The Frequency of Ovular Resorption During the First Trimester of Twin Pregnancy

1979 ◽  
Vol 28 (4) ◽  
pp. 270-272
Author(s):  
Lucien Schneider ◽  
Roger Bessis ◽  
Thérèse Simonnet
Keyword(s):  
Twin Pregnancy ◽  
First Trimester ◽  
Twin Pregnancies

A follow-up of 78 twin pregnancies diagnosed in the first trimester indicated that early ovular resorption occurred in 63% of spontaneous and 64% of Clomiphene-induced gestations, so that singletons were born. No failure was observed in the 12 twin conceptions following administration of gonadotropins or Cyclofenil.

When diamniotic twins suddenly become monoamniotic twins: spontaneous septostomy of the dividing membrane

2021 ◽  
Vol 14 (7) ◽  
pp. e243513
Author(s):  
Angela Vidal ◽  
Cristina Nastasia ◽  
Markus Hodel ◽  
Joachim Kohl
Keyword(s):  
Twin Pregnancy ◽  
Rare Condition ◽  
First Trimester ◽  
Sonographic Diagnosis ◽  
Sudden Failure ◽  
Reliable Diagnosis ◽  
Accepted Standard ◽  
Perinatal Management ◽  
Twin Pregnancies ◽  
First Trimester Ultrasound

In twin pregnancies, amnionicity and chorionicity are crucial as they strongly determine prenatal and perinatal management. First trimester ultrasound allows a highly reliable diagnosis of amnionicity and chorionicity, making it an internationally accepted standard in antenatal care. However, in rare cases, amnionicity can change from diamniotic to monoamniotic throughout pregnancy, substantially impacting perinatal management. We report the case of a confirmed monochorionic diamniotic twin pregnancy with a diagnosis of spontaneous septostomy of the dividing membrane (SSDM) at 28 weeks of gestation, resulting in a pseudomonoamniotic pregnancy. Even though SSDM is a rare condition and its sonographic diagnosis might be challenging, it should be considered if, in a known diamniotic pregnancy, there is a sudden failure to visualise the intertwin membrane truly separating both twins.

scholarly journals Association Between First-Trimester Intrauterine Hematoma and Twin Pregnancy Outcomes: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Wanqing Ji ◽  
Jie Zheng ◽  
Weidong Li ◽  
Fang Guo ◽  
Bo Hou ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Odds Ratio ◽  
Vaginal Bleeding ◽  
Pregnancy Loss ◽  
Twin Pregnancy ◽  
Adjusted Odds Ratio ◽  
First Trimester ◽  
Multivariable Logistic Regression Analysis ◽  
Vanishing Twin Syndrome ◽  
Twin Pregnancies

Abstract Background: In recent years, we have found that first-trimester intrauterine hematoma in twin pregnancy has become increasingly common. The majority of studies on intrauterine hematoma have excluded twin pregnancies, while others did not differentiate between singleton and twin pregnancies. The associations in twin pregnancy are not clear. Therefore, the primary objective of our study was to examine the associations between first-trimester intrauterine hematoma and pregnancy outcomes in twin pregnancy. Material and methods: 1020 twin pregnancies in women who underwent a routine examination from January 2014 to December 2018 were enrolled. According to the presence or absence of intrauterine hematoma, we compared the baseline data and pregnancy outcomes between two groups. Multivariable logistic regression analysis was used to adjust for possible confounding factors. Results: A total of 209 patients (21.3%) developed intrauterine hematoma in the first trimester. First-trimester intrauterine hematoma was significantly associated with increased odds of miscarriage (adjusted odds ratio 14.27, 95% CI 8.25-24.70) and the vanishing twin syndrome (adjusted odds ratio 3.26, 95% CI 1.11-4.61). However, It did not have increased odds of adverse pregnancy outcomes after 20 Weeks of Gestation .In the final regression model analysis, the associations of hematoma with previous miscarriage history, accepted assisted conception, accompanying vaginal bleeding and miscarriage and vanishing twin syndrome were no longer significant. No association was found between hematoma size or the presence of vaginal bleeding and the risk of pregnancy loss or the vanishing twin syndrome before 20 weeks of gestation (P>0.05). Conclusion: In women with twin pregnancies, the presence of intrauterine hematoma in the first trimester was associated with one or both fetal losses before 20 weeks of gestation. However, chorionicity in twins, the conception method, the intrauterine hematoma size and the presence of vaginal bleeding were not independently associated with pregnancy loss.

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.

Is Routine Hospitalization in Twin Pregnancy Necessary? A Follow-up Study

1985 ◽  
Vol 34 (3-4) ◽  
pp. 189-192 ◽  
Author(s):  
Anna-Liisa Hartikainen-Sorri
Keyword(s):  
Pregnancy Complications ◽  
Premature Birth ◽  
Twin Pregnancy ◽  
Bed Rest ◽  
Follow Up Study ◽  
Hospital Bed ◽  
Gestational Week ◽  
A Prospective Study ◽  
Twin Pregnancies

AbstractDuring the years 1979-1980, a prospective study was carried out to evaluate the value and efficacy of routine hospital bed rest in the prevention of premature birth and pregnancy complications in twin gestation. This was done by comparing hospital bed rest to special antenatal care at outpatient clinic. Since the results did not support the idea of using routine hospital bed rest, this was abandoned. Because the material was rather small, the results of the changed policy of management were controlled in the present follow-up study. The material consists of 102 twin pregnancies diagnosed during the years 1982-1983. The number of deliveries before the 34th gestational week and of < 1500 g weighing infants were still decreasing (9.0% and 3.0%). Perinatal mortality after the 24th gestational week was 2.0%. The follow-up study confirmed the unefficacy of routine hospital bed rest. Early diagnosis is the basis of the management of twin pregnancy. This allows counselling of the pregnant women, regular examinations to detect pregnancy complications, and also planning of the delivery.

scholarly journals Influence of chorionicity on healthy twin pregnancy outcome

2020 ◽  
Vol 77 (10) ◽  
pp. 1080-1085
Author(s):  
Slavica Aksam ◽  
Snezana Plesinac ◽  
Jelena Dotlic ◽  
Dusica Kocijancic-Belovic ◽  
Mirjana Marjanovic-Cvjeticanin
Keyword(s):  
Pregnancy Outcome ◽  
Apgar Score ◽  
Twin Pregnancy ◽  
First Trimester ◽  
Monochorionic Twins ◽  
Membrane Rupture ◽  
Clinical Center ◽  
Gestational Week ◽  
Adverse Pregnancy ◽  
Twin Pregnancies

Background/Aim. It is still under debate in what sense and extent can chorionicity impact the pregnancy outcome of twins without gestational complications specific for monochorionicity. The study aimed to evaluate the effect of chorionicity on healthy twin pregnancy outcome. Methods. The study included patients with uncomplicated twin pregnancies after first trimester that were checked-up and delivered at the Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade during three years (2010?2013). Data regarding mother?s age, comorbidities, parity, presence and type of gestational complications, chorionicity, mode and time of pregnancy ending, birth-weight and Apgar score of twins were determined. Obtained data were compared and statistically analyzed. Results. The study included 361 women with mean age of 33 years. Regardless of chorionicity, twins were mostly born during the 36th gestational week and received Apgar score ? 8. Only three monochorionic twins were stillborn, two preterm (29 and 32 gestational week) and one in term (35 gestational week) delivery. Contrary, no intrauterine fetal deaths were recorded. Monochorionicity negatively correlated with having live-born twins (OR = 0.023; CI = [0.001?0.609]; p = 0.024), but was not associated with twins condition at birth, i.e. Apgar score (p = 0.345), pregnancy ending time (p = 0.578) or any other twins characteristic. However, premature preterm membrane rupture and earlier gestational week of pregnancy ending were important confounding factors for relationship between chorionicity and pregnancy outcome. Conclusion. Monochorionicity increases risk for adverse pregnancy outcomes even for uncomplicated, healthy twin pregnancy, but has no influence on the condition of twins who survive until term. If appropriate surveillance and therapy are applied, both healthy twins can be delivered at term regardless of chorionicity.

scholarly journals Management of twin pregnancy with a hydatidiform mole and surviving healthy co-existent fetus

2017 ◽  
Vol 6 (12) ◽  
pp. 5636
Author(s):  
Hale Goksever Celik ◽  
Gözde Meriç Demirezen ◽  
Baki Erdem ◽  
Alev Atış Aydın ◽  
Volkan Ülker
Keyword(s):  
Maternal Morbidity ◽  
Twin Pregnancy ◽  
Hydatidiform Mole ◽  
Uterine Cavity ◽  
First Trimester ◽  
Molar Pregnancy ◽  
Complete Mole ◽  
Live Fetus ◽  
Twin Pregnancies ◽  
Normal Placenta

Twin pregnancies with complete mole and a coexisting live fetus are rare obstetric conditions seen in 1 case of 22000 to 100000 pregnancies. In our case, a twin molar pregnancy was diagnosed in the first trimester by ultrasound. In a 27-year-old patient with the first pregnancy, a 12-week live fetus with a normal placenta and a twin molar pregnancy appearance were observed on a routine ultrasonographic examination of the uterine cavity. Twin molar pregnancies are reported to be terminated by live birth in the literature, but termination of pregnancy is an important option to prevent maternal morbidity since molar pregnancy may lead to complications ranging from theca lutein cysts to gestational trophoblastic neoplasia.

scholarly journals Is twin pregnancy, calving and pregnancy loss predictable by serum pregnancy-specific protein b (pspb) concentration 28–35 days after ai in dairy cows?

2018 ◽  
Vol 66 (3) ◽  
pp. 451-461
Author(s):  
Zoltán Szelényi ◽  
Orsolya Gabriella Balogh ◽  
Fernando Lopez-Gatius ◽  
Irina Garcia-Ispierto ◽  
Eszter Krikó ◽  
...  
Keyword(s):  
Serum Concentration ◽  
Milk Production ◽  
Pregnancy Loss ◽  
Twin Pregnancy ◽  
First Trimester ◽  
Specific Protein ◽  
Holstein Friesian ◽  
Study Population ◽  
Twin Pregnancies ◽  
Protein B

Double ovulation occurs more frequently in multiparous cows with high milk production than in primiparous cows and the rate of twin pregnancy/calving is increasing worldwide. Diagnosis of twin pregnancy is possible by ultrasound at the time of early pregnancy examination [28–34 days after artificial insemination (AI)]. Pregnancy proteins are also well-known indicators of gestation. The risk of pregnancy loss during the first trimester of gestation for cows carrying twins is three to nine times higher than for cows carrying singletons. Pregnancy-specific protein B (PSPB) is a good indicator not only of pregnancy but also of pregnancy loss. The aims of this study were (a) to collect calving data in some Hungarian Holstein-Friesian herds (n = 7,300) to compare PSPB serum concentrations (measured 29–35 days post insemination) in twin- and singleton-calving cows (Trial 1), and (b) to check the predictive value of PSPB serum concentration for twin pregnancy and pregnancy loss in high-producing Spanish Holstein-Friesian cows (n = 98; Trial 2). Our results showed almost 7% twin calving rate. Although hormonal treatments are commonly believed to be major causes of twin pregnancies, our data do not support this hypothesis. The only exception is the single PGF injection, which significantly increased twin calving. No effect of milk production on the risk of twin pregnancy was found, and twin pregnancy increased with parity. The AI bull, the bull’s sire, the bull’s grandfather and the cow’s father also affected twin calving (P ≤ 0.02). We found much higher frequency of twin calving in cows diagnosed pregnant with higher than 3 ng/ml serum PSPB concentrations at 29–35 days after insemination. In Trial 2, non-significant but well-marked differences were found in PSPB serum concentration between singleton- and twin-pregnant cow samples (2.1 and 2.9 ng/ml) at different bleeding times. Probably the small size of the study population and the effects of milk production on PSPB values may explain this lack of significance.

Diagnosis of Placental Position by Early First-Trimester Ultrasound: A Pilot Study

2019 ◽  
Vol 26 (11) ◽  
pp. 1512-1518 ◽  
Author(s):  
Laura Detti ◽  
Jennifer C. Gordon ◽  
Mary E. Christiansen ◽  
Nicole A. Van de Velde ◽  
Ludwig Francillon ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cesarean Section ◽  
Transvaginal Ultrasound ◽  
First Trimester ◽  
Significant Difference ◽  
Gestational Sac ◽  
Twin Pregnancies ◽  
Anterior Posterior ◽  
First Trimester Ultrasound

Objective: Conventional wisdom is that placental location cannot be identified before 8 weeks’ gestation when the placenta first becomes hyperechogenic on ultrasound. We sought to evaluate whether placental location could be reliably diagnosed between 5 and 6 weeks’ gestation. Materials and Methods: This was a retrospective analysis of prospectively acquired data. Early placental location was diagnosed by evaluation of the embryonal and yolk sac position inside the gestational sac on transvaginal ultrasound. Placental position was described as anterior, posterior, fundal, or lateral. Early and mid-pregnancy placental locations were compared and coded as being the same, having migrated to an adjacent surface, or being on an opposite surface. Results: A total of 111 patients met study criteria, providing 141 placental locations, comprising 85 singleton and reduced pregnancies and 28 dichorionic twin pregnancies. The most common placental location was anterior in both singleton and twin/triplet pregnancies. Placental location at the mid-pregnancy ultrasound was consistent with early pregnancy location in 100% of cases, with 79.5% (112/141) being on the same surface and 20.5% (29/141) having expanded onto an adjacent surface. Placental location was not associated with pregnancy outcome, although our study may have been underpowered to detect a significant difference. Conclusions: Placental location diagnosed at 5 to 6 weeks’ gestation is consistent with the location on mid-pregnancy ultrasound. Excluding the presence of an ectopic, cornual, or cesarean section scar and uterine subseptation pregnancy in early first trimester would allow a more effective tailoring of pregnancy follow-up.

scholarly journals sFlt-1, Not PlGF, Is Related to Twin Gestation Choronicity in the First and Third Trimesters of Pregnancy

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1181
Author(s):  
Szymon Kozłowski ◽  
Anna Stelmaszczyk-Emmel ◽  
Iwona Szymusik ◽  
Aleksandra Saletra-Bielińska ◽  
Robert Brawura-Biskupski-Samaha ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Prospective Observational Study ◽  
First Trimester ◽  
Placental Growth Factor ◽  
Serum Concentrations ◽  
Third Trimester ◽  
Monochorionic Twin ◽  
The Third ◽  
Angiogenic Biomarkers ◽  
Twin Pregnancies

Background: Preeclampsia occurs more often in dichorionic than in monochorionic twin pregnancy. We hypothesize that serum concentrations of biomarkers: placental growth factor (PlGF), serum soluble fms-like tyrosine kinase-1 (sFlt-1), and endoglin (Eng) differ between monochorionic and dichorionic twin pregnancies. Methods: A prospective observational study including 43 monochorionic and 36 dichorionic twin gestation was conducted. Blood samples were collected twice from all participants: between 11 + 0 and 13 + 6 and between 32 + 0 and 34 + 0 weeks of gestation. PlGF, sFlt-1 and Eng were measured using immnunoenzymatic assays. Results: We found a significantly higher concentration of sFlt-1 in dichorionic in comparison to monochorionic pregnancies in both the first and third trimesters. PlGF and sEng levels did not differ between mono- and dichorionic gestation in both study periods. sFlt-1 level was related to twin gestation chorionicity, while PlGF expression was not. PlGF, sFlt-1 and sEng concentrations increased significantly during gestation and were much higher in the third trimester compared to the values measured in the first trimester. Conclusions: Angiogenic biomarkers expression differ between dichorionic and monochorionic twin pregnancy. The sFlt-1 level is related to chorionicity of a twin gestation.

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