Influence of chorionicity on healthy twin pregnancy outcome

Background/Aim. It is still under debate in what sense and extent can chorionicity impact the pregnancy outcome of twins without gestational complications specific for monochorionicity. The study aimed to evaluate the effect of chorionicity on healthy twin pregnancy outcome. Methods. The study included patients with uncomplicated twin pregnancies after first trimester that were checked-up and delivered at the Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade during three years (2010?2013). Data regarding mother?s age, comorbidities, parity, presence and type of gestational complications, chorionicity, mode and time of pregnancy ending, birth-weight and Apgar score of twins were determined. Obtained data were compared and statistically analyzed. Results. The study included 361 women with mean age of 33 years. Regardless of chorionicity, twins were mostly born during the 36th gestational week and received Apgar score ? 8. Only three monochorionic twins were stillborn, two preterm (29 and 32 gestational week) and one in term (35 gestational week) delivery. Contrary, no intrauterine fetal deaths were recorded. Monochorionicity negatively correlated with having live-born twins (OR = 0.023; CI = [0.001?0.609]; p = 0.024), but was not associated with twins condition at birth, i.e. Apgar score (p = 0.345), pregnancy ending time (p = 0.578) or any other twins characteristic. However, premature preterm membrane rupture and earlier gestational week of pregnancy ending were important confounding factors for relationship between chorionicity and pregnancy outcome. Conclusion. Monochorionicity increases risk for adverse pregnancy outcomes even for uncomplicated, healthy twin pregnancy, but has no influence on the condition of twins who survive until term. If appropriate surveillance and therapy are applied, both healthy twins can be delivered at term regardless of chorionicity.

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Decreased first trimester PAPP-A is a predictor of adverse pregnancy outcome

Prenatal Diagnosis ◽

10.1002/pd.407 ◽

2002 ◽

Vol 22 (9) ◽

pp. 778-782 ◽

Cited By ~ 122

Author(s):

Yuval Yaron ◽

Sigal Heifetz ◽

Yifat Ochshorn ◽

Ofer Lehavi ◽

Avi Orr-Urtreger

Keyword(s):

Pregnancy Outcome ◽

Adverse Pregnancy Outcome ◽

First Trimester ◽

Adverse Pregnancy

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When diamniotic twins suddenly become monoamniotic twins: spontaneous septostomy of the dividing membrane

BMJ Case Reports ◽

10.1136/bcr-2021-243513 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243513

Author(s):

Angela Vidal ◽

Cristina Nastasia ◽

Markus Hodel ◽

Joachim Kohl

Keyword(s):

Twin Pregnancy ◽

Rare Condition ◽

First Trimester ◽

Sonographic Diagnosis ◽

Sudden Failure ◽

Reliable Diagnosis ◽

Accepted Standard ◽

Perinatal Management ◽

Twin Pregnancies ◽

First Trimester Ultrasound

In twin pregnancies, amnionicity and chorionicity are crucial as they strongly determine prenatal and perinatal management. First trimester ultrasound allows a highly reliable diagnosis of amnionicity and chorionicity, making it an internationally accepted standard in antenatal care. However, in rare cases, amnionicity can change from diamniotic to monoamniotic throughout pregnancy, substantially impacting perinatal management. We report the case of a confirmed monochorionic diamniotic twin pregnancy with a diagnosis of spontaneous septostomy of the dividing membrane (SSDM) at 28 weeks of gestation, resulting in a pseudomonoamniotic pregnancy. Even though SSDM is a rare condition and its sonographic diagnosis might be challenging, it should be considered if, in a known diamniotic pregnancy, there is a sudden failure to visualise the intertwin membrane truly separating both twins.

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FIRST TRIMESTER MATERNAL BMI AND PREGNANCY OUTCOME AT DMCH, LAHERIASARAI, BIHAR

10.36106/ijsr/6930378 ◽

2020 ◽

pp. 79-81

Author(s):

Supriya Kumari ◽

Surya Narayan ◽

Kumudini Jha ◽

Debarshi Jana

Keyword(s):

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

First Trimester ◽

Normal Weight ◽

Obese Women ◽

Family History Of Diabetes ◽

Medical College ◽

Asian Indian Women ◽

Adverse Pregnancy ◽

Maternal Bmi

Aim: The aim of the study was to find out relationship of maternal BMI to pregnancy outcome. Methodology: The study carried out in Department of Obstetrics and Gynaecology, Darbhanga Medical College and Hospital, Laheriasarai, Bihar from February 2019 to January 2020 and pregnancy outcomes were analyzed in relation BMI recorded in first trimester of primigravida. Results: Mean age of pregnant women was 26.2 years. At first booking obese women were significantlyolder (28.0 years) than others. Family history of diabetes was significantly higher among obese women (8.25%) compared to others. Rates of cesarean sections were higher in obese compared to others. The macrosomia rates were higher in obese compared to other group. The preeclampsia (1.89%), were significantly higher in obese women than others. Conclusions: Obese women were at a high risk of developing adverse pregnancy outcomes in terms ofgestational diabetes, macrosomia, preeclampsia more of ceasarean section. Normal weight women have low risk for cesarean section and macrosomia. These results highlight the need for preconception counseling, especially for obese and overweight and have beneficial outcomes in Asian Indian women.

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O-234 Using serum metabolomics to identify biomarkers of viable early, intrauterine pregnancy: an untargeted 1H NMR-based approach

Human Reproduction ◽

10.1093/humrep/deab128.058 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

C Hill ◽

M Phelan ◽

A Horne ◽

K Gemzell-Danielsson ◽

N Tempest ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcome ◽

1H Nmr ◽

Early Pregnancy ◽

Pregnancy Outcomes ◽

Hydatidiform Mole ◽

First Trimester ◽

Intrauterine Pregnancy ◽

Ectopic Pregnancies ◽

Twin Pregnancies

Abstract Study question Which metabolites are associated with a viable intrauterine pregnancy (VIUP) when compared to other early pregnancy outcomes (failed intrauterine and ectopic pregnancies)? Summary answer Serum levels of four metabolites (phenylalanine, alanine, glutamate and glutamine) were significantly altered in VIUPs compared to other early pregnancy outcomes. What is known already Around 10% of all intrauterine pregnancies are lost in the first trimester. A further 1-2% of pregnancies are located outside the endometrial cavity; these ectopic pregnancies are the leading cause of maternal mortality in the first trimester of gestation. Early miscarriages may also cause significant morbidity when bleeding or infection occurs. The symptoms of miscarriages and ectopic pregnancy are often similar (pain and bleeding), however, such symptoms are also common in VIUPs. To date, no biomarkers have been identified to differentiate VIUPs from non-viable and ectopic pregnancies. Study design, size, duration This is a prospective cohort study that included 332 pregnant women at less than ten weeks of gestation, who attended the early pregnancy assessment unit (EPAU) at Liverpool Women’s Hospital with pain and/or bleeding. Participants/materials, setting, methods Blood samples were collected from the 332 pregnant women prior to final clinical diagnosis of pregnancy outcome. Serum samples were subjected to NMR metabolomics profiling (14 spectra that did not meet the recommended minimum reporting standards were removed from subsequent analysis). 1D 1H-NMR spectra were acquired at 37 °C on a 700 MHz spectrometer. Relative metabolite abundances underwent statistical analysis using MetaboAnalyst 5.0 (p-value FDR adjusted). Main results and the role of chance Final pregnancy outcomes were as follows: one hydatidiform mole (0.3%), 48 ectopic pregnancies (14.4%), three pregnancies of unknown location (PULs, 0.9%), 78 failed pregnancies of unknown location (FPULs, 23.4%), 47 miscarriages (14.1%), two vanishing twin pregnancies (0.6%) and 153 VIUPs (45.8%). Due to small sample numbers, the hydatidiform mole, PULs and vanishing twin pregnancies were excluded from further analysis. To compare VIUPs to other pregnancy outcomes, ectopic pregnancies, FPULs and miscarriages were grouped together. Univariate analysis of serum metabolite concentrations identified four metabolites (phenylalanine, alanine, glutamate and glutamine) as significantly different in VIUPs compared to other pregnancy outcomes. Multivariate partial least squared discriminant analysis provided only weak correlation between the serum metabolome and pregnancy outcome. In summary, we have identified differences in the metabolome of women with VIUPs compared to other common pregnancy outcomes, which may provide diagnostic utility. Limitations, reasons for caution In this study, women with VIUPs presented with pain and/or bleeding. The presence of symptoms may influence the metabolome of this group versus VIUPs without symptoms, thus limiting the translation of our findings. Furthermore, environmental factors were not controlled (e.g. fasting status), making it likely that cohort heterogeneity was enhanced. Wider implications of the findings This study identifies a metabolite profile associated with VIUPs. These findings may be useful in the development of a diagnostic test to confirm VIUPs and thus exclude potentially life-threatening pregnancy outcomes. Such a test would be invaluable in clinical emergencies. Trial registration number NA

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Prevalence of sub clinical hypothyroidism and pregnancy outcome: a prospective comparative study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200909 ◽

2020 ◽

Vol 9 (3) ◽

pp. 1250

Author(s):

Bilal Ur Rehman ◽

Hiba Gull

Keyword(s):

Comparative Study ◽

Pregnant Women ◽

Pregnancy Outcome ◽

Subclinical Hypothyroidism ◽

Apgar Score ◽

Adverse Pregnancy Outcome ◽

Significant Risk ◽

Overt Hypothyroidism ◽

Prospective Comparative Study ◽

Adverse Pregnancy

Background: In pregnancy, subclinical hypothyroidism is more common than overt hypothyroidism, ranging from 15% to 28% in Iodine sufficient region. Evidence suggests that subclinical hypothyroidism is associated with adverse pregnancy outcome. The aim of this study was to find the prevalence of subclinical hypothyroidism in pregnant women and adverse pregnancy outcome.Methods: This hospital based prospective comparative study was conducted over a period of 6 months from 1st July 2018 to 31st December 2018 in department of obstetrics and gynecology SKIMS Soura Kashmir. All the subjects who fulfilled the inclusion criteria and who consented to participate were screened for subclinical hypothyroidism.Results: A total of 175 pregnant women participated in the study and subclinical hypothyroidism was diagnosed in 25 pregnant women (14.2%). Most of our patients were in age group 21 to 30 years (69.1%). Pregnant women with subclinical hypothyroidism had significant risk of preeclampsia (35%) and higher cesarean section rate (29.6%). Neonate of women with subclinical hypothyroidism had higher incidence poor Apgar score, NICU admission.Conclusions: The prevalence of subclinical hypothyroidism is high in pregnant women and the gravity of the complications like pre-eclampsia, neonate with low Apgar score, increased NICU admission, overweight the cost of screening. In this view, we propose screening of all pregnant women in the first trimester for diagnosis.

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OC29.01: Association between first trimester PAPP-A and adverse pregnancy outcome

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.6627 ◽

2009 ◽

Vol 34 (S1) ◽

pp. 55-56

Author(s):

A. Hagen ◽

M. Albig ◽

R. H. Becker ◽

A. Gasiorek-Wiens ◽

M. Entezami

Keyword(s):

Pregnancy Outcome ◽

Adverse Pregnancy Outcome ◽

First Trimester ◽

Adverse Pregnancy

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The Frequency of Ovular Resorption During the First Trimester of Twin Pregnancy

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s000156600000876x ◽

1979 ◽

Vol 28 (4) ◽

pp. 270-272

Author(s):

Lucien Schneider ◽

Roger Bessis ◽

Thérèse Simonnet

Keyword(s):

Twin Pregnancy ◽

First Trimester ◽

Twin Pregnancies

A follow-up of 78 twin pregnancies diagnosed in the first trimester indicated that early ovular resorption occurred in 63% of spontaneous and 64% of Clomiphene-induced gestations, so that singletons were born. No failure was observed in the 12 twin conceptions following administration of gonadotropins or Cyclofenil.

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