Interpersonal Conflicts in the Relationship of Twins

Taking into consideration two facts: that the structure of social life forces twins to part and that the presented roles in a pair are not equal, (one of the twins plays the role of a leader (L) and the other, the subordinate (P.)), one can ask the question — what meaning does the moment of parting have and what are its consequences?In order to do that, a survey was conducted, (a sample of 31 pairs of twins above the age of 30), in which every pair was asked the question: “Which one of you made the decision about parting?” The answer had two options: A – I, B – brother/sister. Out of 31 pairs of twins, 16 pairs chose the variant different from his brother or sister – that is A, B, admitting that the interpersonal conflict was the result of the parting. In 7 pairs, both twins chose the B variant – they withdrew from the conflict; and in 8 pairs they chose the A variant – looking for a compromise as the means of agreement.When analyzing the results of the survey, we can state the following:– in the relationship of twins, there is an interpersonal conflict;– the decision about parting is difficult with prevalent feelings of sadness and sorrow;– after parting, at least one of the twins has problems with preserving his identity and integrity of psychological space.Since the moment of parting is necessary and difficult, specialists and mainly parents are required to consciously change their position towards the relationship of twins. It has to be the result of applied educational methods which aim at creating subjectivity and equality of each of the twins before the moment of parting.

Prevalence and Forms of Congenital Anomalies in Twins Born in Pomeranian District During the Period from 1.07.1997 to 31.12.1998

The authors have analysed the frequency and structure of congenital anomalies in children born in the Pomeranian district in the period from 01.07.1997 to 31.12.1998. Among a total of 28.361 births in that area, 748 (2.64%) were affected by congenital anomalies. Among 28.361 births, 620 (2.18%) were from multiple pregnancies. 23 (3.71%) among births from multiple pregnancies were affected by congenital malformations. The prevalence rate of inborn anomalies in births from multiple pregnancy in our area were higher (3.71%) in comparison to births from singleton pregnancy (2.61%). It implies that children born from multiple pregnancy are at higher risk of developing congenital anomalies.

Neurodevelopmental Dysfunction and Specific Learning Disabilities in School-Aged Twins

The frequency of the developmental dysfunction and specific learning disabilities were assessed in the retrospective study in the group of 56 school-aged twins. The relationships between genetic, perinatal and social factors and learning disability were also determined. It was found that 12.5% of twins had learning disabilities. The most common neurodevelopmental dysfunction were language disorders, poor graphomotor fluency and poor fine motor dexterity. It was also found that educational difficulty were associated with prematurity, low Apgar scores, neonatal complications and familial predisposition.

Yolk Sacs in Twin Pregnancy

OBJECTIVE. The purpose of this study was to evaluate the relationship between the yolk sacs separated or not separated by septum and chorionicity twin pregnancies scanned early in the first trimester, and the relation between size and morphologic features of the yolk sac and the outcome of twin pregnancies.RESULTS. In all 38 sets of twins two yolk sacs were identified. During the first trimester of a dichorionic twin pregnancy, the yolk sacs were always separated by a septum and not separated (“Eight” sign) in monochorionic twin pregnancy. In five cases, one of yolk sac was abnormally large (> 8mm) and had thin wall. Four of the five mothers spontaneously aborted during the next 2-3 weeks. In one case of monochorionic twin ectopic pregnancy two yolk sacs were seen normally.CONCLUSION. The sonographic identification of yolk sacs in multiple pregnancies allows an early and efficient recognition of presence and chorionicity of twin pregnancy, both in intra – and extrauterine. Identification of abnormal yolk sac or yolk sacs suggests death of one or all embryos.

Renal Blood Flow in Twins

The aim of this preliminary study was the estimation of renal blood flow in 16 premature newborns from twin pregnancies with mean body weight 1270 g and mean gestational age 29 weeks.In control group we have 16 singleton newborns with mean gestational age 29 weeks and mean birth weight 1240 g. In both intervention and control group we have the similar clinical symptoms. The renal blood flow was carried out in the first day of life with the Acuson 128 XP Colour Doppler using the 6 and 7 MHz linear transducer. The renal blood flow parameters-PI, RI, Vmax, Vmin Vmean were measured in right and left renal arteries in theirs courses from the aorta to the renal hilus, by color sinal. In the investigation group the mean value of RI in right and left renal artery was 0,88. Mean PI in right vessel was 1,67 and in left 1,56. Mean V min in right and in left artery was 0,03 and mean V max in right artery was 0,34 and in left 0,33. Mean value of mean velocity in right vessels was 0,18 and in left 0,19.In control group we observed in right artery mean value of PI 1,74 and in left 1,6. Mean RI was 0,86 and 0,86 in right vessel in left vessel. Mean V min was 0,05 in right and 0,04 in left artery. Mean V max was 0,37 in right and 0,34 in left artery. Mean value of V mean was 0,19 in right artery and 0,18 in left artery.Using the student, Mann-Whitney and Shapiro-Wilk tests we have not observed statistically significant difference of Doppler parameters between control and investigation group and between the left and right artery. Although in newborns with broad PDA we noted significant higher value of RI (0,97, 0,98) than in newborns without PDA (0,78, 0,81).

A Case of Successful Twin Pregnancy Placed in Separate Horns of Bicornuate, Unicollis Uterus

We described a case of pregnancy, delivery and peurperium of 28 years old multipara with twins pregnancy in bicornuate, unicollis uterus. Each fetus was placed in separate horn of uterus. Biological mature pregnancy was delivered by cesarean section. During the peurperium the involution disturbances of one of the uterus horns were observed. The case was discussed in context of other similar anomalies.

Type 1 Diabetes and Prediabetic State in a Monozygotic Triplet

Type 1 diabetes mellitus (IDDM) results from a chronic process of autoimmune destruction of ß cells of the Langerhans islets. The presence of autoantibodies (ICA, GADA, anti-IA2, IAA) in serum preceds the clinical onset of the disease. Genetic predisposition for IDDM is connected with HLA, CTLA-4 and insulin gene region.The aim of the study was the genetic and immunological analysis of a triplet. One of them developed Type 1 diabetes mellitus. We analysed HLA class II, CTLA-4 and insulin gene polymorphisms in the whole family. Besides, we investigated immunological status of three brothers.All patients present identical genotype for VNTR loci: D1S80, D17S5 and Apo B, as well as for HLA-DRB1, — DQA1, — DQB1, CTLA-4 gene and all studied insulin gene polymorphisms. That proves their monozigosity. The triplet presents strong genetic predisposition for IDDM. The two patients without overt diabetes have increased levels of ICA, GADA, IA2 and IAA.

Characteristics of Adaptation Period for Extrauterine Life of Neonates from Multiple Pregnancies

Multiple pregnancies pose numerous threats both for foetuses and neonates. The following disorders are encountered among the most important perinatal disturbances: EPH – gestosis, immature labour and premature rupture of foetal membranes. Also during the labour, particularly the second one and the following ones, various lesions that may cause increased incidence of diseases and mortality in this group of neonates [5, 6, 10, 18, 21, 22, 25]. Complications encountered in neonates from multiple pregnancies, resulting both from abnormal conditions of intrauterine development and from perinatal pathology, require still wider studies, particularly within the context of intensified obstetrical care of women with multiple pregnancies [7, 11, 13, 16, 24].In the years 1996-1998, out of 3883 neonates born in the Chair of Obstetrics and Gynaecology of the Silesian Medical Academy, 152 (3,9%) came from multiple pregnancies. This period included one case of quadruplets, eight cases of triplets and 62 twin pregnancies. Pregnant women were directed to our Chair within the program of multidisciplinary care of women with complicated pregnancies and they also came from the Department of Pathology of Pregnancy in our Chair. In 18 women, treated for infertility, the pregnancy was accomplished as a result of application of various techniques of assisted procreation. In one case – 4 foetuses were indicated, in five cases – three foetuses and in 12 cases – two foetuses.

Long-Term Follow-Up Study of Somatic Development in Prematurely Born Twins after Life-Threatening Episodes

The study comprised 14 pairs of twins. All the children were prematurely born between the 27 and the 33 weeks of pregnancy with birth weight 600-1900 g. Somatic development was assessed on the basis of the body weight, length/height measurements taken in the 6th and 12th months of the corrected age and in the 24th month of the calendar age. Body mass index was also calculated as weight in kilograms divided by the square of the height in meters. The obtained results were compared with the regional norms for children from Lodz. Moreover, in each child individual measurements and body mass index were normalized as compared to the arithmetic mean and the standard deviation for the established age norm. The percentage of children with body mass deficiency and decreased body length/height was relatively high. Individual assessment of somatic development, taking into account the normalized values enable observation of the direction of changes within the range of somatic features in individual children. Retardation of somatic development of prematurely born twins should be first of all associated with their very low birth weight. Severe complications of prematurity affect physical development of the children examined by us, especially in the first two years of life.