scholarly journals The Impact of Entry Technique and Access Diameter on Prelabour Rupture of Membranes Following Primary Fetoscopic Laser Treatment for Twin-Twin Transfusion Syndrome

2016 ◽  
Vol 40 (2) ◽  
pp. 100-109 ◽  
Author(s):  
Scott G. Petersen ◽  
Kristen S. Gibbons ◽  
Francois I. Luks ◽  
Liesbeth Lewi ◽  
Anke Diemert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Preterm Birth ◽  
Laser Surgery ◽  
Fetal Death ◽  
Cervical Length ◽  
Exclusion Criteria ◽  
Instrument Choice ◽  
The Impact ◽  
Twin Pregnancies

Objective: To evaluate the impact of entry method and access diameter at fetoscopic surgery for twin-twin transfusion syndrome in twin pregnancies with at least one survivor. The outcomes evaluated were prelabour rupture of membranes (PROM) and birth <4 weeks, preterm birth (PTB) <28 weeks, and latency to birth. Methods: A retrospective analysis of prospectively collected data of consecutive laser procedures from 6 centers was performed. Three entry methods (sheath + trocar; cannula + trocar; cannula + Seldinger) and 6 access diameters (2.3, 3.0, 3.3, 3.5, 3.8, 4.0 mm) were used. Exclusion criteria were subsequent invasive interventions, termination of pregnancy or double fetal death after laser. Multivariate analysis was performed to determine risk factors for the study outcomes. Results: Six hundred seventy three fetoscopic laser cases were analyzed. The use of different entry methods and access diameters did not affect PROM or birth <4 weeks, or latency from laser to birth. Access diameter was associated with PTB <28 weeks. Cervical length was associated with PROM and birth <4 weeks, and latency from laser to birth. Conclusion: Instrument choice at fetoscopic laser procedures did not affect outcomes <4 weeks. Access diameter may affect the likelihood for PTB <28 weeks. Cervical length is critically associated with obstetrical outcomes following laser surgery.

scholarly journals Prediction of Outcome for Transabdominal Cerclage in Women with Cervical Insufficiency

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ji Eun Song ◽  
Keun Young Lee ◽  
Ga Hyun Son
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Multivariate Analyses ◽  
Univariate Analysis ◽  
Cervical Length ◽  
Cervical Insufficiency ◽  
Prediction Of Outcome

We investigated pregnancy outcome following transabdominal cerclage (TAC) in women with cervical insufficiency (CI) and explored parameters for predicting pregnancy outcomes following TAC. In this retrospective cohort study, we included 161 women with TAC. We considered demographic, obstetric, and gynecologic histories, pre- and postoperative cervical length (CL), and CL at 20–24 weeks as parameters for predicting outcomes following TAC. Univariate and multivariate analyses were used to identify risk factors for predicting delivery before 34 weeks after TAC. 182 pregnancies occurred after TAC, and 290 pregnancies prior to TAC were identified. The rate of delivery <34 weeks significantly decreased following TAC (5% versus 82%,P<0.001). Univariate analysis demonstrated that a short CL (<25 mm) at 20–24 weeks and adenomyosis were associated with delivery at <34 weeks’ gestation following TAC (P=0.015andP=0.005, resp.). However, multivariate analysis demonstrated that only a short CL (<25 mm) at 20–24 weeks was a significant predictor (P=0.005). TAC is an efficacious procedure that prolongs pregnancy in women with CI. A short CL at 20–24 weeks may predict the delivery at <34 weeks’ gestation following TAC.

scholarly journals The Presurgical Controlling Nutritional Status (CONUT) Score is Independently Associated with Severe Peristomal Skin Disorders: A Single-center Retrospective Cohort Study

2021 ◽  
Author(s):  
Takuya Shiraishi ◽  
Hiroomi Ogawa ◽  
Chika Katayama ◽  
Katsuya Osone ◽  
Takuhisa Okada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Nutritional Status ◽  
Laparoscopic Approach ◽  
Skin Disorders ◽  
Nutritional Interventions ◽  
Stoma Creation ◽  
Peristomal Skin ◽  
The Impact ◽  
Conut Score

Abstract Purpose: While nutritional interventions may potentially lower the risk of peristomal skin disorders (PSDs) and their exacerbation, no prior studies have evaluated the relationship between PSDs and nutritional status using the Controlling Nutritional Status (CONUT) score. Therefore, the purpose of this study was to assess the impact of preoperative nutritional status on stoma development, and determine risk factors for postoperative PSDs and their increased severity. Methods: A retrospective analysis was performed in 116 consecutive patients with rectal cancer who underwent radical surgery with stoma creation, including ileostomy and colostomy. Results: PSDs were diagnosed in 32 patients (27.6%); 10 (8.7%) cases were defined as severe based on the ABCD-stoma score. A multivariate analysis indicated that the laparoscopic approach (odds ratio [OR], 3.221; 95% confidence interval [CI], 1.001–10.362; P = 0.050) and ileostomy (OR, 3.394; 95% CI, 1.349–8.535; P = 0.009) were both independent risk factors for PSD. In a separate multivariate analysis for severe PSD, the only independent risk factor was the CONUT score (OR, 11.298; 95% CI, 1.382–92.373; P = 0.024). Conclusion: Severe PSDs are associated with preoperative nutritional disorders, as determined via the CONUT score. Furthermore, PSDs may potentially increase in severity, regardless of stoma type.

Prediction of spontaneous preterm birth in asymptomatic twin pregnancies with the use of combined fetal fibronectin and cervical length

2009 ◽  
Vol 201 (3) ◽  
pp. 313.e1-313.e5 ◽  
Author(s):  
Nathan S. Fox ◽  
Daniel H. Saltzman ◽  
Chad K. Klauser ◽  
Danielle Peress ◽  
Christina V. Gutierrez ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cervical Length ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Twin Pregnancies

775: Prediction of spontaneous preterm birth and very preterm birth in twin pregnancies using the change in cervical length over time

2008 ◽  
Vol 199 (6) ◽  
pp. S220
Author(s):  
Nathan Fox ◽  
Andrei Rebarber ◽  
Chad Klauser ◽  
Christine Ggtierrez ◽  
Danielle Peress ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cervical Length ◽  
Spontaneous Preterm Birth ◽  
Very Preterm ◽  
Very Preterm Birth ◽  
Twin Pregnancies ◽  
Over Time

Prospective risk of intrauterine death of monochorionic twins: update

2016 ◽  
Vol 44 (8) ◽  
Author(s):  
Teresinha Simões ◽  
Alexandra Queirós ◽  
Ana Teresa Marujo ◽  
Sandra Valdoleiros ◽  
Patricia Silva ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Fetal Death ◽  
Intrauterine Death ◽  
Monochorionic Twins ◽  
Death Rates ◽  
Gestational Period ◽  
Period Data ◽  
Prospective Risk ◽  
Twin Pregnancies ◽  
Over Time

AbstractObjective:To calculate an updated prospective risk of fetal death in monochorionic-biamniotic (MCBA) twins.Study design:We evaluated 520 MCBA twin pregnancies that had intensive prenatal surveillance and delivered in a single Portuguese referral center. The prospective risk of fetal death was calculated as the total number of deaths at the beginning of the gestational period divided by the number of continuing pregnancies at or beyond that period. Data were compared to the 2006 previous report.Results:Nearly 80% of the neonates weighed <2500 g, including 13.5% who weighed <1500 g. Half were born at <36 weeks, including 13.8% who were born at <32 weeks. The data indicate an increased IUFD rate over time – 16 fetal deaths per pregnancy (3.1%) and 22 IUFDs per fetus (2.1%). The rate of IUFD after 32–33 weeks, however, was halved (1/187 pregnancies and 1/365 fetuses, 0.5 and 0.3%, respectively).Conclusion:Intensive prenatal surveillance might decrease the unexpected fetal death rates after 33 week’s gestation and our data do not support elective preterm birth for uncomplicated MCBA twins.

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