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.

scholarly journals Nutrition Discussion Forum

1997 ◽  
Vol 77 (1) ◽  
pp. 141-148 ◽  
Author(s):  
D. J. Millward ◽  
S. A. Bingham
Keyword(s):  
Dietary Intake ◽  
Protein Intake ◽  
Dietary Habits ◽  
Dietary Assessment ◽  
Healthy Individuals ◽  
Free Living ◽  
Check Method ◽  
Diet History ◽  
The Relationship ◽  
Urinary Nitrogen

In work aimed at developing methodologies for validation of estimates of the dietary intake of free-living individuals, Bingham and colleagues have examined the use of urinary nitrogen (UN) excretion as an index of protein intake (Bingham & Cummings, 1985; Bingham, 1994; Bingham et al. 1995). The basis of this approach is that in subjects in N equilibrium, N intake is assumed equal to N excretion. Thus, if N excretion is measured it should indicate N and dietary protein intakes. In practice, since most N excretion occurs via the urine, which is relatively simple to collect, Bingham and colleagues examined the relationship between 24 h UN and N intake (DN). They argued that in subjects on typical UK diets UN should bear a fixed relationship to DN, and measured it carefully in a group of subjects. They showed that in a group of eight individuals in which intake and N excretion were measured meticulously, UN was 81% DN (SD 2, range 78–83%). They argued that measurement of this ratio could be used to assess the validity of food intake measurement and concluded ‘In healthy individuals eating normal western diets, 24 h urine N from an 8 day collection verified for its completeness by the PABA check method, should establish urine N to within 81(SD 5)% of the habitual dietary intake, range 70–90%. If the dietary assessment from 18 days of records or 24 h recalls or the diet history falls within these limits, it can be stated that there is no evidence of interference with normal dietary habits, or of reporting errors….’ (Bingham & Cummings, 1985).

scholarly journals Study of maternal and fetal outcome in twin pregnancy

2017 ◽  
Vol 6 (6) ◽  
pp. 2272 ◽  
Author(s):  
Lata Singh ◽  
Kiran Trivedi
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Twin Pregnancy ◽  
Fetal Outcome ◽  
Medical Sciences ◽  
Maternal Complications ◽  
Perinatal Mortality Rate ◽  
Increased Risk ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

Background: Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality especially in developing countries. The present study aims to understand the maternal and perinatal outcomes of multiple and singleton pregnancies delivering at Rajendra Institute of Medical Sciences, Ranchi, India. Aim of study was to investigate the maternal and fetal outcome in twin pregnancies in Rajendra Institute of Medical Sciences (RIMS), RanchiMethods: This comparative prospective study was conducted in the department of obstetrics and gynecology, Rajendra Institute of Medical Sciences, Ranchi from the period of 1st April 2015 to 30th September 2016. Consecutive sampling was done till the sample size of 75 was reached for both twin and singleton pregnancies. It included all women admitted in antenatal ward and labor room with clinical or ultrasound diagnosis of twin pregnancy after 28 weeks of gestation.Results: The incidence of twins in this study was 1.85%. Mean maternal age was 25.25±4.5 years for twin pregnancies and 23.53 ± 3.3 for singleton pregnancies. Twins were seen more in multigravida (70.7%) as compared to primigravida (29.3%). Preterm labor (74.7%), anemia (44%) and hypertensive disorders (32%) and PPH (13.33%) were the most common complication in twin pregnancies. Significantly higher rate of LSCS were seen in twin pregnancies (32.67%) as compared to singletons 18.67%. Mean weight of first twin was 2.03±0.52kg and for second twin it was 1.98±0.51kg. There was higher incidence of moderate to severe asphyxia, IUGR and higher rate of NICU admissions in twins as compared to singletons. Perinatal mortality rate of monchrionic pregnancy was 30% and it was 10.2% for dichorionic pregnancy which shows a significant association of perinatal mortality rate and chorionicity.Conclusions: Good antenatal care, with increased rest and nutritional supplementation, early detection of fetal and maternal complications together with thorough intranatal and postnatal vigilance, can lower both maternal and fetal dangers.

scholarly journals Yolk Sacs in Twin Pregnancy

1998 ◽  
Vol 47 (3-4) ◽  
pp. 177-181 ◽  
Author(s):  
W. Malinowski
Keyword(s):  
Ectopic Pregnancy ◽  
Twin Pregnancy ◽  
First Trimester ◽  
Yolk Sac ◽  
Thin Wall ◽  
Multiple Pregnancies ◽  
Monochorionic Twin ◽  
The Relationship ◽  
Twin Pregnancies ◽  
Efficient Recognition

AbstractOBJECTIVE. The purpose of this study was to evaluate the relationship between the yolk sacs separated or not separated by septum and chorionicity twin pregnancies scanned early in the first trimester, and the relation between size and morphologic features of the yolk sac and the outcome of twin pregnancies.RESULTS. In all 38 sets of twins two yolk sacs were identified. During the first trimester of a dichorionic twin pregnancy, the yolk sacs were always separated by a septum and not separated (“Eight” sign) in monochorionic twin pregnancy. In five cases, one of yolk sac was abnormally large (> 8mm) and had thin wall. Four of the five mothers spontaneously aborted during the next 2-3 weeks. In one case of monochorionic twin ectopic pregnancy two yolk sacs were seen normally.CONCLUSION. The sonographic identification of yolk sacs in multiple pregnancies allows an early and efficient recognition of presence and chorionicity of twin pregnancy, both in intra – and extrauterine. Identification of abnormal yolk sac or yolk sacs suggests death of one or all embryos.

Nutrition in Twin Pregnancy

1979 ◽  
Vol 28 (4) ◽  
pp. 289-291 ◽  
Author(s):  
Ian MacGillivray
Keyword(s):  
Energy Intake ◽  
Twin Pregnancy ◽  
Twin Pregnancies ◽  
Urinary Nitrogen

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.

scholarly journals Comparison of phenylalanine tolerance in singleton and twin pregnancies in patients with phenylketonuria

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052093462
Author(s):  
Kamil Konrad Hozyasz ◽  
Joanna Żółkowska ◽  
Katarzyna Chyż
Keyword(s):  
Steady State ◽  
Twin Pregnancy ◽  
Target Range ◽  
Singleton Pregnancy ◽  
Empirical Determination ◽  
Twin Pregnancies ◽  
Frequent Assessment ◽  
Singleton Pregnancies

Objectives Empirical determination of phenylalanine (Phe) tolerance in patients with phenylketonuria (PKU) relies on frequent assessment of blood Phe concentrations in relation to Phe intake from detailed meal records. This study aimed to determine Phe tolerance in twin pregnancies. Methods The reviewed cases included three women with PKU who each had a singleton and twin pregnancy (i.e., they were pregnant twice). All patients were under regular supervision to maintain Phe concentrations in a steady state and determine safe Phe intake. Restriction of Phe in the patient’s diet was determined depending on the amount of Phe intake, which allowed for stable blood Phe concentrations within the target range. Results In all three patients with PKU, the ratio of Phe tolerance during the course of the twin and singleton pregnancies was <1 for most of the pregnancy. The ratio of the increase in Phe tolerance between 29 and 34 weeks of gestation and that between 15 and 28 weeks of gestation was 0.66 and 1.17, 0.51 and 0.14, and 0.76 and 1.42 in the twin and singleton pairs of pregnancies, respectively. Conclusions Our study shows that Phe tolerance in a twin pregnancy is not greater than that in a singleton pregnancy.

The regulation of plasma relaxin levels during human pregnancy

1994 ◽  
Vol 142 (2) ◽  
pp. 261-265 ◽  
Author(s):  
M R Johnson ◽  
A A Abbas ◽  
A C J Allman ◽  
K H Nicolaides ◽  
S L Lightman
Keyword(s):  
Corpus Luteum ◽  
Plasma Levels ◽  
Twin Pregnancy ◽  
Human Pregnancy ◽  
Fetal Reduction ◽  
Twin Pregnancies ◽  
Circulating Levels ◽  
Selective Fetal Reduction ◽  
Singleton Pregnancies

Abstract The factors that determine the circulating levels of relaxin during pregnancy have been investigated by comparing the plasma levels of relaxin throughout pregnancy in women who became pregnant spontaneously (singleton, n=240) or following superovulation (singleton and multifetal pregnancies (two to ten conceptuses), n=83). Some of the women with multifetal pregnancies underwent selective fetal reduction to twin pregnancies. Relaxin levels were higher at 7–34 weeks of gestation in singleton pregnancies achieved following superovulation when compared with levels in spontaneously conceived singleton pregnancies (P<0·05–0·001). In samples obtained between 10 and 12 weeks of gestation (before fetal reduction for the multifetal pregnancies), plasma relaxin levels correlated with fetal number (r=0·526, P=0·0001). Reduction in fetal number to a twin pregnancy did not alter relaxin levels. These data suggest that the circulating levels of relaxin throughout pregnancy are determined during the cycle of conception by gonadotrophin stimulation, and within the first 10 weeks of pregnancy by the luteotrophic stimulus from the conceptus. Furthermore, once corpus luteum synthesis of relaxin is established, then reduction in the luteotrophic stimulus does not appear to affect it. Journal of Endocrinology (1994) 142, 261–265

scholarly journals Pulmonary function in advanced uncomplicated singleton and twin pregnancy

2014 ◽  
Vol 40 (3) ◽  
pp. 244-249 ◽  
Author(s):  
Anwar Hasan Siddiqui ◽  
Nazia Tauheed ◽  
Aquil Ahmad ◽  
Zehra Mohsin
Keyword(s):  
Pulmonary Function ◽  
Pregnant Women ◽  
Respiratory Function ◽  
Twin Pregnancy ◽  
Normal Pregnancy ◽  
Singleton Pregnancy ◽  
Respiratory Parameters ◽  
Test Parameters ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

Objective: Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Methods: Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups), as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. Results: All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Conclusions: Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy.

The Importance of Plasma Volume Expansion and Nutrition in Twin Pregnancy

1984 ◽  
Vol 33 (1) ◽  
pp. 19-24 ◽  
Author(s):  
D.M. Campbell ◽  
I. MacGillivray
Keyword(s):  
Birth Weight ◽  
Plasma Volume ◽  
Volume Expansion ◽  
Twin Pregnancy ◽  
Nutrient Supply ◽  
Physiological Adaptation ◽  
Singleton Pregnancy ◽  
Plasma Volume Expansion ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

AbstractPhysiological 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.

scholarly journals Prevalence and risk of pre-eclampsia and gestational hypertension in twin pregnancies: a population-based register study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029908 ◽  
Author(s):  
Katariina Laine ◽  
Gulim Murzakanova ◽  
Kristina Baker Sole ◽  
Aase Devold Pay ◽  
Siri Heradstveit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Twin Pregnancy ◽  
Gestational Hypertension ◽  
Population Based ◽  
Secondary Outcome ◽  
In Vitro Fertilisation ◽  
Birth Registry ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

ObjectivesThe aim of this study was to assess the prevalence and risk of pre-eclampsia and gestational hypertension in twin pregnancies compared with singleton pregnancies.DesignPopulation-based cohort study.SettingMedical Birth Registry of Norway and Statistics Norway.Participants929 963 deliveries with 16 174 twin pregnancies in 1999–2014.MethodsPre-eclampsia prevalences in twin and singleton pregnancies were described in percentages. Multivariable regression analyses were performed to assess the risks of pre-eclampsia and gestational hypertension in twin pregnancies compared with those in singleton pregnancies, adjusted for previously known risk factors.Primary and secondary outcome measuresPrevalence and risk of pre-eclampsia and gestational hypertension.ResultsThe prevalence of pre-eclampsia in the study population was 3.7% (3.4% in singleton pregnancies, 11.8% in twin pregnancies (p=0.001)). The OR for pre-eclampsia in twin pregnancies was three to fourfold compared with singleton pregnancies (OR 3.78; 95% CI 3.59 to 3.96). After adjustment for known risk factors, twin pregnancy remained an independent risk factor for pre-eclampsia (adjusted OR 4.07; 95% CI 3.65 to 4.54). The prevalence of gestational hypertension was 1.7% in women with singleton pregnancies and 2.2% in those with twin pregnancies (OR 1.27; 95% CI 1.14 to 1.41). After adjustment for known risk factors, gestational hypertension was not significantly associated with twin pregnancy.ConclusionsThe risk of pre-eclampsia in twin pregnancies was three to fourfold compared with singleton pregnancies, regardless of maternal age, parity, educational level, smoking, maternal comorbidity or in vitro fertilisation. The risk of gestational hypertension was not increased in women with twin pregnancies after adjustment for the main risk factors.

scholarly journals Systemic immune-inflammation index in twin pregnancies compared to singleton pregnancies

2021 ◽  
Vol 29 (3) ◽  
pp. 250-254
Author(s):  
Ezgi Turgut ◽  
Bedri Sakcak ◽  
Deniz Oluklu ◽  
Şule Göncü Ayhan ◽  
Dilek Şahin
Keyword(s):  
Twin Pregnancy ◽  
First Trimester ◽  
Control Group ◽  
Test Results ◽  
Lymphocyte Ratio ◽  
Laboratory Test Results ◽  
The Mean ◽  
Immune Inflammation ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

Objective To evaluate the systemic immune-inflammation index (SII) in twin pregnancies. Methods The retrospective study included 200 twin (dichorionic/ diamniotic and monochorionic/diamniotic) and 200 singleton pregnancies (control group). All pregnant women were in the first trimester (<14 weeks of gestation). The study and the control groups were compared in terms of demographic characteristics, laboratory test results, and SII values. Results The mean week of gestation was 9.7±2 in dichorionic diamniotic twin pregnancy group, 10.4±2 in monochorionic diamniotic twin pregnancy group and 9.4±2 for the control group (p=0.083). The lymphocyte value was lower in the dichorionic group and monochorionic group than in the control group (p=0.020 and p=0.020, respectively). The platelet-to-lymphocyte ratio (PLR) values were higher in the dichorionic group than in the control group (p=0.002). However, there was no statistical difference between the groups for neutrophil-to-lymphocyte ratio (NLR) and SII values (p>0.05). Conclusion Physiological inflammatory/immune reaction of early pregnancy may affect PLR values in twin pregnancies. We observed that chorionicity is considerable for these inflammatory indices, especially for dichorionic twin pregnancies. However, we could not detect a significant change in SII values in twin pregnancy.

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