scholarly journals Single Fetal Demise in Twin Pregnancy—A Great Concern but Still a Favorable Outcome

Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 33
Author(s):  
Bogdan Ioan Stefanescu ◽  
Ana-Maria Adam ◽  
Georgiana Bianca Constantin ◽  
Constantin Trus
Keyword(s):  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
Twin Pregnancy ◽  
First Trimester ◽  
Neurological Complications ◽  
Third Trimester ◽  
Fetal Demise ◽  
Assisted Reproduction Techniques ◽  
Intrauterine Growth ◽  
Frequent Use

The incidence of multiple pregnancies has increased in the last decades, mostly explained by the more frequent use of ovulation induction drugs and assisted reproduction techniques. Although single fetal death in the first trimester of twin pregnancy is not an uncommon event nor does it have serious consequences on the survival fetus, the death of one fetus in the second or third trimester of pregnancy is associated with a serious increase in morbidity and mortality for the surviving co-twin. Preterm labor, preeclampsia, intrauterine growth restriction (IUGR), neurological complications or even the death of the surviving twin have been associated with single fetal demise after mid gestation. We present a very rare case of twin pregnancy with single fetal demise at 26 weeks of gestation successfully managed to term.

scholarly journals Living with the Dead

2020 ◽  
pp. 17-21
Author(s):  
Dr. Ashok Anand ◽  
Dr. Binita Shah ◽  
Dr. Saman Syed
Keyword(s):  
Congenital Anomaly ◽  
Preterm Labor ◽  
Fetal Death ◽  
First Trimester ◽  
Future Research ◽  
Third Trimester ◽  
Maternal Complications ◽  
Fetal Demise ◽  
Neurodevelopmental Impairment ◽  
The Mind

Intrauterine twin gestation with death of one foetusleads to anxiety in the mind of patient, relatives and even obstetrician. Fetal demise of a twin in the first trimester (vanishing twin) is not very rare and does not impair the development of the surviving twin. However Fetal death in late second and third trimester increase the risk of complications for the surviving co twin such as IUGR, preterm labor, neurodevelopmental impairment and maternal complications such as maternal coagulopathy, preeclampsia, sepsis and perinatal mortality. The causes of fetal death vary and include twin to twin transfusion, placental insufficiency, IUGR, preeclampsia, velamentous insertion of cord, cord around neck, congenital anomaly, etc. The objective of this study is to ascertain the prognosis of the surviving co twin to aid counseling of patients and foreground future research.

scholarly journals Monocarboxylate transporter 8 expression in the human placenta: the effects of severe intrauterine growth restriction

2006 ◽  
Vol 189 (3) ◽  
pp. 465-471 ◽  
Author(s):  
S-Y Chan ◽  
J A Franklyn ◽  
H N Pemberton ◽  
J N Bulmer ◽  
T J Visser ◽  
...  
Keyword(s):  
Human Placenta ◽  
Fetal Development ◽  
Intrauterine Growth Restriction ◽  
First Trimester ◽  
Growth Restriction ◽  
Monocarboxylate Transporter ◽  
Trophoblast Cells ◽  
Third Trimester ◽  
Neurodevelopmental Delay ◽  
Intrauterine Growth

Thyroid hormones (THs) are essential for normal fetal development, with even mild perturbation in maternal thyroid status in early pregnancy being associated with neurodevelopmental delay in children. Transplacental transfer of maternal THs is critical, with increasing evidence suggesting a role for 3,3′,5-tri-iodothyronine (T3) in development and function of the placenta itself, as well as in development of the central nervous and other organ systems. Intrauterine growth restriction (IUGR) is associated with fetal hypothyroxinaemia, a factor that may contribute to neurodevelopmental delay. The recent description of monocarboxylate transporter 8 (MCT8) as a powerful and specific TH membrane transporter, and the association of MCT8 mutations with profound neurodevelopmental delay, led us to explore MCT8 expression in placenta. We describe the expression of MCT8 in normal human placenta throughout gestation, and in normal third-trimester placenta compared with that associated with IUGR using quantitative reverse transcriptase PCR. MCT8 mRNA was detected in placenta from early first trimester, with a significant increase with advancing gestation (P=0.007). In the early third trimester, MCT8 mRNA was increased in IUGR placenta compared with normal samples matched for gestational age (P<0.05), but there was no difference between IUGR and normal placenta in the late third trimester. Western immunoblotting findings in IUGR and normal placentae were in accord with mRNA data. MCT8 immunostaining was demonstrated in villous cytotrophoblast and syncytiotrophoblast as well as extravillous trophoblast cells from the first trimester onwards with increasingly widespread immunoreactivity seen with advancing gestation. In conclusion, expression of MCT8 in placenta from early gestation is compatible with an important role in TH transport during fetal development and a specific role in placental development. Altered expression in placenta associated with IUGR may reflect a compensatory mechanism attempting to increase T3 uptake by trophoblast cells.

scholarly journals The physiologic and therapeutic role of Heparin in implantation and placentation

2014 ◽  
Author(s):  
Michela Quaranta ◽  
Offer Erez ◽  
Salvatore Andrea Mastrolia ◽  
Arie Koifman ◽  
Elad Leron ◽  
...  
Keyword(s):  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
Normal Pregnancy ◽  
Fetal Demise ◽  
Therapeutic Role ◽  
Intrauterine Growth ◽  
Treatment And Prevention ◽  
Normal Gestation

Implantation, trophoblast development and placentation are crucial processes in the establishment and development of normal pregnancy. Abnormalities of these processes can lead to pregnancy complications named the great obstetrical syndromes (preeclampsia, intrauterine growth restriction, fetal demise, premature prelabor rupture or membranes, preterm labor, and recurrent pregnancy loss). There is mounting evidence regarding the physiological and therapeutic role of heparins in the establishment of normal gestation and as a modality for treatment and prevention of pregnancy complications. In this review we will summarize the properties and the physiological contribute of heparins to the success of implantation and placentation and normal pregnancy.

Fetal Infections I: Viral Infections

2020 ◽  
Author(s):  
Khady Diouf ◽  
Ruth Tuomala ◽  
Nawal M Nour
Keyword(s):  
Intrauterine Growth Restriction ◽  
Viral Infections ◽  
Treatment Strategies ◽  
First Trimester ◽  
Congenital Defects ◽  
Third Trimester ◽  
Fetal Demise ◽  
Immunization Strategies ◽  
Fetal Infection ◽  
Mother To Child

Viral infections in pregnancy can lead to significant maternal and fetal morbidity and mortality. They can have varying effects on pregnancy outcomes including spontaneous abortion, intrauterine growth restriction, intrauterine fetal demise, and fetal infection. Compared to infections acquired in the second or third trimester, infections in the first trimester usually carry a lower risk of transmission to the fetus, but may be more detrimental since they are acquired during the period of organogenesis. Although not all fetal infections lead to congenital defects, infants can be severely affected at birth and develop disease manifestations throughout the first few years of life. Most viral infections do not have effective treatment strategies when diagnosed during pregnancy, but prenatal screening for certain viruses may play an important role in educating pregnant women. Immunization strategies may also aid in preventing disease acquisition for some of these viral illnesses. This review contains 4 tables, 10 figures and 56 references. Keywords: CMV, congenital transmission, fetal viral infection, herpes virus, mother to child transmission, parvovirus, placenta, protozoa, rubella, teratogenicity, toxoplasmosis

scholarly journals Pregnancy and Uterine Anomalies

2011 ◽  
Vol 5 (3) ◽  
pp. 187-191
Author(s):  
Wiku Andonotopo ◽  
Noroyono Wibowo ◽  
Azen Salim
Keyword(s):  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
First Trimester ◽  
Diagnostic Techniques ◽  
Intrauterine Growth ◽  
Uterine Malformation ◽  
Uterine Anomalies ◽  
Uterine Malformations ◽  
Heterogenous Population ◽  
Actual Incidence

ABSTRACT Congenital uterine malformations are known to have a higher incidence of infertility, repeated first trimester spontaneous miscarriages, fetal intrauterine growth restriction, fetal malposition, preterm labor, retained placenta and increased cesarean section rate. The actual incidence of uterine malformation is unknown, since many women do not have any symptoms. They are estimated to occur in 0.4% (0.1-3%) of the general population and in 4% of infertile women, and in patients with repeated spontaneous miscarriages the figures fluctuate between 3 and 38%. The discrepancy among different publications stems from their use of different diagnostic techniques, heterogenous population samples and clinical diversity of Mullerian anomalies.

scholarly journals The physiologic and therapeutic role of Heparin in implantation and placentation

2014 ◽  
Author(s):  
Michela Quaranta ◽  
Offer Erez ◽  
Salvatore Andrea Mastrolia ◽  
Arie Koifman ◽  
Elad Leron ◽  
...  
Keyword(s):  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
Normal Pregnancy ◽  
Fetal Demise ◽  
Therapeutic Role ◽  
Intrauterine Growth ◽  
Treatment And Prevention ◽  
Normal Gestation

Implantation, trophoblast development and placentation are crucial processes in the establishment and development of normal pregnancy. Abnormalities of these processes can lead to pregnancy complications named the great obstetrical syndromes (preeclampsia, intrauterine growth restriction, fetal demise, premature prelabor rupture or membranes, preterm labor, and recurrent pregnancy loss). There is mounting evidence regarding the physiological and therapeutic role of heparins in the establishment of normal gestation and as a modality for treatment and prevention of pregnancy complications. In this review we will summarize the properties and the physiological contribute of heparins to the success of implantation and placentation and normal pregnancy.

Is ProBNP a New Marker for Predicting Intrauterine Growth Restriction?

2021 ◽  
Vol 225 (02) ◽  
pp. 125-128
Author(s):  
Hasan Eroğlu ◽  
Nazan Vanlı Tonyalı ◽  
Gokcen Orgul ◽  
Derya Biriken ◽  
Aykan Yucel ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Final Analysis ◽  
First Trimester ◽  
Maternal Serum ◽  
Growth Restriction ◽  
Control Group ◽  
Aneuploidy Screening ◽  
Intrauterine Growth ◽  
Potential Marker ◽  
The Mean

Abstract Purpose To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11–14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at −80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age. Results The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679–0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

2015 ◽  
Vol 39 (4) ◽  
pp. 279-286 ◽  
Author(s):  
Gabriella Martillotti ◽  
Isabelle Boucoiran ◽  
Amélie Damphousse ◽  
Andrée Grignon ◽  
Eric Dubé ◽  
...  
Keyword(s):  
Gestational Age ◽  
Predictive Value ◽  
Intrauterine Growth Restriction ◽  
Adverse Outcome ◽  
Prenatal Ultrasound ◽  
Intestinal Lumen ◽  
Third Trimester ◽  
Mesenteric Circulation ◽  
Intrauterine Growth ◽  
Bowel Dilatation

Introduction: The objective of the study was to establish the predictive value of prenatal ultrasound markers for complex gastroschisis (GS) in the first 10 days of life. Material and Methods: In this retrospective cohort study over 11 years (2000-2011) of 117 GS cases, the following prenatal ultrasound signs were analyzed at the last second- and third-trimester ultrasounds: intrauterine growth restriction, intra-abdominal bowel dilatation (IABD) adjusted for gestational age, extra-abdominal bowel dilatation (EABD) ≥25 mm, stomach dilatation, stomach herniation, perturbed mesenteric circulation, absence of bowel lumen and echogenic dilated bowel loops (EDBL). Results: Among 114 live births, 16 newborns had complex GS (14.0%). Death was seen in 16 cases (13.7%): 3 intrauterine fetal deaths, 9 complex GS and 4 simple GS. Second-trimester markers had limited predictive value. Third-trimester IABD, EABD, EDBL, absence of intestinal lumen and perturbed mesenteric circulation were statistically associated with complex GS and death. IABD was able to predict complex GS with a sensitivity of 50%, a specificity of 91%, a positive predictive value of 47% and a negative predictive value of 92%. Discussion: Third-trimester IABD adjusted for gestational age appears to be the prenatal ultrasound marker most strongly associated with adverse outcome in GS.

First trimester uterine artery Doppler and subsequent intrauterine growth restriction and preterm birth

2004 ◽  
Vol 191 (6) ◽  
pp. S22
Author(s):  
Lorraine Dugoff ◽  
John Hobbins ◽  
Vincent Faber ◽  
Fergal Malone ◽  
Michael Belfort ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
First Trimester ◽  
Growth Restriction ◽  
Uterine Artery Doppler ◽  
Intrauterine Growth

Decreased Total Placental Mass Found in Twin-Twin Transfusion Syndrome Gestations with Selective Growth Restriction

2016 ◽  
Vol 40 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Kristi R. Van Winden ◽  
Rubén A. Quintero ◽  
Eftichia V. Kontopoulos ◽  
Lisa M. Korst ◽  
Arlyn Llanes ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Laser Surgery ◽  
Growth Restriction ◽  
Placental Weight ◽  
Apparent Difference ◽  
Inclusion Criteria ◽  
Fetal Demise ◽  
Intrauterine Growth ◽  
Share Data ◽  
The Individual

Introduction: We examined placental weight characteristics associated with donor selective intrauterine growth restriction (SIUGR) among patients with twin-twin transfusion syndrome (TTTS) who underwent laser surgery. Materials and Methods: Fresh placental specimens were studied. Pregnancies with higher-order multiples, fetal demise, or disrupted or nonsubmitted placental specimens were excluded. Placental characteristics prospectively collected included total placental weight, individual placental weight, and placental share. Data were compared between pregnancies with SIUGR (TTTS + SIUGR group) and those without SIUGR (TTTS-only group). Results: Of 369 consecutive patients who underwent laser surgery for TTTS, 155 (42%) met inclusion criteria: 91 with TTTS + SIUGR and 64 with TTTS-only. Compared to the TTTS-only group, patients in the TTTS + SIUGR group had a lower total placental weight (608 ± 163 vs. 687 ± 224 g, p = 0.012), with a lower donor individual placental weight (237 ± 91 vs. 291 ± 124 g, p = 0.002), but no apparent difference in the individual placental weight of recipient twins (371 ± 109 vs. 396 ± 133 g, p = 0.211). Donor placental share was smaller in those pregnancies affected by SIUGR (38.7 ± 9.6 vs. 42.3 ± 9.8%, p = 0.029). Discussion: TTTS patients with SIUGR had a lower total placental weight and a lower donor individual placental weight compared to those without SIUGR. These findings suggest that differences in donor individual placental weights for SIUGR gestations may not solely be related to differences in placental share.

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