scholarly journals Re: Monochorionic diamniotic twin pregnancy with selective fetal growth restriction Type II: sonographic and fetoscopic findings of poor prognosis

2018 ◽  
Vol 51 (2) ◽  
pp. 280-280
Author(s):  
R. Quintero ◽  
R. H. Chmait
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Poor Prognosis ◽  
Twin Pregnancy ◽  
Growth Restriction ◽  
Type Ii

scholarly journals OP11.04: A novel fetoscopic finding of poor prognosis in selective fetal growth restriction type II

2018 ◽  
Vol 52 ◽  
pp. 95-96
Author(s):  
E. Gil Guevara ◽  
R. Diaz ◽  
S. Chavez ◽  
F. Lim ◽  
J. Peiro
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Poor Prognosis ◽  
Growth Restriction ◽  
Type Ii

scholarly journals Endoscopic Placental Laser Coagulation in Monochorionic Diamniotic Twins with Type II Selective Fetal Growth Restriction

2015 ◽  
Vol 38 (2) ◽  
pp. 86-93 ◽  
Author(s):  
Gergana Peeva ◽  
Sarah Bower ◽  
Laszlo Orosz ◽  
Petya Chaveeva ◽  
Ranjit Akolekar ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Laser Surgery ◽  
Cervical Length ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Laser Coagulation ◽  
Multivariable Logistic Regression Analysis ◽  
Type Ii ◽  
Discharge From Hospital

Objective: To determine predictors of survival in monochorionic diamniotic twins with selective fetal growth restriction type II (sFGR-II), with or without twin-to-twin transfusion syndrome (TTTS), treated by endoscopic placental laser coagulation. Methods: Laser surgery was performed at 20 (15-27) weeks' gestation in 405 cases of sFGR-II with and 142 without coexisting TTTS. Multivariable logistic regression analysis was performed to determine significant predictors of survival to discharge from hospital. Results: There was survival of the small twin in 216 (39.5%) and of the large twin in 379 (69.3%) cases. Significant predictors of survival of both the small and larger twin were ductus venosus Doppler findings in the small twin, gestational age at laser and cervical length, but not the presence of TTTS or Doppler findings in the large twin. Conclusions: In sFGR-II, survival after laser surgery is primarily dependent on the condition of the small twin.

scholarly journals OP0175 INTERNATIONAL MULTICENTRIC PROSPECTIVE STUDY ON PREGNANCY IN SYSTEMIC SCLEROSIS (IMPRESS-2)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 105.1-105
Author(s):  
E. Tombetti ◽  
V. Ramoni ◽  
M. Betelli ◽  
Y. Allanore ◽  
M. Matucci Cerinic ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Twin Pregnancy ◽  
Gestational Hypertension ◽  
Immunosuppressive Agents ◽  
Growth Restriction ◽  
Controlled Study ◽  
Obstetric Outcomes

Background:Data about the obstetric outcomes of pregnant women with Systemic Sclerosis (SSc) mainly derive from retrospective studies. Moreover, little evidence is available to define if pregnancy impacts on SSc course and if children of SSc mothers have a normal post-natal development.Objectives:To assessed the obstetric, pediatric and rheumatologic outcomes of SSc pregnancies in a prospective controlled studyMethods:Prospective recruitment of three cohorts.1) 110 pregnant women with SSc.2) 218 control pregnancies without systemic autoimmune diseases3) 78 non-pregnant control SSc with a matching subject in cohort-1.SSc was characterized for disease activity, severity, cutaneous/organ involvement and therapy. Women and their offspring were followed until 21 months after enrollment (ie, 12 months after expected delivery).Results:Gestational and neonatal outcomesMiscarriages and fetal death occurred in 7% and 5% of SSc pregnancies. Compared to control pregnancies, SSc pregnancies had higher rates of gestational hypertension (12% Vs 4%, p=0.004), pre-eclampsia (9% Vs 1%, p=0.002), fetal growth-restriction (13% Vs 4%, p=0.004), prematurity (26% Vs 7%, p<0.001) and cesarean section (52% Vs 4%, p=0.002). Newborns from SSc mothers weighted less (2773 Vs 3243g, p<0.001), were more frequently small for gestational age (SGA, 18% Vs 12%, p=0.05) and required neonatal-intensive care unit (ICU) more frequently (12% Vs 1%, p<0.001). Rates of newborn malformation/death, and one year-pediatric outcomes were similar.Univariate and multivariate analyses were performed for relevant outcomes. For example, pre-eclampsia positively associated with baseline skin score and its evolution during pregnancy (p=0.015 and 0.013), immunosuppressive agents, bosentan and iloprost at baseline (p=0.001, 0.041 and 0.007), and twin pregnancy(p=0.006). Multivariate logistic regression for pre-eclampsia in SSc identified baseline arterial hypertension, immunosuppressive agents or of iloprost, twin pregnancy and assisted conception as risk factors (p=0.000, 0.002, 0.0025, 0.000 and 0.027), and baseline calcium channel blockers as protective factors (p=0.001).SSc course during pregnancyAs compared to matched non-pregnant SSc, SSc pregnant women had lower Medsger disease severity index (0.6 +/-0.9 Vs 1.0 +/-1.1, p=0.022), health assessment questionnaire (HAQ, 0.21 +/-0.38 Vs 0.40 +/-0.55, p=0.026), and lower rate of iv iloprost (21% Vs 42%, p=0.006). Pregnant and non-pregnant SSc women had a similar disease course during the 21 months of follow-up, despite a lower use of immunosuppressive agents (17% Vs 36%, p=0.014). Two scleroderma-renal-crises (SRC) occurred during pregnancy (one was a relapse of a previous SRC; the other occurred at week 33, and resolved after premature delivery of a SGA newborn and ACE-inhibitors, preventing differentiation from pre-eclampsia).Conclusion:SSc pregnancies have generally a favorable obstetric/pediatric outcome, albeit at a higher risk of gestational hypertension, pre-eclampsia, fetal growth restriction, prematurity, delivery of SGA newborn and requirement of neonatal-ICU. Pregnancy does not impact on SSc course, although SRC during late pregnancy and pre-eclampsia might be hardly discriminated.References:[1]Taraborelli M et al., Arthritis Rheum, 2012.Disclosure of Interests:None declared

Possible molecular and biological mechanisms for the development of selective fetal growth restriction in monochorionic twin pregnancy

2021 ◽  
Vol 10_2021 ◽  
pp. 5-12
Author(s):  
Neftereva A.A. Neftereva ◽  
Sakalo V.A. Sakalo ◽  
Gladkova K.A. Gladkova ◽  
Kоstyukov K.V. Kоstyukov K ◽  
Khodzhaeva Z.S. Khodzhaeva ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Twin Pregnancy ◽  
Growth Restriction ◽  
Biological Mechanisms ◽  
Monochorionic Twin
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