Perinatal outcomes of intrauterine transfusion for the surviving twin in monochorionic twin gestation involving a single fetal demise

2020 ◽  
Vol 46 (8) ◽  
pp. 1319-1325
Author(s):  
Masako Kanda ◽  
Shohei Noguchi ◽  
Ryo Yamamoto ◽  
Haruna Kawaguchi ◽  
Shusaku Hayashi ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Fetal Demise ◽  
Monochorionic Twin ◽  
Intrauterine Transfusion

Perinatal outcomes of intrauterine transfusion for foetal anaemia due to red blood cell alloimmunisation

2019 ◽  
Vol 40 (5) ◽  
pp. 649-653
Author(s):  
Ayşe Özge Şavkli ◽  
Berna Aslan Çetin ◽  
Zuat Acar ◽  
Zeynep Özköse ◽  
Mustafa Behram ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Perinatal Outcomes ◽  
Intrauterine Transfusion

scholarly journals Monochorionic Twin Pregnancy— Potential Risks and Perinatal Outcomes

10.5772/58951 ◽  
2015 ◽  
Author(s):  
Julio Elito ◽  
Eduardo Félix Martins Santana ◽  
Gustavo Nardini Cecchino
Keyword(s):  
Twin Pregnancy ◽  
Perinatal Outcomes ◽  
Monochorionic Twin ◽  
Potential Risks

Abnormal Umbilical Cord Coiling is Associated with Adverse Perinatal Outcomes

2000 ◽  
Vol 3 (5) ◽  
pp. 462-471 ◽  
Author(s):  
Geoffrey A. Machin ◽  
Jeanne Ackerman ◽  
Enid Gilbert-Barness
Keyword(s):  
Umbilical Cord ◽  
Growth Retardation ◽  
Perinatal Outcomes ◽  
Well Being ◽  
Neurological Status ◽  
Adverse Outcomes ◽  
Placental Pathology ◽  
Fetal Demise ◽  
Fetal Death Rate ◽  
Clinical Correlations

The normal umbilical cord coil index is one coil/5 cm, i.e., 0.2 ±0.1 coils completed per cm. We report the frequency and clinical correlations of abnormally coiled cords among 1329 cases referred to our placental pathology services. Twenty-one percent of cords were over-coiled and 13% were undercoiled. Abnormal cord coiling was seen at all gestational ages. Principal clinical correlations found in overcoiled cords were fetal demise (37%), fetal intolerance to labor (14%), intrauterine growth retardation (10%), and chorioamnionitis (10%). For undercoiled cords, the frequencies of these adverse outcomes were 29%, 21%, 15%, and 29%, respectively. Abnormal cord coiling was associated with thrombosis of chorionic plate vessels, umbilical venous thrombosis, and cord stenosis. Thus, abnormal cord coiling is a chronic state, established in early gestation, that may have chronic (growth retardation) and acute (fetal intolerance to labor and fetal demise) effects on fetal well-being. The cause of abnormal cord coiling is not known. Its effects on neurological status of survivors are also unknown. Antenatal detection of abnormal cord coil index by ultrasound could lead to elective delivery of fetuses at risk, thereby reducing the fetal death rate by about one-half. We recommend that the cord coil index become part of the routine placental pathology examination.

scholarly journals The comparison of the perinatal outcomes in monochorionic twin pregnancies with and without selective intrauterine growth restriction

2021 ◽  
Vol 29 (1) ◽  
pp. 20-26
Author(s):  
Elif Fide Pişirgen ◽  
Münip Akalın ◽  
Oya Demirci ◽  
Pınar Kumru ◽  
Emine Eda Akalın
Keyword(s):  
Flow Pattern ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Monochorionic Twin ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Artery Flow ◽  
Twin Pregnancies

Objective Both fetuses may be affected negatively as a result of the non-equal share of the placenta and vascular anastomoses in monochorionic pregnancies with selective intrauterine growth restriction (sIUGR). In our study, we aimed to investigate the perinatal outcomes of both larger and smaller fetuses in monochorionic pregnancies with and without sIUGR (non-sIUGR) separately. Methods A total of 196 monochorionic twin pregnancies were evaluated retrospectively between January 2013 and January 2019. The cases were grouped as sIUGR and non-sIUGR pregnancies. The pregnancies with sIUGR were also separated into sub-groups as the cases with normal umbilical flow pattern and the cases with abnormal umbilical flow pattern. The perinatal outcomes were investigated separately between the groups for larger and smaller fetuses. Results Of 153 monochorionic pregnancies included in the study, 17.6% (n=27) were sIUGR cases and 82.4% (n=126) were non-sIUGR cases. While the umbilical artery flow pattern was normal in 59.3% (n=16) of the pregnancies which developed sIUGR, 40.7% (n=11) of them had abnormal umbilical artery flow pattern. The preeclampsia rate was found significantly higher in sIUGR pregnancies than non-sIUGR pregnancies (25.9% vs. 11.1%, p=0.042). The need for intensive care for both larger and smaller newborns was significantly higher in sIUGR pregnancies compared to non-sIUGR pregnancies (p<0.001). Three (11.1%) of newborns in sIUGR pregnancies passed away during neonatal period. All of the newborns that passed away were the smaller newborns from sIUGR pregnancies with abnormal umbilical artery flow pattern. Conclusion The pregnancies with selective intrauterine growth restriction (sIUGR) are more associated with high risks in terms of perinatal outcomes compared to the pregnancies with non-sIUGR. In pregnancies developing sIUGR, the risk increases for larger fetus as well as smaller fetus. More prospective studies are needed to investigate whether this increased risk in the pregnancies with sIUGR is associated with prematurity which is more common or is a result of sIUGR.

scholarly journals Single fetal demise in multiple pregnancy

2019 ◽  
Vol 6 (5) ◽  
pp. 31-38 ◽  
Author(s):  
A. A. Kuznetsov ◽  
A. N. Romanovsky ◽  
A. V. Shlykova ◽  
T. A. Kashtanova ◽  
V. V. Shman ◽  
...  
Keyword(s):  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Neurological Complications ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Perinatal Morbidity ◽  
Delivery Time ◽  
Monochorionic Twins ◽  
Fetal Demise ◽  
Management Of Complications

Single intrauterine fetal demise (sIUFD) in multiple pregnancy occurs with frequency from 3.7 up to 6.8 % and is associated with an risk of premature birth, death of cotwin and high morbidity and mortality rates in newborns. The time of sIUFD and type of twin gestation would determine perinatal outcomes. The rate of prenatal death of the co-twin is different and depend on the type of multiple pregnancy, accounting 4 % for dichorionic and 12 % in monochorionic pregnancies. However, the correlation between the type of chorionicity, delivery time and the frequency of preterm delivery is not clearly established. The risk of neurological complications in newborns after sIUFD fluctuate significantly in case of the type of chorionicity and could achieve 18 % in monochorionic twins and only 1 % in dichorionic twins. The paper was discussed the main reasons for sIUFD in multiple pregnancy, rather pathophysiological aspects of perinatal morbidity and mortality for cotwin was also discussed. The management of complications, methods of their correction, optimal methods and time of delivery in case of sIUDF in multiple pregnancies was presented.

Massive Perivillous Fibrin Deposition-A Cause of Recurrent Fetal Demise: A Case Report

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S147-S147
Author(s):  
M Pandiri ◽  
R Kashikar
Keyword(s):  
Case Report ◽  
Significant Risk ◽  
Perinatal Outcomes ◽  
Neurological Impairment ◽  
Fibrin Deposition ◽  
Fetal Demise ◽  
Uncomplicated Pregnancy ◽  
Dehydrogenase Gene

Abstract Introduction/Objective Massive perivillous fibrin deposition (MPFD) and maternal floor infarction (MFI) are rare placental lesions reported in less than 1% of all pregnancies and have a significant risk of recurrence ranging from 12% to 78%. MPFD/MFI is associated with high rates of adverse perinatal outcomes including preterm delivery, severe intrauterine growth restriction, spontaneous abortion, cystic renal cell dysplasia, fetal metabolic disease with reported mutations in the LCHAD (long-chain 3-hydroxy acyl-CoA-dehydrogenase) gene, neonatal death and long- term neurological impairment. Methods/Case Report We report a case of MFPD in a 28-year-old female gravida 3 para 1 with one uncomplicated pregnancy and one therapeutic abortion. The current pregnancy was complicated by abruption resulting in intrauterine fetal demise at 32 weeks of gestation. The placenta was examined. Grossly, the placenta weighed 260 grams (small placenta for the dates) with an eccentrically inserted three vessel umbilical cord and a diffuse, firm pale grey cut surface with focal cystic areas. The histological examination revealed MPFD characterized by extensive transmural perivillous fibrinoid material with encasement of almost entire chorionic villi (transmural type). The villi were viable but fibrotic with focal syncytiotrophoblastic necrosis and focal mild chronic inflammation. The etiology of MPFD is not well understood, but risk factors that have been reported include maternal thrombophilia, coagulopathies, and autoimmune diseases. Given the clinical associations, MFI/MPFD should be reported promptly to the obstetrician and pediatrician. As per the current literature, a combination of thrombolytic therapy (aspirin and heparin), intravenous immunoglobulin and a statin (pravastatin) helps to correct angiogenic/antiangiogenic imbalance which has been thought to be associated with recurrent MFI/MPFD. Results (if a Case Study enter NA) N/A Conclusion In summary, we present this rare recurring entity of MPFD to emphasize the awareness of this condition and the importance of placental examination in all abortions and fetal abnormalities/demise.

Placental angioarchitecture in monochorionic twin pregnancies with twin-twin transfusion syndrome. Perinatal outcomes

2019 ◽  
Vol 5_2019 ◽  
pp. 63-69
Author(s):  
Bugerenko A.E. Bugerenko ◽  
Sukhanova D.I. Sukhanova ◽  
Donchenko Ya.S. Donchenko ◽  
Panina O.B. Panina O ◽  
Sichinava L.G. Sichinava ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Monochorionic Twin ◽  
Twin Pregnancies
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