Twin gestation is now an area of vital concern to the perinatologist. Within the last decade a substantial reduction in perinatal mortality has been achieved, largely through advances in neonatal intensive care. However, preterm birth and its consequences remain the most important causes of perinatal morbidity and mortality. Twin pregnancy accounts for approximately 10% of all premature deliveries. From the data currently available, there is no justification for the routine use of hospital bedrest, prophylactic tocolytic agents, or elective cerclage in the management of twin pregnancy. Programs directed at the prevention of perterm delivery in twin pregnancy will be the focus of more scientific research. The use of ultrasound and antepartum testing in the form of the nonstress test, the biophysical profile, and Doppler ultrasound may lead to major advances in the diagnosis of intrauterine growth retardation and the twin-to-twin transfusion syndrome in twins. Therefore, it is reasonable to expect that fetal death and neonatal death from intrauterine growth retardation can be prevented.
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http://dx.doi.org/10.1097/00003081-199003000-00007 | DOI Listing |
Clin Case Rep
January 2025
Breastfeeding Research Center Family Health Research Institute, Tehran University of Medical Sciences Tehran Iran.
A rare spontaneous triplet heterotopic pregnancy occurred in a patient using emergency contraception. This highlights the need to consider heterotopic pregnancy in differential diagnoses for patients presenting with abdominal pain or vaginal bleeding, even with detected intrauterine pregnancies, especially after failed emergency contraception, necessitating thorough laboratory and ultrasonographic diagnostic work-up.
View Article and Find Full Text PDFArch Gynecol Obstet
January 2025
Department of Perinatal Maternal and Child Medical Center, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-Ku, Shizuoka-Shi, Shizuoka, 420-8660, Japan.
Purpose: This study aimed to investigate the usefulness of emergency cerclage for pregnant women with bulging fetal membranes, as indicated by our original noninvasive clinical scoring system.
Methods: This was a retrospective study of pregnant women who underwent emergency cerclage for bulging fetal membranes within 28 weeks. The primary outcome was the continuation of pregnancy at 34 gestational weeks in singleton pregnancies and 32 gestational weeks in twin pregnancies.
Am J Obstet Gynecol MFM
January 2025
Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands.
Background: Monochorionic (MC) twins share a single placenta which can be unequally shared, leading to selective fetal growth restriction (sFGR). Limited data is available on the prevalence and clinical consequences of proximate cord insertion (PCI) in sFGR pregnancies.
Objective: We aimed to investigate the prevalence of PCI in MC placentas with and without sFGR and per type of sFGR, and study the placental characteristics and perinatal outcome of PCI in sFGR pregnancies.
Ultrasound Obstet Gynecol
January 2025
Johns Hopkins Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Objective: To determine if the resolution of fetal growth discordance after laser surgery in pregnancies with twin-to-twin transfusion syndrome (TTTS) and coexisting selective fetal growth restriction (sFGR) can be predicted by estimated fetal weight (EFW) discordance recorded prior to the development of TTTS (pre-TTTS).
Methods: This was a single-center, retrospective analysis of prospectively collected data on monochorionic twins with concurrent TTTS and sFGR that underwent laser surgery and had available growth ultrasound records from a pre-TTTS ultrasound evaluation. Maternal demographics, pregnancy characteristics and birth outcomes were compared between three outcome groups: double twin survival with resolved sFGR determined by birth weight discordance (BWD) < 20%; double twin survival with ongoing sFGR determined by BWD ≥ 20%; and single or double fetal demise after laser surgery.
Immunohematology
December 2024
Transfusion Medicine, Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, Tamilnadu, India.
Red blood cell (RBC) alloimmunization can occur because of exposure to various sensitizing factors and poses a constant threat in transfusion. Assisted reproductive technology (ART) involves manipulation of sperm, ova, or embryos with the goal of producing a pregnancy. We present an interesting case of ART-induced maternal alloimmunization (AIMA) due to anti-c in a woman carrying a twin pregnancy.
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