Rationale And Objectives: Monochorionic pregnancies are responsible for some severe complications, and selective reduction of a single fetus can improve pregnancy outcomes. This study evaluated the fetal outcomes and procedure-related prognostic factors after radiofrequency ablation (RFA) in complicated monochorionic multiple pregnancies.
Materials And Methods: This prospective cross-sectional study was conducted in an academic center from June 2020 to January 2022. The participants were 70 women with monochorionic multiple pregnancies who were candidates for selective fetal reduction by RFA. All participants' demographic data, RFA-related information, and pregnancy outcomes were evaluated and reported.
Results: The RFA procedure was successful in all participants. The most frequent RFA indications were twin-to-twin transfusion syndrome following selective intrauterine growth restriction. The mean gestational age at birth was 33.60 ± 5.62 weeks. Also, 11 (15.7%) of the cases had preterm delivery up to 30 days after RFA. The total pregnancy loss rate was 12 (17.14%), and the total fetal survival rate after RFA was 82.85%. The mean time of the RFA procedure was 130.8 ± 83.3 seconds. The procedure was conducted easily in 31 (44.2%) cases. Although the meantime of RFA procedure was longer in the not-easy group, the difference in surgery time was not significant (P = .296). There was no significant relationship (P = .623) between RFA indications and the gestational age of the remained fetus at delivery. The RFA needle was passed through the placenta in 18 (25.7%) cases. The mean gestational age at the delivery time was significantly lower in this group compared to their counterparts' gestational ages without needle placental passage (P = .030). Also, there was no significant correlation between gestational age at pregnancy termination and RFA cycles (P = .219).
Conclusion: RFA is a relatively safe and minimally invasive procedure for the selective reduction of complicated monochorionic fetuses. Although mortality, premature membrane rupture, and preterm delivery are the potential risk factors for the remaining co-twin. According to this study, gestational age at the time of the procedure and passing the needle through the placenta can affect the outcome. Other procedure-related factors like easy- or hard-access procedures, and the number of RFA cycles are not significantly associated with gestational age at birth.
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http://dx.doi.org/10.1016/j.acra.2023.06.001 | DOI Listing |
Cureus
December 2024
College of Medicine, Alfaisal University, Riyadh, SAU.
Smell and taste sensations have been linked to positive outcomes in the feeding of premature infants, though the impact on the time required to transition to oral feeding remains unclear. This study aimed to evaluate the beneficial effects of smell and taste interventions on clinical outcomes in preterm infants. We conducted a search in PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials from inception through September 2024 for randomized controlled trials (RCTs) examining the effects of smell and taste on clinical outcomes in preterm infants with a gestational age of less than 34 weeks.
View Article and Find Full Text PDFInnate Immun
December 2024
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Background: We aimed to investigate the potential of altered levels of various acute phase proteins (APPs) in the plasma, either used alone or in combination with ultrasound-, clinical-, and conventional blood-based tests, for predicting the risk of intra-amniotic inflammation (IAI), microbial invasion of the amniotic cavity (MIAC), histologic chorioamnionitis (HCA), and funisitis in women with preterm premature rupture of membranes (PPROM).
Methods: A total of 195 consecutive pregnancies involving singleton women with PPROM (at 23 + 0-34 + 0 weeks) who underwent amniocentesis and from whom plasma samples were obtained at amniocentesis were retrospectively included in this study. Amniotic fluid (AF) was cultured to assess the MIAC and analyzed for interleukin (IL)-6 levels to define IAI (AF IL-6 level of ≥2.
Aerosp Med Hum Perform
November 2024
Introduction: The aviation occupational environment may expose a developing fetus to intermittent hypoxia, high gravitational force, toxic materials, loud noise, high frequency vibrations, and galactic cosmic radiation. These exposures in animal models are associated with adverse neonatal outcomes. We sought to investigate whether a maternal military aviation career was associated with adverse neonatal health outcomes.
View Article and Find Full Text PDFJ Perinat Med
December 2024
Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany.
Objectives: Planning the mode of delivery of a full-term breech singleton remains a challenging task. The aim of this work is to compare the neonatal and maternal short-term outcomes after planned vaginal delivery and caesarean section and to evaluate the influence of an MRI pelvimetry on the short-term outcomes in order to provide appropriate advice to pregnant women with breech presentation.
Methods: This is a retrospective monocentric analysis of all deliveries with singleton pregnancies from breech presentation >36 + 0 weeks of gestation between 08/2021 and 09/2023.
Acta Obstet Gynecol Scand
December 2024
The Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Introduction: Recurrent pregnancy loss (RPL), defined as two or more pregnancy losses, might be associated with elevated obstetrical and perinatal risks in the following pregnancies. RPL and pregnancy problems related to placental development may have similar etiological features. This study explores the incidences of pregnancy and perinatal outcomes in women with RPL.
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