Faculty Opinions recommendation of Cytokines and the risk of preterm delivery in twin pregnancies.

2012 ◽  
Author(s):  
Fatma F Verit
Keyword(s):  
Preterm Delivery ◽  
Twin Pregnancies

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

2008 ◽  
Vol 11 (5) ◽  
pp. 552-557 ◽  
Author(s):  
Katharina Klein ◽  
Hubertus Gregor ◽  
Kora Hirtenlehner-Ferber ◽  
Maria Stammler-Safar ◽  
Armin Witt ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Smoking Habit ◽  
Cervical Length ◽  
Spontaneous Preterm Delivery ◽  
Spontaneous Labour ◽  
High Incidence ◽  
High Cervical ◽  
Twin Pregnancies ◽  
Preterm Rupture Of Membranes ◽  
Spontaneous Delivery

AbstractThe objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

scholarly journals Pregnancy Outcome of Twin Pregnancy at Gandaki Medical College Teaching Hospital, Pokhara, Nepal

2018 ◽  
Vol 11 (02) ◽  
pp. 1-4
Author(s):  
M Tripathi ◽  
R Shrestha
Keyword(s):  
Preterm Delivery ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Twin Pregnancy ◽  
College Teaching ◽  
Neonatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Complications ◽  
Twin Pregnancies

Objectives: To evaluate maternal and neonatal complications and pregnancy outcomes of twin pregnancies. Methods: The cross sectional study was conducted using retrospective data on the twin pregnancies with more than 28 weeks of gestational age. The study used data over a period of five years, from March 10, 2010 to March 9, 2015 in the Department of Obstetrics and Gynecology, GMC Teaching Hospital Pokhara. Results: Of the 50 twin pregnancies, the most common maternal complication was preterm delivery (40%). Other maternal complications were anemia (36%), pregnancy induced hypertension (14%), premature rupture of membranes (14%), postpartum hemorrhage (12%) and antepartum hemorrhage (6%). Median gestational age at delivery was 37 weeks. Most common route of delivery was cesarean section (66%). Most common neonatal complication was low birth weight (48%) births first twin and second twin 56%. Conclusion: Twin pregnancy has high maternal and neonatal complications, especially preterm delivery that increases the risk of significant neonatal morbidity and mortality.

scholarly journals Successfully delayed delivery of second twin after early second trimester rupture of membranes of the first twin: a case report

2020 ◽  
Vol 12 (2) ◽  
pp. 81-85
Author(s):  
Jadranka Georgievska ◽  
Igor Samardziski ◽  
Ana Daneva ◽  
Goran Kocoski
Keyword(s):  
Preterm Delivery ◽  
Good Condition ◽  
Fetal Lung ◽  
Intrauterine Death ◽  
Lung Maturation ◽  
Uterine Contractions ◽  
Regular Control ◽  
Level Institution ◽  
Twin Pregnancies ◽  
Second Twin

Twin pregnancies are high-risk pregnancies accompanied with multiple complications, such as: spontaneous abortion, preterm rupture of the membranes, preterm delivery, intrauterine death of one or both twins etc. There is no consensus about the management of twin  pregnancies complicated with preterm rupture of the membranes of one twin and risk of preterm delivery. These cases are rarely found in the literature. We present a case of a 35 years old patient, hospitalized in a tertiary level institution, because of a diamniotic dichorionic twin pregnancy complicated with preterm rupture of the membranes of the first twin at 19 weeks of gestation. She had one delivery with Caesarean section 16 years ago. In consultation with the patient induction of labor was done with delivery of the first twin, a death male fetus. After that, antibiotics and tocolytic therapy were administrated and the patient remained in the hospital about one week. The patient was discharged at home with regular control of her condition and condition of the fetus. The patient was again hospitalized at 33 weeks of gestation with uterine contractions on cardiotocography. After administration of corticosteroid therapy for fetal lung maturation she delivered spontaneously the second twin in a good condition and  she was discharged from hospital after 16 days. In twin pregnancies clinicians must think about delayed interval delivery of the second twin, after delivery of the first twin, with an aim to increase chances for survival, especially for pregnancies less than 30 weeks of gestation.

scholarly journals 552: Twin pregnancies with short cervix: Vaginal progesterone is agent of choice for preterm delivery prevention

2019 ◽  
Vol 220 (1) ◽  
pp. S368-S369 ◽  
Author(s):  
Jared T. Roeckner ◽  
Melanie Mitta ◽  
Luis Sanchez-Ramos ◽  
Andrew M. Kaunitz
Keyword(s):  
Preterm Delivery ◽  
Short Cervix ◽  
Vaginal Progesterone ◽  
Twin Pregnancies

Cervical Length as a Predictor of Preterm Delivery in an Unselected Cohort of Women with Twin Pregnancies

2018 ◽  
Vol 36 (12) ◽  
pp. 1288-1294 ◽  
Author(s):  
Clifton O. Brock ◽  
Leslie A. Moroz ◽  
Cynthia Gyamfi-Bannerman
Keyword(s):  
Preterm Delivery ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Cervical Length ◽  
Prospective Data ◽  
Spontaneous Preterm Delivery ◽  
False Discovery ◽  
Twin Pregnancies ◽  
Unselected Cohort

Objective To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. Study Design This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and 24 weeks. Prediction thresholds were determined using a false discovery rate of 10%. The risk of SPTD was compared with previously published, prospective data from a meta-analysis. Results A total of 1,228 women were included. SPTD occurred prior to 35 weeks in 232 (18.9%), 126 (10.3%), and 24 (2.0%) women prior to 35, 32, and 28 weeks. TVCL was most predictive at 22 weeks (area under the curve = 0.67). TVCL thresholds for predicting SPTD prior to 35, 32, and 28 weeks were 3.1, 3.0, and 2.9 cm. Compared with a previous meta-analysis, the risk of SPTD < 34, 32, and 28 weeks was lower (positive likelihood ratio 9.0 vs. 5.4, 10.1 vs. 5.9, and 9.6 vs. 4.3). Conclusion TVCL is modestly predictive of SPTD in twin gestations. Compared with previous prospective studies, this cohort has lower risk of SPTD at similar TVCLs.

Preterm delivery rate and fetal outcome in structurally affected twin pregnancies: A retrospective matched control study

1993 ◽  
Vol 13 (3) ◽  
pp. 155-162 ◽  
Author(s):  
R. Heydanus ◽  
J. G. Santema ◽  
P. A. Stewart ◽  
P. G. H. Mulder ◽  
J. W. Wladimiroff
Keyword(s):  
Preterm Delivery ◽  
Matched Control ◽  
Fetal Outcome ◽  
Delivery Rate ◽  
Twin Pregnancies ◽  
Control Study

scholarly journals Preterm Delivery and Growth Restriction in Multifetal Pregnancies reduced to Twins: Case-Control Series

2014 ◽  
Vol 5 (2) ◽  
pp. 40-43
Author(s):  
Anuradha R Shewale ◽  
Bhavana Shewale
Keyword(s):  
Preterm Delivery ◽  
Perinatal Death ◽  
Adverse Pregnancy Outcome ◽  
Case Control ◽  
Growth Restriction ◽  
Control Group ◽  
Control Series ◽  
Increased Risk ◽  
Twin Pregnancies ◽  
Multifetal Pregnancy

ABSTRACT An adverse consequence of the widespread introduction of assisted reproductive techniques has been an exponential increase in the prevalence of multifetal pregnancies (Botting et al 1987). Such pregnancies are associated with increased risk of miscarriage and perinatal death (Kiely et al 1992). One of the options in the management of multifetal pregnancies is embryo reduction to twins which is associated with a reduction in the background risk of adverse pregnancy outcome (Evans et al 1995). The aim of the study was to compare the gestation at delivery and birth weight of surviving twins following multifetal pregnancy reduction to those in a control group of dichorionic non-reduced twins. Materials and methods A case control study evaluating pregnancy outcomes post embryo reduction. Study takes into account all patients with successful day three embryo transfers resulting in multifetal pregnancy. First trimester embryo reduction was carried out by intracardiac injection of KCl. Results A total of 26 multifetal pregnancies were reduced to twins at early gestational age (7-9 weeks). Two cases (7.6%) of miscarriage, no cases of chorioamnionitis and five cases (19.2%) of transient spotting were recorded as postoperative complications. There was no vanishing of embryos in those reduced to twins. A total of 24 patients (92.3%) with twin pregnancies took home at least one baby, while 18 (69.23%) of these took both babies home. This was analyzed and compared with a control group of women with nonreduced twins pregnancies. The preterm delivery rate (defined as fetuses delivered before 37 weeks) in twin pregnancies was 53.8% (n = 14), with a severe preterm rate (defined as fetuses delivered before 32 weeks) of 23.07% (n = 6). One case (1.92%) of stillbirth occurred. The perinatal mortality rate was 13.46% (n = 6 newborns, and a 33-week stillbirth), mainly due to severe preterm labor. The latter group included no registered cases of newborns with congenital malformations. A total of 24 patients (92.3%) with twin pregnancies took home at least one baby, while 18 (69.23%) of these took both babies home. In two of the 26 multifetal pregnancies reduced to twins there was miscarriage of both fetuses before 24 weeks of gestation the median interval between reduction and multifetal loss was 5 weeks. In pregnancy reduced to twins as compared to nonreduced twins the percentage of miscarriage was slightly higher, but not statistically significant (7.6% compared to 6.9%, 0.07 × 2, P 0.8). The median gestation at delivery was lower (33.3 ± 9.2 compared to 35.67 ± 5.84 weeks, 2.26 > 2.0 t, 0.05 P) and the median weight deficit was greater (1.58 ± 0.96 compared to 1.92 ± 0.89 (4.04 > 3.37 t, 0.001 P). How to cite this article Shewale AR, Shewale B. Preterm Delivery and Growth Restriction in Multifetal Pregnancies reduced to Twins: Case-Control Series. Int J Infertil Fetal Med 2014;5(2):40-43.

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