scholarly journals Maternal serum sFlt-1/PlGF ratio in twin pregnancies with and without pre-eclampsia in comparison with singleton pregnancies

2015 ◽  
Vol 45 (3) ◽  
pp. 286-293 ◽  
Author(s):  
L. Dröge ◽  
I. Herraìz ◽  
H. Zeisler ◽  
D. Schlembach ◽  
H. Stepan ◽  
...  
Keyword(s):  
Maternal Serum ◽  
Twin Pregnancies ◽  
Plgf Ratio ◽  
Singleton Pregnancies

Can Early hCG Levels be a Marker for Pregnancy Outcome in ART Cycles?

2009 ◽  
Vol 1 (3) ◽  
pp. 33-39 ◽  
Author(s):  
Mandakini Parihar
Keyword(s):  
Sensitivity And Specificity ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
High Sensitivity ◽  
Maternal Serum ◽  
Multiple Gestations ◽  
Adverse Result ◽  
Ultimate Outcome ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

ABSTRACT With advancing technology of assisted reproduction, physicians today have the ability to achieve conception in many couples who would have been totally incapable doing so only a few years ago. The anxiety and the uncertainty of pregnancy outcomes using ART procedures is widely accepted as one of the main psychological stresses the couples. The ability to predict outcome as soon as possible after assisted conception treatment is important for clinic staff and patients. The aim of this observational study is to highlight the importance of hCG values in predicting the outcome of ART cycle and counseling the patients in case of adverse result. The ultimate aim is to improve the take home baby rate and initial hCG value can help us counsel our patients towards the ultimate outcome. Embryo development in early pregnancy follows a preprogrammed-timing schedule and depends mainly on the embryonic age of the healthy, successfully implanted conceptus. The appearance of hCG in maternal serum is used to assess the time of clinically detectable implantation. bhCG has provided the best sensitivity and specificity for detection of normal and pathological pregnancies. After IVF, early pregnancy loss or multiple gestations may be predicted with high sensitivity and specificity by using cut-off values of serum hCG. The median HCG concentration was 116 IU/l in viable pregnancies and 31 IU/l in nonviable pregnancies. The median hCG concentration in twin pregnancies was almost double that in singleton pregnancies (201 IU/l vs 116 IU/l). Thus we can reassure normally pregnant patients as well as filter and manage those with nonviable outcomes more efficiently.

scholarly journals OC23.07: Maternal serum sFlt-1; PlGF and sFlt-1/PlGF ratio in the assessment of pre-eclampsia in multifetal gestations: comparison to singleton pregnancies

2014 ◽  
Vol 44 (S1) ◽  
pp. 55-55
Author(s):  
L. Droege ◽  
I. Herraiz ◽  
A. Galindo ◽  
H. Zeisler ◽  
D. Schlembach ◽  
...  
Keyword(s):  
Maternal Serum ◽  
Plgf Ratio ◽  
Singleton Pregnancies

scholarly journals The Prognostic Value of Angiogenic Markers in Twin Pregnancies to Predict Delivery Due to Maternal Complications of Preeclampsia

Hypertension ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 176-183 ◽  
Author(s):  
Julia Binder ◽  
Pilar Palmrich ◽  
Petra Pateisky ◽  
Erkan Kalafat ◽  
Lorenz Kuessel ◽  
...  
Keyword(s):  
Predictive Value ◽  
Predictive Accuracy ◽  
Area Under The Curve ◽  
Blood Sampling ◽  
Maternal Complications ◽  
Retrospective Data Analysis ◽  
Twin Pregnancies ◽  
Plgf Ratio ◽  
Rule Out ◽  
Singleton Pregnancies

The sFlt-1 (soluble fms-like tyrosine kinase-1), PlGF (placental growth factor), and their ratio are useful for predicting delivery because of preeclampsia in singleton pregnancies. Evidence on the utility of sFlt-1/PlGF ratio in twin pregnancies is lacking. We aimed to evaluate the predictive value of sFlt-1/PlGF ratio for delivery because of preeclampsia in twins. A retrospective data analysis of 164 twin pregnancies with suspected preeclampsia was performed. The sFlt-1/PlGF ratio, which was known to clinicians, was significantly higher in women who delivered within 1 and 2 weeks compared with those who did not (median: 98.9 and 84.2 versus 23.5 pg/mL, respectively; P <0.001). The area under the curve values sFlt-1/PlGF ratio levels were 0.88 (95% CI, 0.83–0.84) and 0.88 (95% CI, 0.83–0.93) for predicting delivery because of preeclampsia within 1 and 2 weeks of blood sampling, respectively. The predictive accuracy of sFlt-1/PlGF was independent of gestational age at sampling and chorionicity ( P >0.100 for interaction). The area under the curve values of sFlt-1/PlGF were significantly higher than for PlGF alone (mean 0.88 and 0.88 versus 0.81 and 0.80) for predicting delivery because of preeclampsia within 1 and 2 weeks of blood sampling ( P =0.055 and 0.001, respectively). sFlt-1/PlGF ratio lower than 38 was able to rule-out delivery within 1 and 2 weeks with a negative predictive value of 98.8% and 96.4% for delivery because of preeclampsia within 1 and 2 weeks, respectively. A cutoff of 38 is applicable for ruling out delivery because of preeclampsia in twin pregnancies.

scholarly journals Gestational Age-Specific Reference Ranges for the sFlt-1/PlGF Immunoassay Ratio in Twin Pregnancies

2021 ◽  
pp. 1-9
Author(s):  
Maria De La Calle ◽  
Juan L. Delgado ◽  
Stefan Verlohren ◽  
Ana Isabel Escudero ◽  
Jose L. Bartha ◽  
...  
Keyword(s):  
Specific Reference ◽  
Reference Ranges ◽  
Range Analysis ◽  
Short Term ◽  
Term Outcome ◽  
Twin Pregnancies ◽  
Plgf Ratio ◽  
Control Study ◽  
Normal Twin ◽  
Singleton Pregnancies

<b><i>Objective:</i></b> Establish reference ranges for the Elecsys® soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) immunoassay ratio in twin pregnancies. <b><i>Methods:</i></b> Data analyzed were from 3 prospective studies: Prediction of Short-Term Outcome in Pregnant Women with Suspected Preeclampsia (PE) (PROGNOSIS), Study of Early-onset PE in Spain (STEPS), and a multicenter case-control study. Median, 5th, and 95th percentiles for sFlt-1, PlGF, and the sFlt-1/PlGF ratios were determined for normal twin pregnancies for 7 gestational windows and compared with the previous data for singleton pregnancies. <b><i>Results:</i></b> The reference range analysis included 269 women with normal twin pregnancies. Before 29 weeks’ gestation, median, 5th, and 95th percentiles for sFlt-1/PlGF ratios did not differ between twin and singleton pregnancies. From 29 weeks’ gestation to delivery, median, 5th, and 95th percentiles for sFlt-1/PlGF ratios were substantially higher in twin versus singleton pregnancies. sFlt-1 values were higher in women with twin pregnancies across all gestational windows. PlGF values were similar or higher in twin versus singleton pregnancies; PlGF concentrations increased from 10 weeks + 0 days to 28 weeks + 6 days’ gestation. <b><i>Conclusions:</i></b> Reference ranges for the sFlt-1/PlGF ratio are similar in women with twin and singleton pregnancies until 29 weeks’ gestation but appear higher in twin pregnancies thereafter.

Outcome of two sequential singleton pregnancies and twin pregnancies among primiparous women at advanced age undergoing IVF

2020 ◽  
Vol 302 (5) ◽  
pp. 1113-1119
Author(s):  
Nizan Mor ◽  
Ronit Machtinger ◽  
Yoav Yinon ◽  
Shlomo Toussia-Cohen ◽  
Daphna Amitai Komem ◽  
...  
Keyword(s):  
Advanced Age ◽  
Twin Pregnancies ◽  
Primiparous Women ◽  
Singleton Pregnancies

scholarly journals Maternal Serum Placental Growth Factor, Soluble Fms-Like Tyrosine Kinase-1, and Soluble Endoglin in Twin Gestations and the Risk of Preeclampsia—A Systematic Review

2020 ◽  
Vol 9 (1) ◽  
pp. 183 ◽  
Author(s):  
Katarzyna Kosinska-Kaczynska ◽  
Magdalena Zgliczynska ◽  
Szymon Kozlowski ◽  
Lukasz Wicherek
Keyword(s):  
Growth Factor ◽  
Tyrosine Kinase ◽  
Serum Levels ◽  
Maternal Serum ◽  
Placental Growth Factor ◽  
Cochrane Library ◽  
Original Research ◽  
Multiple Gestation ◽  
Soluble Endoglin ◽  
Twin Pregnancies

Multiple gestation is one of the key risk factors for the occurrence of preeclampsia (PE). Soluble fms-like tyrosine kinase-1, placental growth factor, and soluble endoglin are molecules involved in the process of angiogenesis with a proven role in the pathogenesis of PE. The aim of the review was to summarize available data on maternal serum levels of the above-mentioned factors and their usefulness in predicting PE in twin pregnancies. Only original research articles written in English were considered eligible. Reviews, chapters, case studies, conference papers, experts’ opinions, editorials, and letters were excluded from the analysis. No publication date limitations were imposed. The systematic literature search using PubMed/MEDLINE, Scopus, Embase, and Cochrane Library databases identified 338 articles, 10 of which were included in the final qualitative analyses. The included studies showed significant differences in maternal serum levels of the discussed factors between women with twin pregnancies with PE and those who did not develop PE, and their promising performance in predicting PE, alone or in combination with other factors. The identification of the most effective algorithms, their prompt introduction to the clinical practice, and further assessment of the real-life performance should become a priority.

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 Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

2021 ◽  
Vol 11 ◽  
Author(s):  
Jill Hutton ◽  
Paul J. Rowan
Keyword(s):  
Vertical Transmission ◽  
Transmission Rate ◽  
Monozygotic Twin ◽  
Dizygotic Twin ◽  
Cmv Infection ◽  
Vertical Transmission Rate ◽  
Congenital Cmv Infection ◽  
Twin Pregnancies ◽  
Congenital Cmv ◽  
Singleton Pregnancies

ObjectiveThe objectives are to estimate the vertical transmission rate in twins relative to singleton pregnancies, to evaluate whether discordance within twin pairs is rare, and to characterize concordance within monozygotic and dizygotic twin pairs in relation to hereditability.MethodsWe first sought to estimate the vertical transmission rate of congenital CMV infection in twins by gathering cohort-based studies of congenital CMV in which vertical transmission in both singleton and twin pregnancies was reported. This also allowed us to compare singleton and twin infection rates. From the above studies and other large cohorts of congenitally infected infants, the percentage of discordantly infected twin pairs determined whether this is a rare phenomenon. Theorizing discordance is not rare, we then analyzed data from cases with twin outcomes for congenital CMV infection, according to whether the twins were monozygotic or dizygotic, and calculated their corresponding concordance rates to estimate the broad-sense heritability. Lastly, we described other factors that might affect vertical transmission.ResultsFrom five articles following at-risk pregnancies, the rate of vertical transmission in twin pregnancies is 58.7% (95% CI 43.3-72.3%) whereas in singleton pregnancies it is 31.4% (95% CI: 29.0-34.0%) p = 0.0002. Of ten studies of larger cohorts of infants with congenital CMV infection, 21 of 42 twin pairs with at least one twin infected were discordant for congenital CMV (50.0%, 95% CI: 34.4–65.6%) indicating discordance of congenital CMV infection in twin pairs is not rare. Of 28 studies covering 37 twin pairs where at least one twin had congenital CMV, and zygosity was known, eleven of thirteen monozygotic twin pairs (84.6%; 95% CI: 53.7-97.3%) were concordant for CMV infection, and nine of twenty-four dizygotic twin pairs (37.5%; 95% CI: 19.6-59.2%) were concordant for infection giving an estimated hereditability of 94.2%. Within these 37 twin pairs, factors such as primary or recurrent maternal infection, prematurity, growth discordance, and sex are described; however, in many of these cases these factors are unknown.ConclusionThe rate of vertical transmission of congenital CMV is higher for twins than singletons. Discordance of congenital CMV in twins is not rare and suggests a possible genetic susceptibility to congenital CMV.

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