CYTOGENETIC STUDY OF LEUCOCYTE CULTURE IN MULTIPLE PREGNANCY LOSS IN MUMBAI

The study of very early pregnancy loss is impractical in the general population, but possible amongst infertility patients receiving carefully monitored treatments. We examined the association between fetal loss and the risk of birth defects in the surviving co-twin in a retrospective cohort study of infertility patients within an infertility clinic in South Australia from January 1986 to December 2002, linked to population registries for births, terminations and birth defects. The study population consisted of a total of 5683 births. Births from singleton pregnancies without loss were compared with survivors from (1) pregnancies with an empty fetal sac at 6–8 weeks after embryo transfer, (2) fetal loss subsequent to 8-week ultrasound and (3) multiple pregnancy continuing to birth. Odds ratios (OR) for birth defects were calculated with adjustment for confounders. Amongst infertility patients, the prevalence of birth defects was 7.9% for all twin pregnancies without fetal loss compared with 14.6% in pregnancies in which there had been an empty sac at ultrasound, and 11.6% for pregnancies with fetal loss after 6–8 weeks. Compared with singleton pregnancies without loss, the presence of an empty sac was associated with an increased risk of any defect (OR=1.90, 95% confidence intervals (CI)=1.09–3.30) and with multiple defects (OR=2.87, 95% CI=1.31–6.28). Twin pregnancies continuing to birth without loss were not associated with an overall increased prevalence of defects. We conclude that the observed loss of a co-twin by 6–8 weeks of pregnancy is related to the risk of major birth defects in the survivor.

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Pregnancy Loss: Multiple Pregnancy versus Multiple Birth

Multiple Pregnancy ◽

10.1201/b14615-40 ◽

2005 ◽

pp. 282-284 ◽

Cited By ~ 1

Keyword(s):

Pregnancy Loss ◽

Multiple Pregnancy ◽

Multiple Birth

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Twins in Dairy Herds. Is It Better to Maintain or Reduce a Pregnancy?

Animals ◽

10.3390/ani10112006 ◽

2020 ◽

Vol 10 (11) ◽

pp. 2006 ◽

Cited By ~ 1

Author(s):

Fernando López-Gatius

Keyword(s):

Pregnancy Loss ◽

Animal Health ◽

Multiple Pregnancy ◽

Prostaglandin F2α ◽

Hormone Treatment ◽

Dairy Herds ◽

Multiple Pregnancies ◽

Pregnancy Diagnosis ◽

Best Management ◽

Twin Pregnancies

Multiple ovulations and so multiple pregnancies have increased recently in dairy cattle. The incidence of the double ovulation impact in high producers at insemination may be over 20%. Twin pregnancies are undesirable as they seriously compromise the welfare and productive lifespan of the cow and herd economy. Clinical problems extend from the time of pregnancy diagnosis to pregnancy loss, abortion or parturition. Early pregnancy loss or abortion of multiple pregnancies lead in most cases to culling. In cows reaching their term, mean productive lifespan is up to about 300 days shorter for cows delivering twins than for cows delivering singletons. While there is an urgent need to address multiple pregnancy prevention procedures in the foreseeable future, the incidence of twin pregnancies continues to rise in parallel with increased milk production. Herein, we review two contrasting measures proposed for the time of twin pregnancy diagnosis: (1) gonadotropin-releasing hormone treatment for pregnancy maintenance, or (2) embryo reduction. These options are discussed in terms of their implications for individual animal health and herd economy. Our main conclusions find that manual twin reduction has proven to be the best management option, whereas the use of prostaglandin F2α for inducing abortion may be a better option than doing nothing.

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Safety and Efficacy of Higher Order Multifetal Pregnancy Reduction: A Single-Center Retrospective Study

American Journal of Perinatology Reports ◽

10.1055/s-0040-1715167 ◽

2020 ◽

Vol 10 (03) ◽

pp. e228-e233

Author(s):

Yan Liu ◽

Xie Tong Wang ◽

Hong Yan Li ◽

Hai Yan Hou ◽

Hong Wang ◽

...

Keyword(s):

Retrospective Study ◽

Birth Weight ◽

Pregnancy Loss ◽

Multiple Pregnancy ◽

Perinatal Outcomes ◽

Higher Order ◽

Sample Population ◽

Safety And Efficacy ◽

Multifetal Pregnancy ◽

Multifetal Pregnancy Reduction

Abstract Objective This research was aimed to study the safety and efficacy of higher order multifetal pregnancy reduction (MFPR). Study Design This was a retrospective study of patients from an academic maternity center between 2005 and 2015. We evaluated outcomes of 131 consecutive patients who underwent higher order MFPR (quadruplets and greater). MFPR was performed at 11 to 18 weeks of gestation in all cases. In total, 122 of 131 cases of higher order multiple pregnancy were reduced to twins. We discuss the perinatal outcomes of patients who underwent higher order MFPR, followed by a comparative analysis between the 122 cases of MFPR that were reduced to twins and 101 cases of nonreduced twin pregnancies. Results The study included 104 sets of quadruplets, 20 sets of quintuplets, 5 sets of sextuplets, 1 set of septuplets, and 1 set of octuplets. The perinatal outcomes of the 131 cases were as follows: pregnancy loss, preterm deliveries at 28 to 33 (+6/7) weeks, and preterm deliveries at 34 to 36 (+6/7) weeks occurred in 23.66, 9, and 37% of cases, respectively. The mean time of delivery was 36.56 ± 1.77 weeks, and mean birth weight was 2,409.90 ± 458.16 g, respectively. A total of 122 cases that were reduced to twins were compared with nonreduced twins. The pregnancy loss rate for reduced twins was significantly higher than that for nonreduced twins. The preterm labor rate, mean delivery week, mean birth weight, birth-weight discordance, incidence of gestational diabetes mellitus, and pregnancy-induced hypertension were not significantly different between the groups (p > 0.05). Conclusion Perinatal outcomes were significantly improved by reducing the number of fetuses in higher order multifetal pregnancies. This study involved a large, diverse sample population, and the results can be used as a reference while conducting prenatal counseling.

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Interstitial laser therapy for fetal reduction in monochorionic multiple pregnancy: loss rate and association with aplasia cutis congenita

Prenatal Diagnosis ◽

10.1002/pd.2025 ◽

2008 ◽

Vol 28 (6) ◽

pp. 535-543 ◽

Cited By ~ 32

Author(s):

Keelin O'Donoghue ◽

Olivia Barigye ◽

Lucia Pasquini ◽

Lucy Chappell ◽

Ruwan C. Wimalasundera ◽

...

Keyword(s):

Laser Therapy ◽

Pregnancy Loss ◽

Loss Rate ◽

Multiple Pregnancy ◽

Aplasia Cutis Congenita ◽

Fetal Reduction ◽

Interstitial Laser Therapy ◽

Interstitial Laser ◽

Aplasia Cutis

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Pregnancy Loss: Multiple Pregnancy versus Multiple Birth

Prenatal Assessment of Multiple Pregnancy ◽

10.4324/9780429462023-42 ◽

2018 ◽

pp. 282-284

Keyword(s):

Pregnancy Loss ◽

Multiple Pregnancy ◽

Multiple Birth

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Single center experience in selective feticide in high-order multiple pregnancy: clinical and ethical issues

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0340 ◽

2016 ◽

Vol 44 (2) ◽

Cited By ~ 4

Author(s):

Giovanni Monni ◽

Tamara Illescas ◽

Ambra Iuculano ◽

Marcella Floris ◽

Federica Mulas ◽

...

Keyword(s):

Pregnancy Loss ◽

Ethical Issues ◽

Chromosomal Abnormalities ◽

Multiple Pregnancy ◽

Nuchal Translucency ◽

High Order ◽

Single Center ◽

Operator Experience ◽

Single Center Experience ◽

Time Period

AbstractThis paper describes the 20-year experience with selective feticide (SF) of high-order multiple quadruplet and higher pregnancies in a single center.The paper describes protocols, procedures, management, outcomes, and ethical issues.SF was performed in 49 pregnancies with 244 fetuses, with median gestational age of 12+2 weeks. The initial number was nine (one case), eight (one case), seven (three cases), six (11 cases), five (eight cases), and four (27 cases). Nuchal translucency was utilized prior to the procedure starting in 1996. The technique was transabdominal ultrasound-guided and intrathoracic injection of potassium chloride. One pregnancy (with seven fetuses) was reduced to three, 42 to two, and four (starting with four fetuses) to singletons. There were ten pregnancy losses (20.4%). A decreasing trend in losses was evident over the 20-year time period: 7/23 (30.4%) from 1994 to 2004 down to 3/26 (11.5%) for 2004–2014. No chromosomal abnormalities were present in any of the survivors. The ethical issues focus on the justification of SF in high-order multifetal pregnancies.In this series, pregnancy loss decreased with operator experience. Excellent outcomes can be achieved with the ethically justified use of feticide in high-order multiple pregnancies.

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