scholarly journals Locked twins—remote from term: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Abraham Fessehaye ◽  
Ferid A. Abubeker ◽  
Mekdes Daba
Keyword(s):  
Gestational Age ◽  
Twin Pregnancy ◽  
Caesarian Section ◽  
Obstetric Complication ◽  
Second Stage ◽  
Case Summary ◽  
History Of ◽  
Twin Pregnancies ◽  
Abdominal Delivery ◽  
First Stage Of Labor

Abstract Background Locked twins is a rare and hazardous obstetric complication, which occurs in approximately 1:100 twin pregnancies. One of the known etiologic factors for locked twins is size of the twins. We report a case of chin-to-chin locked twins that occurred at gestational age of 30 weeks pus 6 days. Case summary A 27 years-old primigravida Oromo mother presented with a history of pushing down pain and passage of liquor of 6 hours duration at gestational age of 30 weeks plus 6 days. With a diagnosis of twin pregnancy (first twin non-vertex), abdominal delivery was decided in latent first stage of labor but mother refused caesarian delivery and she was allowed to labor with the hope of achieving a vaginal delivery. In second stage, interlocking twin was encountered and a low vertical cesarean section was done to effect delivery of twins without the need to decapitate the first twin. Conclusion Locked twin is a rare obstetric complication. Whenever it is encountered, successful delivery can be achieved without the need to have decapitation of the first twin during caesarian section.

Where There is No Ultrasound: Delay and Failure of Antenatal Diagnosis of Twin Pregnancy

2003 ◽  
Vol 33 (1) ◽  
pp. 5-7 ◽  
Author(s):  
M C Groot ◽  
E J Buchmann
Keyword(s):  
South Africa ◽  
Antenatal Care ◽  
Twin Pregnancy ◽  
Previous History ◽  
Third Trimester ◽  
Second Stage ◽  
The Third ◽  
Second Stage Of Labour ◽  
History Of ◽  
Twin Pregnancies

We investigate the problem of late diagnosis of twin pregnancy in Soweto, South Africa, where routine antenatal ultrasound is not available. One hundred consecutive pairs of twins were studied, using the notes of mothers who delivered twins at Chris Hani Baragwanath Hospital and the referring Soweto clinics. A positive history was found in 31 mothers (22 family history, nine previous history of twins). Six mothers did not attend for antenatal care. Twenty-five twin pregnancies were discovered at delivery, 15 of them in the second stage of labour, and 27 were diagnosed accidentally in the third trimester. Only 15 pregnancies were referred specifically for suspicion of twin pregnancy. Most twin pregnancies are detected only in the third trimester or at delivery. Until routine ultrasound is available to all pregnant women, the teaching of antenatal care in South Africa must give emphasis to clinical suspicion of twin pregnancy.

scholarly journals Pregnancy Outcome of Twin Pregnancy at Gandaki Medical College Teaching Hospital, Pokhara, Nepal

2018 ◽  
Vol 11 (02) ◽  
pp. 1-4
Author(s):  
M Tripathi ◽  
R Shrestha
Keyword(s):  
Preterm Delivery ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Twin Pregnancy ◽  
College Teaching ◽  
Neonatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Complications ◽  
Twin Pregnancies

Objectives: To evaluate maternal and neonatal complications and pregnancy outcomes of twin pregnancies. Methods: The cross sectional study was conducted using retrospective data on the twin pregnancies with more than 28 weeks of gestational age. The study used data over a period of five years, from March 10, 2010 to March 9, 2015 in the Department of Obstetrics and Gynecology, GMC Teaching Hospital Pokhara. Results: Of the 50 twin pregnancies, the most common maternal complication was preterm delivery (40%). Other maternal complications were anemia (36%), pregnancy induced hypertension (14%), premature rupture of membranes (14%), postpartum hemorrhage (12%) and antepartum hemorrhage (6%). Median gestational age at delivery was 37 weeks. Most common route of delivery was cesarean section (66%). Most common neonatal complication was low birth weight (48%) births first twin and second twin 56%. Conclusion: Twin pregnancy has high maternal and neonatal complications, especially preterm delivery that increases the risk of significant neonatal morbidity and mortality.

Amniocentesis Complications in Yazd Baghaeipour Polyclinic: A Cross-Sectional Study

2020 ◽  
Author(s):  
Nasim Shirgholami ◽  
Fatemeh Abdi ◽  
Mahta Mazaheri ◽  
Razieh Sadat Tabatabaee
Keyword(s):  
Gestational Age ◽  
Fetal Death ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Second Stage ◽  
History Of ◽  
The Mean ◽  
Pass Through ◽  
Type Of Delivery

Background: Amniocentesis, like other invasive methods, has complications such as abortion, premature rupture - second pregnancy and at 29 weeks of membranes, infection, bleeding, etc. Here, we aimed to study the complications of amniocentesis in pregnant women. Methods: This descriptive cross-sectional study was included 409 women with positive first and second stage screening or required amniocentesis referred to Baghaeipour Clinic in 2017. Data was collected by a pre-prepared questionnaire. Results: The mean age of the patients and gestational age was 33.49 ± 6.51 years and 17.39 ± 1.36  weeks, respectively. 132 patients (32.2%) had a history of abortion. Regarding the frequency of needle passage through the placenta, the results showed that in 369 people (90.2%) the needle did not pass through the placenta and in 40 people (9.8%). The needle has passed through the pair. Regarding the frequency distribution of amniocentesis complications, fetal death in (2.4%), bleeding in (2.2%) and PROM (1.7%) were observed in patients and no case of infection and abortion was observed. In terms of age, gestational age, gestational number, placental location, needle passage, aspirated fluid color, history of abortion and type of delivery, there were no significant differences. Conclusion: In this study the most common complication of amniocentesis was fetal death (2.4%), followed by bleeding and Spotting (2.2%), PROM (1.7%), infection and abortion, respectively.

Uterine Height and Umbilical Perimeter Curves in Twin Pregnancies

1982 ◽  
Vol 31 (3-4) ◽  
pp. 195-198 ◽  
Author(s):  
B. Leroy ◽  
F. Lefort ◽  
R. Jeny
Keyword(s):  
Gestational Age ◽  
Twin Pregnancy ◽  
Two Parameters ◽  
Twin Pregnancies

From previous research, which gave standard curves for the evolution of uterine height and umbilical perimeter according to gestational age in the case of single pregnancies, the authors propose curves which show the variations of these two parameters in twin pregnancies.The observed differences are sufficient to allow a diagnosis of twin pregnancy as soon as the 18th week of amenorrhea.This observation is interesting because, until now, a systematic early B-scan examination has not been performed as a rule.

Bed Rest in Twin Pregnancy

1985 ◽  
Vol 34 (1-2) ◽  
pp. 67-71 ◽  
Author(s):  
B. Kappel ◽  
K.B. Hansen ◽  
J. Moller ◽  
J. Faaborg-Andersen
Keyword(s):  
Birth Weight ◽  
Preterm Delivery ◽  
Gestational Age ◽  
Twin Pregnancy ◽  
Bed Rest ◽  
Fetal Weight ◽  
Reduced Frequency ◽  
Twin Pregnancies ◽  
At Home

AbstractA total of 146 twin pregnancies were studied to evaluate the importance of bed rest. A significantly reduced frequency of preterm delivery was found after bed rest in hospital as compared to bed rest at home or no bed rest at all. An increase in gestational age and in birth weight was seen after bed rest. No effect was found on the intrauterine increase of fetal weight per time. Early routine ultrasound is recommended, so that effective bed rest may be instituted in due time.

scholarly journals Twin pregnancies: incidence and outcomes in a tertiary health centre of Uttarakhand, India

2018 ◽  
Vol 7 (9) ◽  
pp. 3520 ◽  
Author(s):  
Purnima Upreti
Keyword(s):  
Gestational Age ◽  
Twin Pregnancy ◽  
Health Centre ◽  
Mode Of Delivery ◽  
Presentation Mode ◽  
Fetal Outcomes ◽  
Health Care Centre ◽  
Risk Pregnancy ◽  
Term Labour ◽  
Twin Pregnancies

Background: The frequency of twin pregnancies varies among different regions, countries and populations mostly due to the variation in dizygotic twinning. Twin pregnancy is associated with adverse maternal and fetal outcomes. This study was aimed to find out the frequency and outcome of twin pregnancies in a tertiary health centre of Uttarakhand.Methods: This is a retrospective hospital record-based study of the twin deliveries (with gestational age of 28 weeks and above) which took place in a tertiary health care centre of Uttarakhand from January 2016 to December 2017. Data regarding age, parity and registration status of women who delivered twins, factors associated with twin pregnancy, gestational age, fetal presentation, mode of delivery, pregnancy complications and neonatal outcome was collected and analyzed.Results: The frequency of twin pregnancy was found to be 1 in 52 pregnancies or 1.9%. Majority (56.4%) of the participants were in the age group of 21-25 years. 52.8% were multipara. 74.3% were unbooked. 3.7 % conceived after ovulation induction and 8.2% had family history of twins. Pre-term labour (58.3%) was the most common complication followed by malpresentation (around 37%). Cephalic-cephalic was the commonest fetal presentation (43.8%).58.3% neonates were premature at birth and 83.4% had low birth weight. Male-male was the commonest sex combination of twin pair (30.4%) followed by female-female (28.6%).Conclusions: Twin pregnancy is a high-risk pregnancy associated with adverse maternal and fetal outcomes.

Clinical characteristics and outcome of twin pregnancies complicated by single intrauterine death

2018 ◽  
Vol 46 (1) ◽  
pp. 75-79
Author(s):  
Qiong Luo ◽  
Xiujun Han
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Congenital Anomalies ◽  
Clinical Characteristics ◽  
Twin Pregnancy ◽  
Pregnancy Termination ◽  
Demographic Data ◽  
Intrauterine Death ◽  
School Of Medicine ◽  
Twin Pregnancies

Abstract:Aim:To investigate the clinical characteristics and outcome of twin pregnancies complicated by single intrauterine death and how to improve the outcomes of surviving twins. Three thousand three hundred and eighty-four women who delivered twin pregnancies at Women’s Hospital, Zhejiang University, School of Medicine were included. Clinical and demographic data on gestational age, etiology, morbidity and mortality for mothers and fetuses were collected.Results:The median gestational age for detecting a single intrauterine death in twin pregnancy was 29 weeks and the average gestational age of pregnancy termination was 32 weeks. At least one complication occurred in 93 of 134 mothers (69.4%). The leading causes of a single intrauterine death were umbilical cord abnormality (21.6%), congenital anomalies (17.9%), twin-twin transfusion syndrome (TTTS) (8.2%) and velamentous placenta (7.4%). Of the 134 cases, in 115 cases the remaining twin survived. The birth weight of the surviving twin was significantly higher in pregnancies that continued for more than 1 week after single intrauterine death compared to that ended within 1 week after intrauterine death.Conclusions:Extension of gestation for the surviving twin fetus as long as possible in ensuring the health of the surviving twin and mother, will improve the prognosis of surviving twin after a single intrauterine death.

scholarly journals Perinatal Outcome in Twin Pregnancy at Khaipur Medical College, Khairpur Mirs, Pakistan

2021 ◽  
pp. 46-52
Author(s):  
Nusrat Fozia Pathan ◽  
Shazia Jamali ◽  
Maqsood Ahmed Siddiqui ◽  
Khushi Muhammad Sohu ◽  
Ameer Ali Jamali ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Gestational Age ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Mode Of Delivery ◽  
Case Series ◽  
Risk Pregnancy ◽  
The Mean ◽  
Twin Pregnancies

Objective: To determine the perinatal outcome of twin pregnancy and to find out the frequency of twin deliveries in hospital based population. Study Design: Descriptive case series. Place and Duration of Study: The study was conducted over a period of 02 Year 1st January 2018 to 31st December 2019 in the Obstetrics and Gynaecology Department at KMC Khairpur Mirs, Sindh Pakistan. Methodology: All the patients of age 20-35 years with twin pregnancies of gestational age above 30 weeks presenting in labour ward of KMC Khairpur Mirs were studied. A detailed history was taken, general physical (G.P) examination and obstetrical examination performed, targeted investigations carried out to detect various fetal complications. Patients were assessed for a mode of delivery, records for data like age, gestational age, weight of baby, APGAR score expressed in term of mean±SD and data like perinatal mortality, prematurity, intra uterine growth restriction (IUGR), the weight of baby and APGAR score expressed in terms of frequencies and percentages on SPSS version 20. Results: In this study total numbers of deliveries were 7200, among them 83 were twin pregnancies the frequency of twin was 1.15%. Booked cases were 24.1%, unbooked was 75.9%. The highest incidence of 42.2% of twin gestation was seen in women between ages 31-35 years, the mean age of patients was seen 30.1±4.1 and regarding the parity incidence was high 54.2% in multiparous l-5. The total number of preterm deliveries was 45(55.2%), gestational age was (35-36+6dnys) weeks in 22.89% of cases, and the mean gestational age of patients was 35.7±2.5. Perinatal mortality was 38(22.9%), stillborn and early neonatal deaths (ENND) were 18.4% and 36.8% and common in twin-2. Conclusion: Twin pregnancy is-a-high-risk-pregnancy still is a major obstetrical and perinatal challenge. The frequency of twin pregnancy seen in this study is 1.15% unbooked and unsupervised pregnancies are more common i.e 75.9%.  Prematurity is common perinatal morbidity 51.20%.  perinatal mortality is 22.9% and highest in twin-2.

scholarly journals Intrapartum Fetal Electrocardiogram in Small- and Large-for-Gestational Age Fetuses

2021 ◽  
Author(s):  
Lena Braginsky ◽  
Steven J. Weiner ◽  
George R. Saade ◽  
Michael W. Varner ◽  
Sean C. Blackwell ◽  
...  
Keyword(s):  
Gestational Age ◽  
Secondary Analysis ◽  
Waveform Analysis ◽  
Large For Gestational Age ◽  
Fetal Electrocardiogram ◽  
Second Stage ◽  
St Depression ◽  
Fetal Ecg ◽  
St Elevation ◽  
First Stage Of Labor

Objective This study aimed to evaluate whether intrapartum fetal electrocardiogram (ECG) tracings with ST-elevation or depression occur more frequently in each stage of labor in small-for-gestational age (SGA) or large-for-gestational age (LGA), as compared with appropriate-for-gestational age (AGA) fetuses. Study Design We conducted a secondary analysis of a large, multicenter trial in which laboring patients underwent fetal ECG waveform-analysis. We excluded participants with diabetes mellitus and major fetal anomalies. Birth weight was categorized as SGA (<10th percentile), LGA (>90th percentile), or AGA (10–90th percentile) by using a gender and race/ethnicity specific nomogram. In adjusted analyses, the frequency of ECG tracings with ST-depression or ST-elevation without depression was compared according to birthweight categories and labor stage. Results Our study included 4,971 laboring patients in the first stage and 4,074 in the second stage. During the first stage of labor, there were no differences in the frequency of ST-depression in SGA fetuses compared with AGA fetuses (6.7 vs. 5.5%; adjusted odds ratio [aOR]: 1.41, 95% confidence interval [CI]: 0.93–2.13), or in ST-elevation without depression (35.8 vs. 34.1%; aOR: 1.17, 95% CI: 0.94–1.46). During the second stage, there were no differences in the frequency of ST-depression in SGA fetuses compared with AGA fetuses (1.6 vs. 2.0%; aOR: 0.69, 95% CI: 0.27–1.73), or in ST-elevation without depression (16.2 vs. 18.1%; aOR: 0.90, 95% CI: 0.67–1.22). During the first stage of labor, there were no differences in the frequency of ST-depression in LGA fetuses compared with AGA fetuses (6.3 vs. 5.5%; aOR: 0.97, 95% CI: 0.60–1.57), or in ST-elevation without depression (33.1 vs. 34.1%; aOR: 0.80, 95% CI: 0.62–1.03); during the second stage of labor, the frequency of ST-depression in LGA compared with AGA fetuses (2.5 vs. 2.0%, aOR: 1.36, 95% CI: 0.61–3.03), and in ST-elevation without depression (15.5 vs. 18.1%; aOR: 0.83, 95% CI: 0.58–1.18) were similar as well. Conclusion The frequency of intrapartum fetal ECG tracings with ST-events is similar among SGA, AGA, and LGA fetuses. Key Points

scholarly journals Fetal Growth and Adipose Fat Tissue Trajectories in Twin Pregnancies after Gastric Bypass Surgery

Obesity Facts ◽  
2021 ◽  
Author(s):  
Gülen Yerlikaya-Schatten ◽  
Theresa Schönleitner ◽  
Michael Feichtinger ◽  
Grammata Kotzaeridi ◽  
Daniel Eppel ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Birth Weight ◽  
Fetal Growth ◽  
Twin Pregnancy ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Abdominal Circumference ◽  
Intrauterine Growth ◽  
History Of ◽  
Twin Pregnancies

Introduction: Previous studies demonstrated a continues decline in fetal growth throughout singleton pregnancy after bariatric surgery. However, intrauterine growth in twin pregnancy is subjected to further underlying processes. This study was to investigate the longitudinal assessment of fetal biometry and abdominal fat thickness of twin pregnancies conceived after gastric bypass surgery and compare them to BMI-matched and obese controls. Materials and methods: We retrospectively assessed ultrasound data of 30 women with dichorionic-diamniotic twin pregnancy (11 women after gastric bypass surgery, 9 obese mothers with pregestational BMI ≥ 30 kg/m² and 10 BMI and age matched controls). We assessed fetal growth parameters including fetal subcutaneous adipose tissue thickness (FSCTT) as well as newborn biometry after delivery. Patient characteristics were obtained from the medical records. Results: The rise in FSCTT curves was markedly slower in twin offspring of women with history of gastric bypass as compared to offspring of obese mothers and offspring of BMI matched controls. Hence, FSCTT was significantly decreased in gastric bypass offspring as compared to both control groups at 34 weeks of gestation. Also, growth curves of abdominal circumference were decreased in offspring of gastric bypass patients as compared to obese mothers. Infants of mothers with history of gastric bypass showed significantly lower birth weight percentiles compared to newborns of obese mothers (27.2 vs 48.8 pct, p=0.025). There was no significant difference in inter twin birth weight difference between offspring of gastric bypass (median: 9.9%, IQR: 6.5 to 20.0) vs. obese (median: 14.6%, IQR: 8.2 to 21.6) and BMI matched controls (median: 9.0%, IQR: 6.3 to 12.6, p=0.714). Conclusions: In summary, intrauterine growth delay in twin pregnancies after GB is assumed to be a multifactorial event with altered metabolism as the most important factor. However, special attention must be paid to the particularity of twin pregnancies as they seem to be subject to other additional mechanism.

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