scholarly journals Obstetric and perinatal aspects of multiple pregnancy

2021 ◽  
Vol 6 ◽  
pp. 7-18
Author(s):  
V.G. Siusiuka ◽  
A.D. Kyryliuk ◽  
О.V. Babinchuk ◽  
N.Y. Boguslavska ◽  
O.I. Bachurina ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Perinatal Care ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Breech Presentation ◽  
Epidemiological Data ◽  
Conjoined Twins ◽  
Multiple Pregnancies ◽  
Maternal Condition ◽  
Unsuccessful Attempt

The article presents epidemiological data, modern terminology, features of the course of gestation, as well as obstetric and perinatal outcomes of childbirth in women with multiple pregnancy. The relevance of study this problem is due to the fact that the course of multiple pregnancy in almost all patients is accompanied by various complications, and their prognosis and prevention are of paramount importance. Despite the attention paid to multiple pregnancy, the complication rate remains high. Their treatment should be carried out in III level of perinatal care facilities. Attention is focused on the features of childbirth of pregnant women in accordance with the procedure for providing medical care to women with multiple pregnancies. An important issue remains to determine the time and tactic of delivery in multiple pregnancy. The choice of childbirth method depends on the obstetric anamnesis, gestational age, position and presentation of fetuses, estimated weight and size of fetuses, chorionicity, fetal and maternal condition, and the presence/absence of indications for caesarean section also matters. The optimal delivery time for uncomplicated twins is 37 weeks of pregnancy (monochorionic diamniotic twins — 36–37 weeks, dichorionic — 37–38 weeks), since in this period of pregnancy, the risks of antenatal fetal death and early neonatal death are minimal. Delivery of women with monochorionic monoamniotic twins is performed at the full 32 weeks of pregnancy by caesarean section. Among other indications for caesarean section are triplets and a larger number of fetuses, as well as conjoined twins, transverse or breech presentation of the first fetus, twins in combination with a scar on the uterus, an unsuccessful attempt of external-internal rotation of the second fetus in a transverse position after the birth of the first fetus, and others. An analysis of domestic and foreign publications was carried out in the article, which indicates the need for in-depth research in this direction, namely the elucidation of new pathogenetic links in multiple pregnancies, depending on the type of placentation, the search for new ways of management and the development of diagnostic criteria for the childbirth of this contingent of women.

scholarly journals BREECH PRESENTATION

2012 ◽  
Vol 19 (04) ◽  
pp. 542-545
Author(s):  
SHAHID IRSHAD RAO ◽  
SHAZIA SIDDIQ ◽  
RABIA REHMAN
Keyword(s):  
Caesarean Section ◽  
Congenital Anomalies ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Setting

Objective: To determine the frequency of breech presentation at term. Design: Cross sectional study. Setting: Department ofObstetrics and Gynaecoogy, Unit-III, Nishtar Hospital, Multan. Period: June 2010 to May 2011 Material and methods: This study was carriedout in women with the age group 0-40 years. Breech presentation at term (37-41 completed weeks). Results: The frequency of breechpresentation at term was found to be 6.2%. 91% (215) of the patients were delivered by caesarean section and 9% (20) were delivered vaginally.Placenta previa and multiple pregnancy 8.51% each, congenital anomalies 4.25% and in 16.17% of the patients, no obvious cause was found.Conclusion: It is concluded from the study that the frequency of the breech presentation at term increased.

scholarly journals Risks and challenges in multiple pregnancy

2021 ◽  
Vol 10 (12) ◽  
pp. 4578
Author(s):  
Aditi Agarwal ◽  
Arti Sharma ◽  
Neeta Bansal ◽  
Neha Panwar ◽  
Shweta Singh ◽  
...  
Keyword(s):  
Placenta Previa ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Obstetric Care ◽  
Elevated Risk ◽  
Multiple Pregnancies ◽  
Triplet Pregnancy ◽  
Mother And Child ◽  
Fetal Complications ◽  
Fetal Malformations

Because of breakthroughs in reproductive medicine, multiple pregnancies have become more common in the industrialized world. As a result, obstetric care for women with multiple pregnancies and neonatal care for the same has become more demanding. Multifetal pregnancies are linked to an elevated risk for both the mother and child. There is increased incidence of obstetric complications such as spontaneous abortion, hypertensive disorders, placenta previa, and fetal malformations. Perinatal outcome is also affected which is attributable to increased incidence of fetal complications like prematurity, congenital malformations, growth discordance and cord accidents. We are presenting 2 cases, one of MCMA twin pregnancy with fetal congenital anomaly and another of a triplet pregnancy and their perinatal outcomes.

scholarly journals Comparative study of perinatal outcome between abdominal and vaginal route of delivery in case of breech presentation

2018 ◽  
Vol 7 (9) ◽  
pp. 3758
Author(s):  
Gourav Ranjan Tripathy ◽  
M. Smitha ◽  
Anand Acharya
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Vaginal Route ◽  
Breech Delivery ◽  
Labour Room ◽  
Route Of Delivery

Background: Breech presentation is also one of the most interesting subjects in obstetrics as no other malpresentation has so many manoeuvres during vaginal delivery and their impact on perinatal mortality. The mode of delivery also depends on so many variables like parity, type of breech presentation, associated obstetric complications, estimated birth weight etc and also from obstetrician point of view.Methods: Pregnant mother with breech presentation of gestational age 32 weeks or more were included in this study. Multiple pregnancy with first baby in breech presentation were excluded from this study. New born baby with gross congenital anomalies like anencephaly, omphalocele were excluded from this study. The cases for present study were collected from antenatal OPD, labour room, High-risk ward and Post-natal ward of KIMS & RF from June 2016 to December 2017.Results: Out of 61 cases of caesarean section there were 4 cases (6.55%) of neonatal death. PNM among the 100 cases was 4% in caesarean section. In 32 assisted breech delivery cases there were 8 cases (25%) of perinatal death. PNM among the 100 cases was 8% in assisted breech delivery. Out of 4 cases of breech extractions there were 3 cases (75%) of perinatal death. PNM among the 100 cases was 3% in breech extraction.Conclusions: Present study suggests that breech delivery should preferably be always managed in the hospital by skilled and experienced obstetrician with an assistant in collaboration with a pediatrician and an anesthetist. As good numbers of babies were premature a good premature care unit should be pre-managed under the supervision of a pediatrician.

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 Challenges and prospects of preterm birth prediction in multiple pregnancies

2018 ◽  
Vol 67 (4) ◽  
pp. 48-59 ◽  
Author(s):  
Olga V Kosyakova ◽  
Olesya N Bespalova
Keyword(s):  
Preterm Birth ◽  
Metabolic Disorders ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
High Rate ◽  
Premature Births ◽  
Multiple Pregnancies ◽  
Priority Task ◽  
Adverse Perinatal Outcomes ◽  
High Level

For today, twins make up about 1.5% of the population of our planet. It is more than one hundred million people, which in number corresponds to the population of two Frances. The number of twins born relative to the total number of newborns in different countries and on different continents is different, but the overall trend is that it continues to grow. In recent years, the percentage of multiple pregnancy has increased almost 2.5 times, which is associated with the widespread use of assisted reproductive technologies.At the same time, pregnancy in multiple births is an extremely important problem in modern obstetrics, as it is accompanied by a high level of complications for both the mother and the fetuses. Multiple pregnancy contributes significantly to the formation of adverse perinatal outcomes, which is primarily due to the high rate of preterm birth. Premature twins are at high risk of neurological and neuropsychiatric disorders, respiratory distress, endocrine and metabolic disorders, which subsequently become the cause of disability and social maladaptation of children. In this regard, the reduction in the number of premature births is today a priority task, the solution of which is possible only through timely and correct forecasting. The multifactority of pathogenic mechanisms determines the necessity of diagnostic search strategies that can identify markers of various pathogenetic ways of preterm birth. (For citation: Kosyakova OV, Bespalova ОN. Challenges and prospects of preterm birth prediction in multiple pregnancies. Journal of Obstetrics and Women’s Diseases. 2018;67(4):48-59. doi: 10.17816/JOWD67448-59).

scholarly journals Factors affecting elective cesarean section in women with multiple pregnancy in Caruban, Indonesia

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1481
Author(s):  
Muhammad Pradhiki Mahindra ◽  
Mahendra Tri Arif Sampurna ◽  
Muhammad Pradhika Mapindra ◽  
Apriska Mega Sutowo Putri ◽  
Aries Krisbiyantoro ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Multiple Pregnancy ◽  
Previous History ◽  
Retrospective Chart Review ◽  
Vaginal Birth ◽  
Elective Cesarean Section ◽  
Multiple Pregnancies ◽  
Maternal Characteristics ◽  
Significant Difference

Background: Caesarean sections have become the most popular method for delivering twin babies because of the safety concerns associated with a natural birth. This study aims to identify the maternal characteristics and obstetric parameters that serve as risk factors influencing caesarean delivery in twin pregnancies by comparing women delivering via caesarean section and vaginal birth. Methods: A retrospective chart review design was used to analyse 47 women with multiple pregnancies from the medical records at a primary referral hospital in East Java, Indonesia. Women delivering vaginally were then compared with women who underwent a caesarean section to identify any differences between the groups. Results: More women delivered by caesarean section than by vaginal birth. In this study, women were more likely to undergo a caesarean section if they had a previous history of undergoing a caesarean section or if there were no foetal malpresentations during their pregnancy. There was a significant difference in maternal age between groups. We found that foetal malpresentation did not significantly increase the likelihood of caesarean delivery in women with multiple pregnancies. Conclusions: The percentage of multiple pregnancies delivered via caesarean section is quite high. Similar to previous studies, we identified a few factors including foetal malpresentation and labour augmentation that did not significantly increase the risk of caesarean delivery. However, we suggest that there is more than one reason responsible for the increase in caesarean sections in multiple pregnancies.

scholarly journals Prevention and therapy of threatened preterm birth in multiple pregnancy

2019 ◽  
Vol 68 (4) ◽  
pp. 55-70
Author(s):  
Olga V. Kosyakova ◽  
Olesya N. Bespalova
Keyword(s):  
Preterm Birth ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Bed Rest ◽  
Good Evidence ◽  
Therapeutic Interventions ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Multiple Pregnancies ◽  
Adequate Treatment

Preterm birth in multiple pregnancy is an important medical, economic and social problem. Currently, more than half of twins are born prematurely, which puts them at high risk of developing neonatal diseases causing lifelong disability and social maladjustment. In this regard, reducing the frequency of preterm multiple births is an important task of modern obstetrics. Improving perinatal outcomes of multiple pregnancies can only be achieved using the most effective measures that have a good evidence base. At the same time, numerous studies on the effectiveness of therapeutic interventions aimed at prolonging multiple pregnancies have reported contradictory results. This review included most of the randomized controlled trials of methods for the prevention and treatment of threatening preterm birth in multiple pregnancies, as available in PubMed, Google Academy, Elibrary, and the Cochrane Central Register of Controlled Trials. Thus far, studies on the use of bed rest, prophylactic tocolysis, most of the progestins, and cervical cerclage in multiple pregnancy have shown no efficacy in reducing the risk of premature birth. However, encouraging data were obtained on improving neonatal outcomes of multiple pregnancies using vaginal progesterone and an obstetric pessary, but these results require additional confirmation in larger multicenter randomized studies. Further clinical trials are needed to develop algorithms for timely diagnosis and adequate treatment of threatened preterm birth in case of multiple pregnancy, including the use of the most rational preventive and therapeutic methods that have a high evidence level.

Breech Presentation: Vaginal Delivery or Caesarean Section?

2016 ◽  
Vol 2 (1) ◽  
pp. 153
Author(s):  
Tomescu Cezar Laurentiu ◽  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Brezeanu Dragos ◽  
Aneta Tomescu
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Total Population ◽  
Population Sample ◽  
Breech Presentation ◽  
Current Paper ◽  
Clinical Hospital ◽  
Obstetrics And Gynaecology ◽  
Number Of Patients

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.

Preterm labour in multiple pregnancies

1993 ◽  
Vol 5 (2) ◽  
pp. 105-119 ◽  
Author(s):  
James P Neilson ◽  
Caroline A Crowther
Keyword(s):  
Perinatal Mortality ◽  
Preterm Labour ◽  
Multiple Pregnancy ◽  
High Rate ◽  
Fetal Malformation ◽  
Multiple Pregnancies ◽  
Neonatal Deaths ◽  
Late Abortion ◽  
Early Neonatal Deaths ◽  
Singleton Pregnancies

Multiple pregnancy is associated with a high rate of perinatal loss – mainly due to preterm labour but with important contributions from fetal malformation, intrauterine growth retardation and twin-twin transfusion syndrome. The overall perinatal mortality rate is consistently around six times that of singleton pregnancies but the rate rises progressively with the number of fetuses. Rates of 63,164,200,214 and 416 per 1000 births have been recently reported for twins, triplets, quadruplets, quintuplets and sextuplets respectively. In addition to these alarming figures, it should be emphasized that the restricted concept of perinatal mortality obscures the real extent of loss. If we include late abortion (after 20 weeks), late neonatal deaths and deaths in infancy from perinatal causes, as well as the usual indices of perinatal mortality (stillbirths and early neonatal deaths) we find that the total loss rate from twin pregnancy alone doubles and may be close to 10%. Although the rate of loss from multiple pregnancies is now substantially higher than that associated with the pregnancies of diabetic women, the challenge of multiple pregnancy has not been met with the same commitment or organisation of specialized perinatal services as has diabetes.

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