Impact of different prenatal management strategies in short‐ and long‐term outcomes in monochorionic twin pregnancies with selective intrauterine growth restriction and abnormal flow velocity waveforms in the umbilical artery Doppler: a retrospective observational study of 108 cases

2020 ◽  
Vol 128 (2) ◽  
pp. 401-409 ◽  
Author(s):  
C Colmant ◽  
A Lapillonne ◽  
J Stirnemann ◽  
I Belaroussi ◽  
E Leroy‐Terquem ◽  
...  
2014 ◽  
Vol 60 (6) ◽  
pp. 585-590 ◽  
Author(s):  
Rita de Cássia Alam Machado ◽  
Maria de Lourdes Brizot ◽  
Seizo Miyadahira ◽  
Rossana Pulcineli Vieira Francisco ◽  
Vera Lúcia Jornada Krebs ◽  
...  

Objective: to evaluate neonatal morbidity and mortality in monochorionic- -diamniotic (MCDA) twin pregnancies complicated by selective intrauterine growth restriction (sIUGR) and non-selective intrauterine growth resctriction (nsIUGR). Methods: neonatal morbidity parameters and mortality were analyzed in 34 twins with IUGR (< 10th percentile on twins’ growth charts): 18 with sIUGR and 16 with nsIUGR. The sIUGR group was made up of 18 pregnancies in which growth was restricted in only one fetus (n = 18). The nsIUGR group was composed of 8 pregnancies in which both fetuses presented restricted growth (n = 16). Cases of twin-to-twin transfusion syndrome and fetal malformation were not included in the study. Results: the MCDA twin pregnancies with sIUGR had a higher rate of orotracheal intubation (p = 0.001) and mechanical ventilation (p = 0.0006), as well as longer than average fasting time (p = 0.014) compared to those in which the fetuses had nsIUGR. A higher incidence was also observed of types II and III umbilical artery Doppler velocimetry patterns in the sIUGR cases (p = 0.002). There was no significant difference between the two groups as to mortality during pregnancy and the neonatal period (p = 0.09). Conclusion: in MCDA twin pregnancies, sIUGR presents more severe umbilical artery Doppler velocimetry abnormalities and worse morbidity than nsIUGR.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Erich Cosmi ◽  
Tiziana Fanelli ◽  
Silvia Visentin ◽  
Daniele Trevisanuto ◽  
Vincenzo Zanardo

Intrauterine growth restriction is a condition fetus does not reach its growth potential and associated with perinatal mobility and mortality. Intrauterine growth restriction is caused by placental insufficiency, which determines cardiovascular abnormalities in the fetus. This condition, moreover, should prompt intensive antenatal surveillance of the fetus as well as follow-up of infants that had intrauterine growth restriction as short and long-term sequele should be considered.


1997 ◽  
Vol 54 (10) ◽  
pp. 2255-2276 ◽  
Author(s):  
P Marchal

Most of the Northeast Atlantic stocks are currently fished above the biological reference points (e.g., Fmax). In attempting to achieve such targets, advisers and managers have faced two main problems. First, it is impractical to (i) simultaneously maximize yields, stabilize fisheries, and safeguard stocks and (ii) optimize both short- and long-term outcomes for the industry. Second is the lack of predictability, several years ahead, in factors influencing decisions. This study addresses these twin issues by exploring the relative performances of various multiannual and compromise (or composite) management strategies. Multiannual fishing efforts are set in advance for a ``resolution'' period of several years, at the end of which they are updated. They are calculated to satisfy a prior weighted compromise amongst three criteria: (i) minimizing fishing effort variability, (ii) minimizing catch variability, and (iii) reaching a ``mobile target:'' the latter is defined with a second weighted compromise between the long-term target and the fishing effort at the beginning of the resolution period. A safe and optimal balance between all the short- and long-term fishery outcomes is found with a 5-year resolution period, during which the mobile target is split into 40-60% of the long-term target, and 60-40% of the fishing effort at the start of the resolution period, while criteria i, ii, and iii are weighted equally.


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