scholarly journals Early fetal loss in monochorionic and dichorionic twin pregnancies: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort

2013 ◽  
Vol 41 (6) ◽  
pp. 632-636 ◽  
Author(s):  
F. D'Antonio ◽  
A. Khalil ◽  
T. Dias ◽  
B. Thilaganathan ◽  
Keyword(s):  
Multiple Pregnancy ◽  
Fetal Loss ◽  
Pregnancy Cohort ◽  
Twin Pregnancies

Spontaneous loss of a co-twin and the risk of birth defects after assisted conception

2016 ◽  
Vol 7 (6) ◽  
pp. 678-684 ◽  
Author(s):  
M. J. Davies ◽  
A. R. Rumbold ◽  
M. J. Whitrow ◽  
K. J. Willson ◽  
W. K. Scheil ◽  
...  
Keyword(s):  
Birth Defects ◽  
Pregnancy Loss ◽  
Multiple Pregnancy ◽  
Fetal Loss ◽  
South Australia ◽  
Increased Risk ◽  
Study Population ◽  
Infertility Patients ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

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.

scholarly journals OC22.01: Embryonic growth discordance and early fetal loss in twins: the STORK multiple pregnancy cohort

2013 ◽  
Vol 42 (s1) ◽  
pp. 44-44
Author(s):  
F. D'Antonio ◽  
A. Khalil ◽  
E. Mantovani ◽  
B. Thilaganathan
Keyword(s):  
Multiple Pregnancy ◽  
Fetal Loss ◽  
Embryonic Growth ◽  
Pregnancy Cohort

Accuracy of Predicting Fetal Loss in Twin Pregnancies Using Gestational Age-Dependent Weight Discordance Cut-Offs: Analysis of the STORK Multiple Pregnancy Cohort

2015 ◽  
Vol 38 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Francesco D'Antonio ◽  
Asma Khalil ◽  
Maddalena Morlando ◽  
Basky Thilaganathan ◽  
Keyword(s):  
Gestational Age ◽  
Characteristic Curve ◽  
Multiple Pregnancy ◽  
Fetal Loss ◽  
Area Under The Curve ◽  
Fetal Weight ◽  
Third Trimester ◽  
The Third ◽  
Age Dependent ◽  
Twin Pregnancies

Objectives: A third-trimester fetal weight discordance of 25% has been proposed as an independent predictor of fetal loss in twin pregnancies. As fetal weight gain at this stage of pregnancy increases exponentially, it is not entirely certain whether a single cut-off for inter-twin weight discordance is appropriate. The aim of this study was to investigate whether a single weight discordance cut-off can be used or whether different cut-offs should be adopted according to the gestational age at assessment. Methods: This was a retrospective study of all twin pregnancies of known chorionicity from a large regional cohort over a 10-year period. Receiver operating characteristic curve and logistic regression analyses were used to explore the relation between estimated fetal weight (EFW) discordance detected within 4 weeks from the occurrence of the outcome and single fetal loss at different gestational age windows. Results: 957 twin pregnancies (173 monochorionic and 784 dichorionic) were included in the analysis. EFW discordance was independently associated with the occurrence of single fetal loss in twin pregnancies in each gestational age window. Ultrasound EFW discordance had an area under the curve of 0.77 (95% CI: 0.67-0.87) for the prediction of single fetal loss in the third trimester of pregnancy, with an optimal cut-off of around 25% (23.2%). The optimal cut-offs of EFW discordance for the prediction of single fetal loss were different in each gestational age window. Conclusion: The accuracy of EFW discordance in predicting single fetal loss in twin pregnancies varies during the third trimester of pregnancy. The degree of fetal weight discordance associated with fetal loss decreases during the third trimester, suggesting that the weight discordance threshold for intervention should vary according to gestational age.

scholarly journals Embryonic growth discordance and early fetal loss: the STORK multiple pregnancy cohort and systematic review

2013 ◽  
Vol 28 (10) ◽  
pp. 2621-2627 ◽  
Author(s):  
F. D'Antonio ◽  
A. Khalil ◽  
E. Mantovani ◽  
B. Thilaganathan ◽  
Rosol Hamid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Multiple Pregnancy ◽  
Fetal Loss ◽  
Embryonic Growth ◽  
Pregnancy Cohort
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