scholarly journals Twin-to-twin transfusion syndrome: an obstetric catastrophe

2020 ◽  
Vol 10 (3) ◽  
pp. 207-211
Author(s):  
Tanzeem S Chowdhury ◽  
Naushaba Tarannum Mahtab ◽  
Syeda Rifat Mahmud ◽  
TA Chowdhury
Keyword(s):  
Heart Failure ◽  
Mortality Rate ◽  
General Hospital ◽  
Perinatal Mortality ◽  
Fetal Growth ◽  
Twin Pregnancy ◽  
Delayed Diagnosis ◽  
Monochorionic Twin ◽  
Blood Flows ◽  
Stage Of Diagnosis

Twin-to-twin transfusion syndrome (TTTS) is an obstetric condition with high perinatal mortality, which develops when blood flows disproportionately from one fetus to another in a monochorionic twin pregnancy. Approximately 1 in 7 monochorionic pregnancies are affected with TTTS. The donor twin develops oligohydramnios and poor fetal growth, while the recipient twin develops polyhydramnios, heart failure and hydrops. Here we report two cases of severe TTTS in BIRDEM General Hospital 2 within a period of two years. It has been observed in different studies that, the mortality rate of both twins can be as high as 80% in TTTS depending on the stage of diagnosis and progression of the condition if untreated. In both our cases, the outcome was poor due to delayed diagnosis and lack of intrauterine therapies. So, there is an urgent need for timely diagnosis and appropriate management of this rare but complex condition which prompted us to report these two cases. Birdem Med J 2020; 10(3): 207-211

scholarly journals Study of maternal and fetal outcome in twin pregnancy

2017 ◽  
Vol 6 (6) ◽  
pp. 2272 ◽  
Author(s):  
Lata Singh ◽  
Kiran Trivedi
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Twin Pregnancy ◽  
Fetal Outcome ◽  
Medical Sciences ◽  
Maternal Complications ◽  
Perinatal Mortality Rate ◽  
Increased Risk ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

Background: Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality especially in developing countries. The present study aims to understand the maternal and perinatal outcomes of multiple and singleton pregnancies delivering at Rajendra Institute of Medical Sciences, Ranchi, India. Aim of study was to investigate the maternal and fetal outcome in twin pregnancies in Rajendra Institute of Medical Sciences (RIMS), RanchiMethods: This comparative prospective study was conducted in the department of obstetrics and gynecology, Rajendra Institute of Medical Sciences, Ranchi from the period of 1st April 2015 to 30th September 2016. Consecutive sampling was done till the sample size of 75 was reached for both twin and singleton pregnancies. It included all women admitted in antenatal ward and labor room with clinical or ultrasound diagnosis of twin pregnancy after 28 weeks of gestation.Results: The incidence of twins in this study was 1.85%. Mean maternal age was 25.25±4.5 years for twin pregnancies and 23.53 ± 3.3 for singleton pregnancies. Twins were seen more in multigravida (70.7%) as compared to primigravida (29.3%). Preterm labor (74.7%), anemia (44%) and hypertensive disorders (32%) and PPH (13.33%) were the most common complication in twin pregnancies. Significantly higher rate of LSCS were seen in twin pregnancies (32.67%) as compared to singletons 18.67%. Mean weight of first twin was 2.03±0.52kg and for second twin it was 1.98±0.51kg. There was higher incidence of moderate to severe asphyxia, IUGR and higher rate of NICU admissions in twins as compared to singletons. Perinatal mortality rate of monchrionic pregnancy was 30% and it was 10.2% for dichorionic pregnancy which shows a significant association of perinatal mortality rate and chorionicity.Conclusions: Good antenatal care, with increased rest and nutritional supplementation, early detection of fetal and maternal complications together with thorough intranatal and postnatal vigilance, can lower both maternal and fetal dangers.

Possible molecular and biological mechanisms for the development of selective fetal growth restriction in monochorionic twin pregnancy

2021 ◽  
Vol 10_2021 ◽  
pp. 5-12
Author(s):  
Neftereva A.A. Neftereva ◽  
Sakalo V.A. Sakalo ◽  
Gladkova K.A. Gladkova ◽  
Kоstyukov K.V. Kоstyukov K ◽  
Khodzhaeva Z.S. Khodzhaeva ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Twin Pregnancy ◽  
Growth Restriction ◽  
Biological Mechanisms ◽  
Monochorionic Twin

Serial Amniocenteses in the Treatment of Twin to Twin Transfusion Complicated with Acute Polyhydramnios

1986 ◽  
Vol 35 (1-2) ◽  
pp. 107-113 ◽  
Author(s):  
M. Feingold ◽  
C.L. Cetrulo ◽  
E.R. Newton ◽  
J. Weiss ◽  
C. Shakr ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Amniotic Fluid ◽  
Perinatal Mortality ◽  
Twin Pregnancy ◽  
Clinical Problem ◽  
Abdominal Discomfort ◽  
Premature Labor ◽  
Uterine Activity ◽  
Monozygous Twin ◽  
Fetal Surveillance

AbstractTwin to twin transfusion, complicated by acute polyhydramnios in a monozygous twin pregnancy, is a difficult clinical problem. A precipitous course usually results in termination of the pregnancy within a few days and often is associated with a high perinatal mortality rate. Two cases are presented that were treated with repeated amniocenteses for the relief of extreme abdominal discomfort and to prevent imminent premature labor. The amount of amniotic fluid removed each time varied from 300 cc to 1200 cc, which was enough to relieve symptoms but not enough to induce uncontrolled uterine activity. A total of 3500 cc and 4750 cc of amniotic fluid were removed from the first and the second patient, respectively. The procedure was found to be safe and resulted in prolonging the pregnancies by 14 and 11 days, respectively. This management, with the addition of tocolysis and close fetal surveillance can offer some hope in an otherwise hopeless situation.

scholarly journals Assessing an impact on perinatal outcome in monochorionic and dichorionic twin pregnancy complicated with discordant fetal growth

2021 ◽  
Vol 15 (1) ◽  
pp. 51-60
Author(s):  
K. V. Kostyukov ◽  
K. A. Gladkova ◽  
O. V. Ionov
Keyword(s):  
Body Weight ◽  
Fetal Growth ◽  
Twin Pregnancy ◽  
Reproductive Technologies ◽  
Morbidity And Mortality ◽  
Monochorionic Twins ◽  
Monochorionic Twin ◽  
Antenatal Period ◽  
Increased Risk ◽  
Twin Pregnancies

Introduction. Multifetal pregnancy is associated with an increased risk of perinatal morbidity and mortality. Type of placentation and discordant fetal growth may be risk factors of adverse pregnancy outcomes.Aim: to compare an impact of dichorionic and monochorionic twin pregnancies with symmetric and discordant fetal growth on perinatal outcomes, as well as morbidity and mortality.Materials and Methods. There was conducted a retrospective study of 485 pregnant women and paired 959 newborns. Depending on the type of chorionicity, subjects were stratified into two study groups being further subdivided into based on describing fetal weight discordance. The antenatal period and the neonatal outcome of newborns in groups and subgroups were compared.Results. We analyzed 308 dichorionic and 177 monochorionic twin pregnancies. It was found that neonate discordant growth was observed in 5.4 % and 13.4 % (p < 0.001), respectively. The incidence of assisted reproductive technologies was higher in dichorionic than in monochorionic twins comprising 66.5 and 40.7 % (р < 0.001). Antenatal mortality in monochorionic vs. dichorionic twins was by 8-fold higher. The preterm birth rate in monochorionic vs. dichorionic twins was 74.6 and 62.7% (p = 0.009), respectively. Neonate body weight in monochorionic vs. dichorionic twins was lowered comprising 1991 and 2430 gr. (р < 0.001), respectively. Low Apgar scores were more common for monochorionic twins with discordant body weight. The rate of early neonatal mortality in monochorionic vs. dichorionic twins was 4.4 % vs. 1.5 % (p = 0.009), whereas in dichorionic vs. monochorionic twins with weight discordance it was up to 5.8 and 10.5% (р < 0.001), respectively.Conclusion. Monochorionic twin pregnancy complicated with growth discordance is associated with a higher risk of adverse antenatal period as well as neonatal morbidity and mortality compared to symmetric DCDA twins. Chorionicity and growth discordancy represent important predictors for outcome of twin pregnancy.

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