Controversial Issues in the Management of Multiple Pregnancies

Twin Research ◽  
2001 ◽  
Vol 4 (3) ◽  
pp. 165-167 ◽  
Author(s):  
Isaac Blickstein
Keyword(s):  
Mode Of Delivery ◽  
Controversial Issues ◽  
Multiple Pregnancies ◽  
Perinatal Medicine ◽  
Genetic Studies ◽  
Special Cases ◽  
Definition Of ◽  
Multifetal Pregnancy ◽  
Selection Of ◽  
Multifetal Pregnancy Reduction

AbstractThe management of multiple pregnancies represents a true challenge for all sub-specialties concerned with perinatal medicine. Many issues were neglected over the years merely because they were rare and therefore considered not sufficiently important to merit clinical trials. This paper discusses a personal selection of controversial issues, such as multifetal pregnancy reduction of triplets and twins, special cases in multifetal preganncy reduction, need for invasive genetic studies, management of twin-twin transfusion, discordant fetal conditions, the definition of “term” in multiples, and the controversy about the mode of delivery.

scholarly journals Recovery of second trimester pre-eclampsia after fetal reduction of a triplet

2019 ◽  
Vol 12 (9) ◽  
pp. e227667
Author(s):  
Jeske M bij de Weg ◽  
Christianne J de Groot ◽  
Eva Pajkrt ◽  
Marjon A de Boer
Keyword(s):  
Severe Hypertension ◽  
Multiple Pregnancy ◽  
Second Trimester ◽  
Multiple Pregnancies ◽  
Review Of The Literature ◽  
Hypertensive Disorders Of Pregnancy ◽  
Triplet Pregnancy ◽  
Increased Risk ◽  
Multifetal Pregnancy ◽  
Multifetal Pregnancy Reduction

Women with a multiple pregnancy are at increased risk of developing hypertensive disorders of pregnancy. We describe a case of a dichorionic triamniotic triplet pregnancy complicated by severe hypertension, proteinuria and maternal symptoms, fitting with the diagnosis of pre-eclampsia, apart from the early gestational age of only 16 weeks. After reduction of the monochorionic pair, the disease resolved and pre-eclampsia was diagnosed again at 30 weeks of gestation, resulting in a delivery on maternal indication at 33 weeks of gestation. In a review of the literature, we found six papers including eight cases on multifetal pregnancy reduction on maternal indication. Multifetal pregnancy reduction resulted in a prolongation of pregnancy of two to 21 weeks and may be considered in extreme early onset pre-eclampsia in dichorionic multiple pregnancies.

scholarly journals Abortion and multifetal pregnancy reduction: An ethical comparison

2021 ◽  
Author(s):  
Silje Langseth Dahl ◽  
Rebekka Hylland Vaksdal ◽  
Mathias Barra ◽  
Espen Gamlund ◽  
Carl Tollef Solberg
Keyword(s):  
Medical Ethics ◽  
Psychological Effects ◽  
Multiple Pregnancies ◽  
Relevant Difference ◽  
Abortion Debate ◽  
Abortion Legislation ◽  
Moral Distinction ◽  
Multifetal Pregnancy ◽  
Multifetal Pregnancy Reduction

In recent years, multifetal pregnancy reduction (MFPR) has increasingly been a subject of debate in Norway. The intensity of this debate reached a tentative maximum when the Legislation Department delivered their interpretative statement, Section 2 - Interpretation of the Abortion Act, in 2016 in response to a request from the Ministry of Health (2014) that the Legislation Department consider whether the Abortion Act allows for MFPR of healthy fetuses in multiple pregnancies. The Legislation Department concluded that the current abortion legislation [as of 2016] allows for MFPR subject to the constraints that the law otherwise stipulates. The debate has not subsided, and during autumn 2018 it was further intensified in connection with the Norwegian Christian Democratic "crossroads" policy and signals from the Conservatives to consider removing section 2.3c and to forbid MFPR. Many of the arguments in the MFPR debate are seemingly similar to arguments put forward in the general abortion debate, and an analysis to ascertain what distinguishes MFPR from other abortions has yet to be conducted. The aim of this article is, therefore, to examine whether there is a moral distinction between abortion and MFPR of healthy fetuses. We will cover the typical arguments emerging in the debate in Norway and exemplify them with scholarly articles from the literature. We have dubbed the most important arguments against MFPR that we have identified the harm argument, the slippery-slope argument, the intention argument, the grief argument, the long-term psychological effects for the woman argument, and the sorting argument. We conclude that these arguments do not measure up in terms of demonstrating a morally relevant difference between MFPR of healthy fetuses and other abortions. Our conclusion is, therefore — despite what several discussants seem to think — that there is no morally relevant difference between the two. Therefore, on the same conditions as we allow for abortions, we should also allow MFPR. Keywords: abortion, ethics, medical ethics, MFPR, selective MFPR

Selection and Preparation of Specific Tissue Regions For Tem Using Large Epoxy-Embedded Blocks

1973 ◽  
Vol 31 ◽  
pp. 324-325 ◽  
Author(s):  
P. M. Lowrie ◽  
W. S. Tyler
Keyword(s):  
Electron Microscopy ◽  
Anatomical Structures ◽  
Ultrastructural Studies ◽  
Transmission Electron ◽  
Microscopic Evaluation ◽  
Embedded Blocks ◽  
Specific Tissue ◽  
Definition Of ◽  
Areas Of Interest ◽  
Selection Of

The importance of examining stained 1 to 2μ plastic sections by light microscopy has long been recognized, both for increased definition of many histologic features and for selection of specimen samples to be used in ultrastructural studies. Selection of specimens with specific orien ation relative to anatomical structures becomes of critical importance in ultrastructural investigations of organs such as the lung. The uantity of blocks necessary to locate special areas of interest by random sampling is large, however, and the method is lacking in precision. Several methods have been described for selection of specific areas for electron microscopy using light microscopic evaluation of paraffin, epoxy-infiltrated, or epoxy-embedded large blocks from which thick sections were cut. Selected areas from these thick sections were subsequently removed and re-embedded or attached to blank precasted blocks and resectioned for transmission electron microscopy (TEM).

scholarly journals Promotion of Resilience in Migrants: A Systematic Review of Study and Psychosocial Intervention

2021 ◽  
Author(s):  
Maria Ciaramella ◽  
Nadia Monacelli ◽  
Livia Concetta Eugenia Cocimano
Keyword(s):  
Systematic Review ◽  
Psychosocial Intervention ◽  
Life Experiences ◽  
Psychosocial Interventions ◽  
Migrant Population ◽  
Methodological Choices ◽  
Research Questions ◽  
Definition Of ◽  
Selection Of

AbstractThis systematic review aimed to contribute to a better and more focused understanding of the link between the concept of resilience and psychosocial interventions in the migrant population. The research questions concerned the type of population involved, definition of resilience, methodological choices and which intervention programmes were targeted at migrants. In the 90 articles included, an heterogeneity in defining resilience or not well specified definition resulted. Different migratory experiences were not adequately considered in the selection of participants. Few resilience interventions on migrants were resulted. A lack of procedure’s descriptions that keep in account specific migrants’ life-experiences and efficacy’s measures were highlighted.

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