Does Early Second-Trimester Sonography Predict Adverse Perinatal Outcomes in Monochorionic Diamniotic Twin Pregnancies?

2014 ◽  
Vol 33 (9) ◽  
pp. 1573-1578 ◽  
Author(s):  
M. Baraa Allaf ◽  
Winston A. Campbell ◽  
Anthony M. Vintzileos ◽  
Sina Haeri ◽  
Pouya Javadian ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Second Trimester ◽  
Adverse Perinatal Outcomes ◽  
Twin Pregnancies

scholarly journals Fetal growth standards for Chinese twin pregnancies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianping Chen ◽  
Jun Zhang ◽  
Yang Liu ◽  
Xing Wei ◽  
Yingjun Yang ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Perinatal Outcomes ◽  
Growth Charts ◽  
Growth Standards ◽  
Growth Standard ◽  
Adverse Perinatal Outcomes ◽  
Chinese Twins ◽  
Twin Pregnancies

Abstract Background The common use of singleton fetal growth standard to access twin growth might lead to over-monitoring and treatment. We aimed to develop fetal growth standards for Chinese twins based on ultrasound measurements, and compare it with Zhang’s and other twin fetal growth charts. Methods A cohort of uncomplicated twin pregnancies were prospectively followed in 2014–2017. Smoothed estimates of fetal growth percentiles for both monochorionic (MC) and dichorionic (DC) twins were obtained using a linear mixed model. We also created growth charts for twins using a model-based approach proposed by Zhang et al. Our twin standards were compared with Hadlock’s (singleton) in predicting adverse perinatal outcomes. Results A total of 398 twin pregnancies were included, with 214 MC and 582 DC live-born twins. The MC twins were slightly lighter than the DC twins, with small differences throughout the gestation. Our ultrasound-based fetal weight standards were comparable to that using Zhang’s method. Compared with previous references/standards from the US, Brazil, Italy and UK, our twins had very similar 50th percentiles, but narrower ranges between the 5th and 95th or 10th and 90th percentiles. Compared with the Hadlock’s standard, the risks of neonatal death and adverse perinatal outcomes for small for gestational age (SGA) versus non-SGA were substantially elevated using our standards. Conclusions A normal fetal growth standard for Chinese twins was created. The differences between MC and DC twins were clinically insignificant. The 50th weight percentiles of the Chinese twins were identical to those in other races/ethnicities but the ranges were markedly narrower. Our standard performed much better than the Hadlock’s in predicting low birth weight infants associated with adverse perinatal outcomes in twin pregnancies. The present study also indicated that Zhang’s method is applicable to Chinese twins, and other areas may use Zhang’s method to generate their own curves for twins if deemed necessary.

scholarly journals Perinatal Outcomes of Twin Pregnancies With Preterm Premature Rupture of the Membranes at 24–34 Weeks’ Gestation

2021 ◽  
Author(s):  
Shuwei Zhou ◽  
Yajun Yang ◽  
XiaoYan Zhang ◽  
Xiaoling Mu ◽  
Quan Quan ◽  
...  
Keyword(s):  
Neonatal Death ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Factors Associated ◽  
Preterm Premature Rupture ◽  
Adverse Perinatal Outcomes ◽  
Twin Pregnancies

Abstract Objective: To describe the perinatal outcomes of twin pregnancies with preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation and identify factors associated with discharge without severe or moderate-severe neonatal morbidity.Methods: This study was conducted as a retrospective analysis of twin pregnancies with PPROM occurring at 24 0/7 to 33 6/7 weeks’ gestation. Perinatal outcomes were assessed by gestational age (GA) at PPROM. Factors associated with discharge without severe or moderate-severe neonatal morbidity were identified using logistic regression analysis.Results: Of the 180 pregnancies (360 foetuses), only 17 (9.4%) women remained pregnant 7 days after PPROM. There were 10 (2.8%) cases of prenatal or neonatal death; 303 (84.2%) and 177 (49.2%) neonates were discharged without severe or moderate-severe morbidity, respectively. As GA at PPROM increased, the adverse obstetric and neonatal outcomes decreased, especially after 32 weeks. The GA at PPROM and latency period were both significantly associated with discharge without severe or moderate-severe neonatal morbidity. Pregnancy complications and 5-min Apgar score < 7 increased severe neonatal morbidity.Conclusion: As GA at PPROM increased, the risk of adverse perinatal outcomes decreased. GA at PPROM and latency period were significantly associated with discharge without severe or moderate-severe neonatal morbidity.

scholarly journals Perinatal Outcomes of Monochorionic-Diamniotic Twin Pregnancies Uncomplicated at 28 Weeks of Gestation

2016 ◽  
Vol 7 ◽  
pp. JCM.S38895 ◽  
Author(s):  
Shunji Suzuki
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Second Trimester ◽  
Perinatal Complications ◽  
Third Trimester ◽  
The Third ◽  
Perinatal Center ◽  
Twin Pregnancies

We examined the prevalence of specific perinatal complications of monochorionic-diamniotic twin pregnancies in cases without any abnormal findings until the second trimester of pregnancy. This was a retrospective cohort study performed at a tertiary perinatal center in Tokyo, Japan. There were 88 cases of uncomplicated monochorionic-diamniotic twin pregnancies at 28 weeks of gestation. In five of them (5.7%), there were serious complications associated with placental circulatory imbalance between the twins during the third trimester of pregnancy. Two cases were complicated by twin–twin transfusion syndrome, two cases were complicated by twin anemia–polycythemia sequence, and one case was complicated by acute twin–twin transfusion syndrome. In the five cases, no abnormal ultrasonographic findings or symptoms were recognized one or two weeks prior to the diagnosis. Fifty-eight cases (65.9%) were delivered at term uneventfully. Serious complications due to placental circulatory imbalance between twins occurred in about 6% of cases during the third trimester of pregnancy.

scholarly journals Adverse perinatal outcomes related to the delivery mode in women with monochorionic diamniotic twin pregnancies

2014 ◽  
Vol 42 (6) ◽  
Author(s):  
Akiko Yamashita ◽  
Keisuke Ishii ◽  
Takako Taguchi ◽  
Aki Mabuchi ◽  
Shiyo Ota ◽  
...  
Keyword(s):  
Neonatal Death ◽  
Multiple Logistic Regression Analysis ◽  
Perinatal Outcomes ◽  
Final Analysis ◽  
Meconium Aspiration Syndrome ◽  
Adverse Outcomes ◽  
Intrauterine Fetal Death ◽  
Delivery Mode ◽  
Adverse Perinatal Outcomes ◽  
Twin Pregnancies

AbstractThe association between the planned delivery mode and adverse perinatal outcomes of monochorionic diamniotic (MCDA) twin pregnancies at ≥36 weeks’ gestation was evaluated.This retrospective cohort study included uncomplicated MCDA twin pregnancies delivered after 36 weeks’ gestation during a 10-year period. Cases were classified into the trial of labor (TOL) or cesarean section (CS) group according to the planned delivery mode. The primary outcome was a composite of adverse outcomes for at least one twin, including intrauterine fetal death (IUFD) after 36 weeks, neonatal death, umbilical artery pH<7.1, 5-min Apgar scores<7, hypoxic ischemic encephalopathy (HIE), meconium aspiration syndrome (MAS), respiratory distress syndrome (RDS), or acute feto-fetal hemorrhage (AFFH). The relationship between outcomes and the planned delivery mode was evaluated using a multiple logistic regression analysis.We included the 310 pregnancies delivered after 36 weeks’ gestation. After excluding 15 patients, the final analysis included 295 MCDA pregnancies: 63% had delivered through TOL and 37% through CS. The incidences of composite adverse outcomes in the TOL and CS groups were 4.3% and 1.9%, respectively. No IUFD, neonatal death, MAS, RDS, or AFFH was observed; two infants in each group developed HIE. Adverse outcomes were not significantly associated with any risk factor, including delivery through TOL.TOL may not influence the perinatal outcomes of MCDA twin pregnancies delivered at ≥36 weeks’ gestation.

Outcome of monochorionic-biamniotic twins conceived by assisted reproduction: a population-based study

2016 ◽  
Vol 44 (8) ◽  
Author(s):  
Andreja Trojner Bregar ◽  
Isaac Blickstein ◽  
Ivan Verdenik ◽  
Miha Lucovnik ◽  
Natasa Tul
Keyword(s):  
Assisted Reproduction ◽  
Perinatal Outcomes ◽  
Population Based ◽  
Monochorionic Twins ◽  
Population Based Study ◽  
Maternal Characteristics ◽  
Assisted Reproduction Technology ◽  
Increased Risk ◽  
Adverse Perinatal Outcomes ◽  
Twin Pregnancies

AbstractObjecive:To evaluate the perinatal outcome of monochorionic-diamniotic twins conceived by assisted reproduction technology (ART).Methods:We compared data from a national population-based perinatal registry on perinatal outcomes of monochorionic-diamniotic twins conceived by ART with their dichorionic counterparts and with spontaneous monochorionic-diamniotic twins. We compared maternal characteristics, pregnancy complications and perinatal outcomes.Results:Monochorionic-diamniotic twin pregnancies (n=45) comprised 5.5% of all ART twins, and 9.3% of all monochorionic twins in this dataset. ART does not appear to increase the already high risk of monochorionicity compared to spontaneous conception, with the latter having an increased incidence for birth weight <1500 g [odds ratio (OD) 2.6, 95% confidence interval (CI) 1.2–5.4].Conclusion:Our results disagree with hospital-based data and suggest that monochorionic-diamniotic twins following ART are not at increased risk of adverse perinatal outcomes compared to spontaneous monochorionic-diamniotic twins as well as to dichorionc twins conceived by ART.

scholarly journals Does Gestational Diabetes Cause Additional Risk in Twin Pregnancy?

2019 ◽  
Vol 22 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Annabel C. M. Sheehan ◽  
Mark P. Umstad ◽  
Stephen Cole ◽  
Thomas J. Cade
Keyword(s):  
Gestational Diabetes ◽  
Cesarean Delivery ◽  
Twin Pregnancy ◽  
Multivariate Analyses ◽  
Perinatal Outcomes ◽  
Premature Delivery ◽  
Neonatal Hypoglycemia ◽  
Adverse Perinatal Outcomes ◽  
The Impact ◽  
Twin Pregnancies

AbstractIt has been suggested that the risk of adverse perinatal outcomes in twin pregnancies is exacerbated by concomitant gestational diabetes mellitus (GDM). This study aimed to assess the risk incurred by twin pregnancy and by a diagnosis of GDM, separately, on the development of poor perinatal outcomes. A retrospective cohort study was conducted on all pregnant women at a tertiary center between 2016 and 2017. The impact of GDM and twin pregnancies on perinatal outcomes — birth weight above the 90th centile for gestational age, cesarean delivery, clinical neonatal hypoglycemia, and premature delivery (before 37 weeks’ gestation) — was assessed using univariate and multivariate analyses. Overall, 13,527 women were eligible for the study; 11,915 were uncomplicated singleton pregnancies; 1379 of these had GDM; 194 were twin pregnancies, and 39 of these had GDM. Univariate analyses showed that twin pregnancies were associated with a higher risk of all perinatal outcomes except macrosomia. In the multivariate analyses, twin pregnancy was a much higher predictor of cesarean delivery (OR 8.40, 95% CI [6.25, 11.49], p < .0001) and preterm birth (OR 58.82, 95% CI [31.25, 125], p < .0001) compared to GDM but GDM was a higher predictor of neonatal hypoglycemia (OR 4.87, 95% CI [3.74, 6.29], p < .0001). Twin pregnancy is more strongly associated with all adverse perinatal outcomes except macrosomia. GDM does not increase risk of adverse perinatal outcomes except for neonatal hypoglycemia.

Adenomyosis and adverse perinatal outcomes: increased risk of second trimester miscarriage, preeclampsia, and placental malposition

2017 ◽  
Vol 31 (3) ◽  
pp. 364-369 ◽  
Author(s):  
Ayako Hashimoto ◽  
Takayuki Iriyama ◽  
Seisuke Sayama ◽  
Toshio Nakayama ◽  
Atsushi Komatsu ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Second Trimester ◽  
Increased Risk ◽  
Adverse Perinatal Outcomes
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