Adverse Perinatal Outcome of Twin Pregnancies According to Chorionicity: Review of the Literature

2001 ◽  
Vol 18 (01) ◽  
pp. 023-038 ◽  
Author(s):  
David M. Sherer
Keyword(s):  
Perinatal Outcome ◽  
Review Of The Literature ◽  
Adverse Perinatal Outcome ◽  
Twin Pregnancies

scholarly journals Associated obstetric and perinatal determinants of vanishing twin pregnancies

2020 ◽  
Author(s):  
Virág Márton
Keyword(s):  
Gestational Diabetes ◽  
Perinatal Outcome ◽  
Assisted Reproductive Techniques ◽  
Neonatal Outcomes ◽  
Adverse Perinatal Outcome ◽  
Spontaneous Conception ◽  
Increased Risk ◽  
Reproductive Techniques ◽  
Vanishing Twin Syndrome ◽  
Twin Pregnancies

A retrospective cohort study was carried out to reveal the characteristics and the perinatal outcome of vanishing twin pregnancies after spontaneous conception and after assisted reproductive techniques (ART). Vanishing twin (VT) syndrome, defined as the disappearance of one of two embryos with the survival of the co-twin during the first trimester, has been known for more than four decades. Due to the high and ever growing number of assisted reproductive treatments, the incidence of twin pregnancies and thus of vanishing twin syndrome is high. Recent studies have only examined vanishing twins after ART, but we hypothesized that there is a difference in perinatal outcomes between VT pregnancies, depending on the mode of conception, possibly reflecting the potential differences between underlying pathomechanisms. Our study consisted of two parts. We initiated the first study to compare obstetric and neonatal outcomes between the survivors of VT pregnancies and matched originally singleton control pregnancies, and a second study to evaluate whether VT pregnancies after spontaneous conception have a more adverse perinatal outcome than those conceived after assisted reproductive techniques. The study involved 316 VT pregnancies: 81 after in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and 235 after spontaneous conception. Their data were derived from databases in a 22-year study period at the Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary. Our results proved that the frequency of VT pregnancies was significantly higher after natural conception than after ART. A comparison of VT pregnancies demonstrated a higher rate in pregestational and gestational diabetes mellitus (GDM) in IVF/ICSI cases than in spontaneously conceived VT pregnancies. Significant differences in the prevalences of pregnancies and intrapartum complications, and adverse neonatal outcomes were observed in vanishing twins born after IVF/ICSI as compared with those born after implantation without medical assistance, suggesting that adverse perinatal outcome in IVF/ICSI VT pregnancies may be more related to ART or infertility and underlying chronic diseases. Previous induced abortion and second-trimester fetal loss indicated an increased risk of VT pregnancies, while GDM and prematurity of previous pregnancies predicted VT and growth retardation, particularly in the spontaneously conceived VT group. Diabetes is classically defined as being associated with a higher miscarriage rate. We observed a higher recurrence rate of gestational diabetes and increased incidence of pregestational and gestational diabetes mostly in IVF/ICSI VT pregnancies, suggesting that diabetes may share a pathomechanism with VT. After identifying the causes that lead to vanishing twin syndrome, GDM, chronic maternal diseases, advanced maternal age and placentation anomalies all represented independent risk factors for VT following IVF/ICSI. It can be established that the VT phenomenon was a major prognosticator of intrauterine growth restriction for the remaining fetus in VT pregnancies after ART. In conclusion, according to our results, VT is quite frequent. VT pregnancies had a lower prevalence and a worse perinatal outcome following IVF/ICSI as compared with those of their spontaneously conceived counterparts.

Prediction of adverse perinatal outcome and the mean time until delivery in twin pregnancies with suspected pre-eclampsia using sFlt-1/PIGF ratio

2021 ◽  
Vol 24 ◽  
pp. 37-43
Author(s):  
Anne Karge ◽  
Alina Seiler ◽  
Sarah Flechsenhar ◽  
Bernhard Haller ◽  
Javier U. Ortiz ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Adverse Perinatal Outcome ◽  
The Mean ◽  
Mean Time ◽  
Twin Pregnancies

scholarly journals Crown-rump length discordance and adverse perinatal outcome in twin pregnancies: systematic review and meta-analysis

2014 ◽  
Vol 44 (2) ◽  
pp. 138-146 ◽  
Author(s):  
F. D'Antonio ◽  
A. Khalil ◽  
G. Pagani ◽  
A. T. Papageorghiou ◽  
A. Bhide ◽  
...  
Keyword(s):  
Systematic Review ◽  
Perinatal Outcome ◽  
Meta Analysis ◽  
Crown Rump Length ◽  
Adverse Perinatal Outcome ◽  
Twin Pregnancies

scholarly journals Obstetric outcome in twin gestation with reference to chorionicity

2017 ◽  
Vol 6 (11) ◽  
pp. 4908
Author(s):  
Lekshmi Murukesan ◽  
Mayadevi Brahmanandan ◽  
Sujamol Sujamol Jacob
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Newborn Care ◽  
First Trimester ◽  
Care Hospital ◽  
Adverse Perinatal Outcome ◽  
The Mean ◽  
Twin Pregnancies

Background: Monochorionic twin pregnancies are at greater risk for growth abnormalities and other complications. This study aims to outline the obstetric problems faced by twins in general and also to determine the influence of chorionicity on pregnancy and perinatal outcome in twins. Objective of present study was to compare the obstetric and perinatal outcome between monochorionic and dichorionic twins.Methods: A clinical non-interventional prospective observational study was conducted in a tertiary care hospital over a period of 1 year. 232cases of twin pregnancies were followed up from first trimester. The antepartum complications, mode of delivery, presentation, pregnancy outcome, condition of babies and perinatal mortality were compared between mono-chorionic and dichorionic twins.Results: Among 232 cases of twins studied, 2/3rd were dichorionic and 1/3rd were monochorionic. The mean gestational age for Monochorionic (MC) twins was 33.2 weeks whereas it was 35.6 weeks for Dichorionic (DC) twins. Preterm delivery was significantly associated with mono-chorionicity. Elective CS was done more for MC twins compared to DC twins. The mean birth weight of MC twins was 1.7 kg compared to 2.1 kg among DC twins. Low APGAR scores were seen in 31.3% of MC twins compared to 15.8% of DC twins. The number of asphyxiated babies (12.5%), stillborn (7.5%) and macerated babies (10%) were more in MC group in comparison to DC group where it was (9.9%, 2.1%, 0.7%) respectively. Risk of IBN admissions were more in MC than DC twins. (31.3% Vs 21.1%) Adverse perinatal outcome was associated more with MC pregnancies (37.5%) than DC. (11.8%).Conclusions: Mono-chorioncity was significantly associated with pregnancy complications and adverse perinatal outcome. Hence early diagnosis of chorionicity and referral to a tertiary centre with fetal medicine unit and newborn care is very important in reducing morbidity and perinatal mortality among MC twins.

scholarly journals OP08.04: Prediction of adverse perinatal outcome in twin pregnancies using sFlt‐1/PIGF ratio

2019 ◽  
Vol 54 (S1) ◽  
pp. 108-109
Author(s):  
A. Karge ◽  
B. Kuschel ◽  
A. Seiler ◽  
S. Flechsenhar ◽  
J.U. Ortiz ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Adverse Perinatal Outcome ◽  
Twin Pregnancies
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