjusting maternal age and primiparity, the results showed that there were no significant differences between the two groups (P > 0.05) in terms of maternal antenatal complications and neonatal outcomes. In conclusion, our study does not reveal increased risks for pregnancy-related complications and adverse neonatal outcomes in dizygotic twin pregnancies following IVF treatments. With these fundamental data, this study could provide a reference for perinatal care and clinical assisted reproductive technology (ART) treatment and help to inform infertile parents about the potential risks of IVF treatments.

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Stillbirths preceded by reduced fetal movements are more frequently associated with placental insufficiency: a retrospective cohort study

Journal of Perinatal Medicine ◽

10.1515/jpm-2021-0103 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Madeleine ter Kuile ◽

Jan Jaap H.M. Erwich ◽

Alexander E.P. Heazell

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Placental Insufficiency ◽

Maternal Report ◽

Reduced Fetal Movements ◽

Fetal Movements ◽

And Function ◽

Twin Pregnancies

Abstract Objectives Maternal report of reduced fetal movements (RFM) is a means of identifying fetal compromise in pregnancy. In live births RFM is associated with altered placental structure and function. Here, we explored associations between RFM, pregnancy characteristics, and the presence of placental abnormalities and fetal growth restriction (FGR) in cases of stillbirth. Methods A retrospective cohort study was carried out in a single UK tertiary maternity unit. Cases were divided into three groups: 109 women reporting RFM, 33 women with absent fetal movements (AFM) and 159 who did not report RFM before the diagnosis of stillbirth. Univariate and multivariate logistic regression was used to determine associations between RFM/AFM, pregnancy characteristics, placental insufficiency and the classification of the stillbirth. Results AFM or RFM were reported prior to diagnosis of stillbirth in 142 (47.2%) of cases. Pregnancies with RFM prior to diagnosis of stillbirth were independently associated with placental insufficiency (Odds Ratio (OR) 2.79, 95% Confidence Interval (CI) 1.84, 5.04) and were less frequently associated with maternal proteinuria (OR 0.16, 95% CI 0.07, 0.62) and previous pregnancy loss <24 weeks (OR 0.20, 95% CI 0.07, 0.70). When combined, AFM and RFM were less frequently reported in twin pregnancies ending in stillbirth and in intrapartum stillbirths. Conclusions The association between RFM and placental insufficiency was confirmed in cases of stillbirth. This provides further evidence that RFM is a symptom of placental insufficiency. Therefore, investigation after RFM should aim to identify placental dysfunction.

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263: Twin pregnancies with different gender are related with adverse neonatal outcomes in dichorionic twins kyung

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2007.10.277 ◽

2007 ◽

Vol 197 (6) ◽

pp. S84

Author(s):

Joon Oh ◽

Ji Hyun Kang ◽

Hyung-Su Lim ◽

Chan-Wook Park ◽

Joong Shin Park ◽

...

Keyword(s):

Neonatal Outcomes ◽

Adverse Neonatal Outcomes ◽

Twin Pregnancies

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Pregnancy outcomes in women presenting with single versus multiple episodes of reduced fetal movements: A prospective observational study

Indian Journal of Obstetrics and Gynecology Research ◽

10.18231/j.ijogr.2021.074 ◽

2021 ◽

Vol 8 (3) ◽

pp. 356-362

Author(s):

P Pallavee ◽

Prudvi Rani Podili ◽

Rupal Samal ◽

Seetesh Ghose

Keyword(s):

High Risk ◽

Observational Study ◽

Pregnancy Outcomes ◽

Prospective Observational Study ◽

Fetal Movement ◽

Neonatal Outcomes ◽

Reduced Fetal Movements ◽

Fetal Movements ◽

Reduced Fetal Movement ◽

Multiple Episodes

Fetal movement counting may assist clinicians to intervene at the right time and improve perinatal outcomes, but may sometimes cause unnecessary interventions. A recent Cochrane review in 2015 concludes that there is insufficient evidence to influence practice. This prospective observational study was conducted to evaluate pregnancy outcomes of 103 pregnant women presenting with primary complaints of reduced fetal movements to our Institute. All patients underwent ultrasonography (USG) and non-stress testing (NST) as preliminary investigations and were followed up till delivery. Labor outcomes like onset of labor, mode of delivery, neonatal outcomes like APGAR scores, admission to NICU for > 24 hours, birth weight, neonatal complications and maternal complications were noted. One hundred and three pregnant women presented with reduced fetal movements, of whom, 65% were term primigravida between the ages of 18-26 years. 47.5% belonged to the high risk pregnancy group. The rates of admission (62.1%), induction (77.7%) and cesarean section (43.7%) were high in this group. Pregnancy outcomes did not differ between single and multiple episodes of reduced fetal movements. Based on risk categorization we found that a single episode of reduced fetal movement was associated with approximately 70% good neonatal outcomes, whereas there was 50% risk of adverse neonatal outcomes with multiple episodes. Though this was clinically significant we could not establish statistical significance for this result. Reduced fetal movement can occur in both low and high risk pregnant population. Pregnancy outcomes between single and multiple episodes of RFM were not significantly different.

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Maternal alcohol use, adverse neonatal outcomes and pregnancy complications in British Columbia, Canada: a population-based study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03545-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Svetlana Popova ◽

Danijela Dozet ◽

Graham O’Hanlon ◽

Valerie Temple ◽

Jürgen Rehm

Keyword(s):

British Columbia ◽

Risk Factor ◽

Alcohol Use ◽

Pregnancy Complications ◽

Alcohol Exposure ◽

Population Based ◽

Neonatal Outcomes ◽

Fiscal Year ◽

Adverse Neonatal Outcomes ◽

Icd 10

Abstract Background The current study aimed to estimate the prevalence of alcohol use identified as a risk factor during pregnancies by the antenatal care providers, resulting in live births in British Columbia (BC) and to examine associations between alcohol use, adverse neonatal outcomes, and pregnancy complications. Methods This population-based cross-sectional study utilized linked obstetrical and neonatal records within the BC Perinatal Data Registry (BCPDR), for deliveries that were discharged between January 1, 2015 and March 31, 2018. The main outcome measures were alcohol use identified as a risk factor during pregnancy, associated maternal characteristics, pregnancy complications, and adverse neonatal outcomes. Estimates for the period and fiscal year prevalence were calculated. Chi-square tests were used to compare adverse neonatal outcomes and pregnancy complications by alcohol use during pregnancy identified as a risk factor. Logistic regression was used to examine the association between alcohol use identified as a risk factor during pregnancy and adverse neonatal outcomes and pregnancy complications, after adjusting for identified risk factors. Results A total of 144,779 linked records within the BCPDR were examined. The period prevalence of alcohol use during pregnancy identified as a risk factor was estimated to be 1.1% and yearly prevalence was 1.1, 1.1, 1.3 and 0.9% from the 2014/2015 to 2017/2018 fiscal years, respectively. Alcohol use identified as a risk factor was associated with younger maternal age, fewer antenatal visits, being primiparous, a history of mental illness, substance use and smoking. Neonates with alcohol use during pregnancy identified as a risk factor had greater odds of being diagnosed with: “low birth weight (1000-2499g)” (ICD-10: P07.1; aOR = 1.25; 95% CI: 1.01, 1.53), “other respiration distress of newborn” (ICD-10: P22.8; aOR = 2.57; 95% CI: 1.52, 4.07), “neonatal difficulty in breastfeeding” (ICD-10: P92.5; aOR = 1.97; 95% CI: 1.27, 2.92) and “feeding problems, unspecified” (ICD-10: P92.9; aOR = 2.06; 95% CI: 1.31, 3.09). Conclusions The prevalence of alcohol use during pregnancy identified as a risk factor was comparable to previous estimates within the BCPDR. Identified prenatal alcohol exposure was associated with notable differences in maternal and neonatal characteristics and adverse neonatal outcomes. More consistent, thorough screening and prevention efforts targeting alcohol use in pregnancy are urgently needed in Canada.

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