Comparative analysis of the pregnancy, labour and condition of newborn twins with monochorionic type of placentation

2019 ◽  
pp. 46-49
Author(s):  
A.V. Tkachenko ◽  
Keyword(s):  
Comparative Analysis ◽  
High Risk ◽  
Premature Birth ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Monochorionic Twins ◽  
Mortality And Morbidity ◽  
High Incidence ◽  
Pregnancy And Delivery ◽  
Abdominal Delivery

The objective: to analyze the peculiarities of pregnancy, labour and condition of newborn twins with monochorionic type of placentation. Materials and methods. A comparative analysis of pregnancy, labour and perinatal consequences in 110 cases in monochorionic twins pregnancies (MT) was conducted. The I group consisted of 92 patients who did have obstetric complications specific for multiple pregnancy during pregnancy; in group II 18 pregnant women with specific complications during multiple pregnancy were included. Additionaly, ultrasound fetometry, placentalography, doplerometry, cardiotocography were used. Results. Pregnancy with monochorionic twins is a risk factor for the development of pregnancy complications, and specific complications due to this type of placentation are extremely unfavorable in relation to perinatal outcomes. Even with pathogenetic treatment, there is a high risk of pregnancy loss, premature birth, and the development of pathology in newborns. Analysis of perinatal outcomes showed that in the absence of specific complications of MC type of placentation in 49.0% cases normotrophic children were born, according exceeds the percentage of patients whose children were born with hypotrophy varying severity - 51.0% respectively. In both subgroups pregnancies were characterized by high risk of abortion (61.4% and 67.1% respectively), preeclampsia various severity in 33.3% and 44.6%, gestational anemia in 43.4%, and 39.8%, premature birth, which occurred in 66.7% and 46.8% respectively. This explains the high incidence of operative delivery 44.4% and 52.1% respectively, while the incidence of planned abdominal delivery in subgroup 1b was 3.3 times higher than in subgroup 1a. Perinatal loss in patients with MC twins in subgroups were 4.4% and 5.3% respectively. Conclusion. Pregnancy and delivery of monochorionic twins with specific complications has a higher risk for fetus and newborn, which lead to higher rates of perinatal mortality and morbidity in this group of infants. So searching for effective methods of prevention and treatment of these complications is required. The results should be considered during making algorithm of diagnostic and preventive measures in multiple pregnancies. Key words: monochorionic twins, labour, perinatal consequences.

scholarly journals Perinatal outcome of multiple pregnancy

2017 ◽  
Vol 6 (6) ◽  
pp. 2226
Author(s):  
Susithra Saravanan ◽  
Malarvizhi Loganathan
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Antenatal Care ◽  
Social Workers ◽  
Perinatal Outcome ◽  
Multiple Pregnancy ◽  
Multiple Pregnancies ◽  
Mortality And Morbidity ◽  
Obstetrics And Gynaecology ◽  
Multi Disciplinary Team

Background: Multifetal gestation in addition to perinatal mortality and morbidity, attributable to preterm delivery they are more vulnerable to unique complications such as, structural malformations and twin- twin transfusion syndrome so that still birth rates are also appreciably increased. The incidence of multifetal gestation following conventional gonadtropin therapy is 16-40% with 75% being twins, with super ovulation it is 25-30%. The incidence of twins and triplets with embryo transfer 22-24% and 26% respectively.Methods: The clinical material taken from institute of Obstetrics and Gynaecology, Egmore Maternity, Chennai. Material for this study consists of 100 multiple pregnancies from May 2001 to April 2002. During this study period 19,617 patients admitted for delivery. There were 99 seats of twins and 1 Triplets.Results: During the period of 1 year, 150 cases were analyzed. During the period 148 cases 2 cases of tripelets studied, no cases of quadruplets were reported during this period.Conclusions: Multifetal gestation is one of the high-risk pregnancies. Hence women with multifetal gestation should ideally receive antenatal care in special twin clinics to meet their special needs. The multi-disciplinary team should be lead by an obstetrician, should include midwives, USG, Neonatologists, social workers and anesthetists. Women followed in twin clinic had significant improvement in women outcome which includes increased mean birth weight, decreased low birth weight and low ICU admissions.

scholarly journals MULTIPLE PREGNANCY, ANTENATAL CARE PROBLEMS AND THEIR SOLUTIONS RESULTS

2017 ◽  
Vol 1 ◽  
pp. 39-45
Author(s):  
Iryna Nikitina ◽  
Natalya Kalashnyk ◽  
Svitlana Smiian ◽  
Tatyana Babar ◽  
Alina Popova
Keyword(s):  
Transvaginal Ultrasound ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Statistical Processing ◽  
Multiple Pregnancies ◽  
Perinatal Complications ◽  
Singleton Pregnancy ◽  
Monochorionic Twins ◽  
Pregnancy And Childbirth ◽  
Ultrasound Monitoring

Aim of the work. The aim of our study is to summarize the course of pregnancy and delivery in multiple pregnancies in modern conditions. Materials and methods. The analysis of the pregnancy course, labor and perinatal outcomes was carried out in 182 women with diochorionic and 86 patients with monochorionic twins and 40 women with a singleton pregnancy. Multiple pregnancies were proved to be a monochorionic (MH) and diochorionic (DH) that is a high risk factor for perinatal complications. The research included clinical and laboratory examination metods, study of hormonal function of fetoplacental complex (FPC), transvaginal ultrasound examination. Statistical processing of data was carried out using the package of applied programs Microsoft Office Excel 2010 and StatSoft Statistica 6.1. Results and discussion. In the analysis of pregnancy the abortion threat was detected in 51 (59.3%) women with monochorionic and 34 (62%) women with diochorionic twins. Preeclampsia during pregnancy complicated in 26 (30.2%) and 43 (23.6%) patients, with monochorionic and diochorionic placentation type, respectively. A frequent complication of both the MH and DH twins was anemia, which was found in more than half of the surveyed (56.9 and 51%, respectively). Delivery in the case of multiple pregnancies is also much more complicated and is terminated surgically three times more often than in singleton births. The most frequent indications for operative delivery were first breech fetus, fetal distress during pregnancy and childbirth, FGR, severe preeclampsia, premature detachment of normally situated placenta, anomalies of labor activity. These perinatal losses were equally observed both after cesarean section and after spontaneous labor and amounted to 4% at monochorionic and 1.7% at diochorionic twins. The frequency dependence of identified lesions at pregnancy with twins was established by chorionic. Careful observation of the patients with multiple pregnancies in the antenatal period, the prevention of the most frequent complications, ultrasound monitoring of early pregnancy allows a differentiated approach to the management of pregnancy and childbirth, helping to reduce perinatal morbidity and mortality. Conclusions. Multiple pregnancies occur with a large number of complications compared with singletons. Thus, the increase of frequency of multiple pregnancy influences the obstetric and perinatal indicators, pushing this issue in a number of the most pressing issues of modern obstetrics and perinatology.

scholarly journals Single fetal demise in multiple pregnancy

2019 ◽  
Vol 6 (5) ◽  
pp. 31-38 ◽  
Author(s):  
A. A. Kuznetsov ◽  
A. N. Romanovsky ◽  
A. V. Shlykova ◽  
T. A. Kashtanova ◽  
V. V. Shman ◽  
...  
Keyword(s):  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Neurological Complications ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Perinatal Morbidity ◽  
Delivery Time ◽  
Monochorionic Twins ◽  
Fetal Demise ◽  
Management Of Complications

Single intrauterine fetal demise (sIUFD) in multiple pregnancy occurs with frequency from 3.7 up to 6.8 % and is associated with an risk of premature birth, death of cotwin and high morbidity and mortality rates in newborns. The time of sIUFD and type of twin gestation would determine perinatal outcomes. The rate of prenatal death of the co-twin is different and depend on the type of multiple pregnancy, accounting 4 % for dichorionic and 12 % in monochorionic pregnancies. However, the correlation between the type of chorionicity, delivery time and the frequency of preterm delivery is not clearly established. The risk of neurological complications in newborns after sIUFD fluctuate significantly in case of the type of chorionicity and could achieve 18 % in monochorionic twins and only 1 % in dichorionic twins. The paper was discussed the main reasons for sIUFD in multiple pregnancy, rather pathophysiological aspects of perinatal morbidity and mortality for cotwin was also discussed. The management of complications, methods of their correction, optimal methods and time of delivery in case of sIUDF in multiple pregnancies was presented.

Trends and forecasts of the global availability of food

2020 ◽  
Vol 16 (7) ◽  
pp. 1297-1316
Author(s):  
O.N. Terent'eva
Keyword(s):  
High Risk ◽  
Growth Rates ◽  
Statistical Data ◽  
Economic Security ◽  
Agricultural Products ◽  
Mortality And Morbidity ◽  
National Economic ◽  
Production Growth ◽  
Country Analysis ◽  
Cross Country

Subject. The stable supply of food to people is a cornerstone for the national economic security, while a lack of food or its expensiveness may undermine the economy, principles of power, and cause panics and wars. Malnutrition and hunger are critical indicators of the insufficient foods supply. Objectives. The article indicates which countries have high risk of hunger, and predicts its further movement. I also evaluate factual trends in the availability of food across countries. Methods. The study refers to statistical data in public domain, including the FAOSTAT. I apply methods of ranking, abstraction, prediction. Results. I performed the cross-country analysis and discovered that 117 countries demonstrated signs of malnutrition. The article sets forth a technique for splitting countries into five groups by level of hunger risk. The article compares data on hunger in the countries and consequences of mortality and morbidity. I ranked countries by key types of agricultural products and explained their production growth rates for a span of 18 years. I predicted how countries would be ranked in terms of hunger from 2030 to 2050, and found the extent to which the hunger risk will escalate in more flourishing countries. Conclusions and Relevance. Hunger and shortage of food seem invincible in the countries where people are hungry or very hungry. Sometimes it appears almost impossible for respective governments to solve the issue. Triggering the systemic hunger, such factors and premises are beyond control of starving countries. Hence, the international community should provide their support and aid to them.

The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study

2020 ◽  
Vol 48 (4) ◽  
pp. 317-321
Author(s):  
Rodney McLaren ◽  
Bharati Kalgi ◽  
Chima Ndubizu ◽  
Peter Homel ◽  
Shoshana Haberman ◽  
...  
Keyword(s):  
High Risk ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Repeated Measures ◽  
Adverse Outcome ◽  
Perinatal Outcomes ◽  
Low Risk ◽  
Doppler Velocity ◽  
Chronic Hypertension ◽  
Adverse Perinatal Outcomes

AbstractObjectiveThe aim of this study was to compare position-related changes in fetal middle cerebral artery (MCA) Doppler pulsatility indices (PI).MethodsA prospective study of 41 women with conditions associated with placental-pathology (chronic hypertension, pregestational diabetes, and abnormal analytes) and 34 women without those conditions was carried out. Fetal MCA Doppler velocity flow waveforms were obtained in maternal supine and left lateral decubitus positions. MCA PI Δ was calculated by subtracting the PI in the supine position from the PI in the left lateral position. Secondary outcomes included a composite of adverse perinatal outcomes (fetal growth restriction, oligohydramnios, and preeclampsia). χ2 and Student t-tests and repeated-measures analysis of variance were used.ResultsMCA PI Δ was significantly less for high-risk pregnant women ([P = 0.03]: high risk, left lateral PI, 1.90 ± 0.45 vs. supine PI, 1.88 ± 0.46 [Δ = 0.02]; low risk, left lateral PI, 1.90 ± 0.525 vs. supine PI, 1.68 ± 0.40 [Δ = 0.22]). MCA PI Δ was not significantly different between women who had a composite adverse outcome and women who did not have a composite adverse outcome (P = 0.843).ConclusionOur preliminary study highlights differences in position-related changes in fetal MCA PI between high-risk and low-risk pregnancies. These differences could reflect an attenuated ability of women with certain risk factors to respond to physiologic stress.

scholarly journals Comparison of immediate postpartum contraception among women with a high versus low risk pregnancy in Mexico: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048048
Author(s):  
Jacqueline Powell ◽  
Evelyn Fuentes-Rivera ◽  
Blair Darney
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Modern Method ◽  
Nutrition Survey ◽  
Postpartum Contraception ◽  
High Risk Women ◽  
Health And Nutrition ◽  
Risk Pregnancy ◽  
Pregnancy And Delivery ◽  
To Receive

ObjectiveWe tested whether women who reported high-risk pregnancies or deliveries were more likely to receive immediate postpartum contraception prior to discharge compared with normal-risk women in Mexico.MethodsThis is a retrospective study using the National Health and Nutrition Survey. We classified women as high-risk based on reported complications in pregnancy and delivery. We used multivariable logistic regression to test the association of high-risk status and receipt of postpartum contraception (any modern method and Tier one methods) prior to discharge.ResultsOur sample included 5030 deliveries (population N=3 923 657). Overall, 19.1% of the sample were high risk. Over 60% of women in the high-risk and normal-risk group received immediate postpartum contraception, but a greater proportion of high-risk women received a method (67% vs 61% normal risk; p<0.001). However, in multivariable models, there were no significant differences in receipt of any modern method or tier 1 method by risk group.ConclusionWomen with high-risk pregnancies were not more likely to receive postpartum contraception than the normal-risk group, once accounting for sociodemographic and clinical factors. Prenatal and postpartum contraception counselling should address the health effects of high-risk pregnancies and interpregnancy intervals to improve maternal health outcomes.

scholarly journals The high-risk pregnancy and delivery factors in the newborn pneumonia

1984 ◽  
Vol 12 (s1) ◽  
pp. 69-70
Author(s):  
W. Grzywna ◽  
K. Kozlowski ◽  
Anna Wylot-Jończyk
Keyword(s):  
High Risk ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
Pregnancy And Delivery

Peculiarities of pregnancy and delivery course in women after the application of assisted reproductive technologies against obesity (Based on the retrospective analysis)

2018 ◽  
pp. 122-126
Author(s):  
I.A. Zhabchenko ◽  
◽  
O.R. Sudmak ◽  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Ischemic Lesion ◽  
Vitro Fertilization ◽  
Pregnancy And Delivery

The objective: to study the structure and frequency of complications of pregnancy, deliveries and perinatal outcomes in three groups of women: women with infertility and obesity, treated by application of in vitro fertilization (hereinafter IVF), pregnant women after IVF application with normal body weight, and pregnant women on the background of obesity which did not have an infertility in past history. Materials and methods. A retrospective analysis of 221 case histories of pregnancies and labors in women who were treated and gave birth in the Pregnancy and delivery pathology Department of SI «Institute of Pediatrics, Obstetrics and Gynecology named after Acad. O. M. Lukyanova of NAMS of Ukraine» for 2012 – 2016 years was carried out. Results. The overwhelming majority of pregnant women after IVF on the background of obesity are primaparas, who have a complicated obstetric history, hormonal changes in the form of progesterone deficiency predominantly and chronic inflammatory processes. Pregnancy with a combination of infertility, treated by the means of IVF application, and obesity, in most cases is accompanied by a long-term threat of termination of pregnancy (48.8%), threatening preterm deliveries (56%), placental dysfunction (41.5%), premature rupture of the amniotic membranes (41.5%), other problems during pregnancy, at the same time, every second woman (58.5%) had a combination of several complications, and required a long-term and repeated inpatient treatment (53.7%). The specific gravity of surgical delivery was 90%, and 16.2% of such deliveries were complicated by pathological blood loss. The number of preterm deliveries was 17.1%, with perinatal losses up to 11.3‰. Among full-term newborns 21.3% of newborns had malnutrition of the I degree and 17% of them had hypoxic-ischemic lesion of CNS. Conclusion. The course of pregnancy, delivery and the postpartum period in the studied contingent of women has a significant frequency of complications, mainly the coinciding ones, which affects on the consequences of perinatal outcomes and requires further study of this problem and the development of differentiated algorithms for antenatal observation. Key words: pregnancy, obesity, in vitro fertilization, complications, delivery, newborn.

Sign in / Sign up

Export Citation Format

Share Document