scholarly journals Spontaneous Version of Fetal Presentation in Twin Pregnancies During Third Trimester: Longitudinal Assessment

2018 ◽  
Vol 21 (3) ◽  
pp. 269-274
Author(s):  
Jeong Woo Park ◽  
Seung Mi Lee ◽  
Hye-Sim Kang ◽  
Soon-Sup Shim ◽  
Jong Kwan Jun

Little is known about longitudinal changes of the first twin presentation in twin gestations. This is a retrospective cohort study including 411 women who were admitted consecutively and delivered live-born twins at 36 weeks of gestation or more. Longitudinal assessment of the first twin presentation was conducted during gestation and at birth in all cases. Gestational age at antenatal assessment was divided into two intervals: early-third trimester (28–31 weeks) and mid-third trimester (32–35 weeks). Fetal presentation was categorized as vertex or non-vertex. We analyzed change of fetal presentation between antepartum intervals and birth. First twin presentation at early-third trimester had the same presentation at birth in 87.6% (360/411) of the study population. In this ‘no change’ group, vertex presentation was seen in 95.6% (283/296) and non-vertex was seen in 67.0% (77/115) of cases. In total, 96.1% (395/411) of the study population maintained their presentation between mid-third trimester and birth. Vertex presentation was seen in 98.4% (310/315) and non-vertex was seen in 88.5% (85/96) of cases. When comparing vertex with non-vertex, vertex presentation during third trimester was a more reliable predictor of presentation at birth (p < .001). The only factor that contributed significantly to spontaneous version of the first twin during mid-third trimester and birth was a lower birth weight of the first twin compared with the second twin. In conclusion, first twin presentation with vertex during third trimester is not likely to change into non-vertex at birth. We concluded that vertex presentation in twin gestations at early- and mid-third trimester is very predictable. In contrast, a non-vertex first twin presentation is relatively unstable.

2020 ◽  
Author(s):  
Avital Wertheimer ◽  
Dean Decter ◽  
Adi Borovich ◽  
Ron Bardin ◽  
Eran Hadar ◽  
...  

Abstract Background: To determine the association between gestational age at amniocentesis and procedure-related complications in twin gestations.Methods: A retrospective cohort study of all twin gestations that underwent amniocentesis in a tertiary hospital between 2007 and 2016. Outcomes and procedure related complications were compared between third trimester (≥24 weeks) and mid-trimester amniocentesis (16-23 weeks). Results: Compared to mid-trimester amniocentesis (n=157 (84.9%)), the third trimester group (n=28 (15.1%)) was younger (31.5 vs. 35.3 years, p<0.001) and presented with more fetal growth restriction (28% vs. 10% p=0.015). Membrane rupture within 4 weeks of amniocentesis was significantly higher in the third trimester amniocentesis group (31% vs. 1%, p<0.001). Multivariate analysis suggested gestational age at amniocentesis as an independent risk factor for premature rupture of membranes within 4 weeks of amniocentesis. Conclusions: Third trimester amniocentesis in twin pregnancies is associated with significantly higher rates of procedure related membrane rupture compared to mid-trimester amniocentesis.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Zeng ◽  
Erica Erwin ◽  
Wendy Wen ◽  
Daniel J. Corsi ◽  
Shi Wu Wen ◽  
...  

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.


2016 ◽  
Vol 7 ◽  
pp. JCM.S38895 ◽  
Author(s):  
Shunji Suzuki

We examined the prevalence of specific perinatal complications of monochorionic-diamniotic twin pregnancies in cases without any abnormal findings until the second trimester of pregnancy. This was a retrospective cohort study performed at a tertiary perinatal center in Tokyo, Japan. There were 88 cases of uncomplicated monochorionic-diamniotic twin pregnancies at 28 weeks of gestation. In five of them (5.7%), there were serious complications associated with placental circulatory imbalance between the twins during the third trimester of pregnancy. Two cases were complicated by twin–twin transfusion syndrome, two cases were complicated by twin anemia–polycythemia sequence, and one case was complicated by acute twin–twin transfusion syndrome. In the five cases, no abnormal ultrasonographic findings or symptoms were recognized one or two weeks prior to the diagnosis. Fifty-eight cases (65.9%) were delivered at term uneventfully. Serious complications due to placental circulatory imbalance between twins occurred in about 6% of cases during the third trimester of pregnancy.


2020 ◽  
Author(s):  
Li Yu ◽  
Hai-Jin Ke ◽  
Di Che ◽  
Yong Guo ◽  
Jie-Ling Wu

Abstract Background: The effect of maternal vitamin D status on the birth weight of offspring is controversial as the results are inconsistent between different populations. This large retrospective cohort study aimed to assess the relationship between maternal vitamin D levels and birth weight of neonate. Methods: Serum samples were collected from 10,586 Chinese women in the 2 nd trimester of pregnancy, and the 25-hydroxyvitamin D [25(OH)D] level of the participants was assessed. Using the INTERGROWTH-21st standards, the offsprings were classified into three groups based on their gestational age and birth weight, which were as follows: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Results: The average maternal vitamin D concentration was 61.1 nmol/L. The 25(OH)D concentrations were <75.0, <50.0, and <25.0 nmol/L in 76.6%, 31.1%, and 1.6% of the participants, respectively. Approximately 6.4%, 86.4%, and 7.2% of women delivered SGA, AGA, and LGA infants, respectively. No significant differences were observed in vitamin D levels between the three groups (P = 0.562). With the increase in 25(OH)D levels, the risk of SGA and LGA tended to increase and decrease, respectively. However, the results were not precise. AGA was not affected by 25(OH)D levels. The results of the curve fitting and threshold effect analyses did not support the correlation between vitamin D levels and SGA or LGA. Based on the univariate prediction model and the model that adjusted for the risk factors, the area under the curve was extremely small. Thus, 25(OH)D level is not an effective predictor of SGA and LGA. Conclusions: Low maternal vitamin D levels were not associated with SGA or LGA.


Author(s):  
Zoly Nantenaina Ranosiarisoa ◽  
Mirana Zita Ramananirina ◽  
Rosa Lalao Tsifiregna ◽  
Lovaniaina Ravelomanana ◽  
Noëline Ravelomanana

Background: Very low birth weight (VLBW) new-borns represent vulnerable group. The lower the birth weight, the higher the mortality rate. The objective of this study was to describe the nutritional management of VLBW new-borns and to determine their hospital outcome.Methods: A retrospective cohort study was carried out during 24 months in a hospital center of Antananarivo. All newborns weighing less than 1500 g at birth and admitted to neonatal resuscitation service were included.Results: Of the 577 newborns admitted during this period, 48 were retained as very low birth weight. All had less than to 37 gestational age. New-borns less than or equal to 32 gestational age had a 4.02-fold risk of dying. VLBW with a birth weight less than 1,000 g were 2.12 times more likely to die than those between 1,000 and 1,499 g. The use of artificial milk was neither associated with the onset of digestive intolerance nor associated with VLBW early outcome.Conclusions: Hospital nutritional management of VLBW requires specific and delicate care. Breast milk is ideal for the newborn. But if it is not available immediately, the alternative that is not disadvantageous is artificial milk.


2020 ◽  
pp. 105566562097776
Author(s):  
Johannes A. Smit ◽  
Puck P. Mulder ◽  
Feike de Graaf ◽  
Bernadette S. de Bakker ◽  
Corstiaan C. Breugem

Objective: To analyze the incidence of submucous cleft palate (SMCP) in a large national database and raise awareness among referring providers: pediatricians, speech pathologists, and dentists to minimize delay in diagnosis. Design: Retrospective cohort study. Setting: Tertiary setting. Patients: Patients were extracted from the “Dutch Association for Cleft and Craniofacial Anomalies” database. A total of 6916 patients were included from 1997 until 2018 and divided into 2 groups (ie, SMCP versus cleft palate [CP]). Patients born before 1997 and adopted patients were excluded. Interventions: Clefts were classified as either hard of soft palatal involvement based on anatomical landmarks at first consultation. Main Outcome Measures: Primary outcomes were the patient characteristics in both groups (ie, gender, birth weight, gestational age, and additional anomalies). Secondary outcome was the time of diagnosis among subgroups. Results: In total, 532 patients were diagnosed with SMCP (7.7%). Birth weight, gestational age, and additional anomalies did not differ between subgroups, but there were more males in the SMCP group ( P < .001). The median age of diagnosis of the SMCP group was significantly higher than of the CP group (987 vs 27 days; P < .001). Over the course of 22 years, the time of diagnosis for SMCP did not decrease. Conclusion: Submucous cleft palate represents <10% of the Dutch cleft population and 19.4% of all CP. Time of diagnosis for SMCP is significantly longer when compared with time of diagnosis of CP, and this has not changed over the study period of 22 years.


2015 ◽  
Vol 43 (4) ◽  
Author(s):  
Ioannis Papastefanou ◽  
Athena P. Souka ◽  
Makarios Eleftheriades ◽  
Athanasios Pilalis ◽  
Charalambos Chrelias ◽  
...  

AbstractTo investigate the value of the birth weight of the previous pregnancy (BWSome 1298 parous women with uncomplicated singleton pregnancies who had a third trimester ultrasound scan were considered as samples in this retrospective cohort study. Maternal and pregnancy characteristics, BWBW: BW


2014 ◽  
Vol 132 (5) ◽  
pp. 273-281 ◽  
Author(s):  
Camila Elizandra Rossi ◽  
Francisco de Assis Guedes de Vasconcelos

CONTEXT AND OBJECTIVE: Being born heavier than 4 kg is associated with current overweight and obesity over the long term. The objective here was to ascertain whether birth weight was related to overweight or obese status, among 7 to 14-year-old schoolchildren, taking into consideration the possible interactions between socioeconomic factors and other biological variables.DESIGN AND SETTING: Retrospective cohort study on a probabilistic sample of 2,696 children and adolescents living in Florianópolis, Santa Catarina, Brazil.METHODS: The following data were collected: anthropometric (student's weight, height and age; and parents' weight and height), socioeconomic (family income, number of people in house and parental schooling level), birth weight and gestational age. Overweight and obesity were classified using percentiles of body mass index and triceps and subscapular skinfolds. The outcome variables were overweight and obesity and the main explanatory variables were birth weight and birth weight according to gestational age. The control variables were the parents' nutritional status, their schooling level and theper capita family income. Poisson multivariate regressions were carried out.RESULTS: Higher prevalence of high birth weight was observed among overweight male adolescents (PR = 1.14; 95% CI = 1.02-1.27; P = 0.03), but this was not observed among obese male adolescents. Low birth weight and being born small for gestational age were also not associated with the outcomes. Among overweight and obese children, birth weight was not significantly different from that of normal-weight children.CONCLUSION: No significant association between birth weight and obesity was observed. However, there was a weak but significant association between high birth weight and overweight, among male adolescents.


2021 ◽  
Vol 9 ◽  
Author(s):  
Ling Sun ◽  
Hong Zhang ◽  
Yingying Bao ◽  
Wenying Li ◽  
Jingyuan Wu ◽  
...  

Unlike other complications among very low birth weight infants (VLBW), the incidence of bronchopulmonary dysplasia (BPD) has not decreased substantially, partly because of the different definitions of BPD applied by different researchers. In this retrospective cohort study, we aimed to compare the 2018 revised definition and the 2001 consensus definition of BPD proposed by the National Institute of Child Health and Human Development (NICHD), as well as to identify which definition better predicts severe respiratory morbidities or death. We included 417 infants born at a gestational age &lt;32 weeks and classified them as having BPD or without BPD based on the two definitions, with a final follow-up at 18–24 months. We performed between-group comparisons of death and respiratory outcomes. Statistical analyses were performed using descriptive statistics, comparative tests, and receiver operating characteristic curves. The mean ± standard deviation gestational age and birth weight of the 417 eligible infants were 29.1 ± 1.4 weeks and 1186.6 ± 197.8 g, respectively. Among the included infants, five and three infants died before and after 36 weeks of post-menstrual age (PMA), respectively, with 68 and 344 infants evaluated at discharge and 36 weeks' PMA, respectively. We diagnosed 163 (39.1%) and 70 (16.8%) infants with BPD according to the 2001 and 2018 NICHD definitions, respectively. The 2001 NICHD definition displayed a higher sensitivity (0.60 vs. 0.28), better negative predictive value (0.89 vs. 0.85), and larger area under the receiver operating characteristic curve (0.66 vs. 0.57), but a lower specificity (0.65 vs. 0.87) and worse positive predictive value (0.26 vs. 0.31), than the 2018 definition for serious respiratory morbidity or mortality at a corrected age of 18–24 months. Compared with the 2018 NICHD definition of BPD, the 2001 NICHD consensus definition may result in more cases of false-positive or unclassified severity. However, it may be a better indicator of severe respiratory morbidities or death during the first 18–24 months. Nevertheless, there is a need for future studies to assess the validity of the new diagnostic criteria.


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