scholarly journals sFlt-1, Not PlGF, Is Related to Twin Gestation Choronicity in the First and Third Trimesters of Pregnancy

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1181
Author(s):  
Szymon Kozłowski ◽  
Anna Stelmaszczyk-Emmel ◽  
Iwona Szymusik ◽  
Aleksandra Saletra-Bielińska ◽  
Robert Brawura-Biskupski-Samaha ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Prospective Observational Study ◽  
First Trimester ◽  
Placental Growth Factor ◽  
Serum Concentrations ◽  
Third Trimester ◽  
Monochorionic Twin ◽  
The Third ◽  
Angiogenic Biomarkers ◽  
Twin Pregnancies

Background: Preeclampsia occurs more often in dichorionic than in monochorionic twin pregnancy. We hypothesize that serum concentrations of biomarkers: placental growth factor (PlGF), serum soluble fms-like tyrosine kinase-1 (sFlt-1), and endoglin (Eng) differ between monochorionic and dichorionic twin pregnancies. Methods: A prospective observational study including 43 monochorionic and 36 dichorionic twin gestation was conducted. Blood samples were collected twice from all participants: between 11 + 0 and 13 + 6 and between 32 + 0 and 34 + 0 weeks of gestation. PlGF, sFlt-1 and Eng were measured using immnunoenzymatic assays. Results: We found a significantly higher concentration of sFlt-1 in dichorionic in comparison to monochorionic pregnancies in both the first and third trimesters. PlGF and sEng levels did not differ between mono- and dichorionic gestation in both study periods. sFlt-1 level was related to twin gestation chorionicity, while PlGF expression was not. PlGF, sFlt-1 and sEng concentrations increased significantly during gestation and were much higher in the third trimester compared to the values measured in the first trimester. Conclusions: Angiogenic biomarkers expression differ between dichorionic and monochorionic twin pregnancy. The sFlt-1 level is related to chorionicity of a twin gestation.

scholarly journals Laboratory options for risk assessment of pregnancy pathologies

2019 ◽  
pp. S415-S425
Author(s):  
A. Kestlerová ◽  
L Krofta ◽  
A. Žufić ◽  
K. Hamplová Běhávková ◽  
J. Račko ◽  
...  
Keyword(s):  
Fetal Heart ◽  
Chromosomal Abnormalities ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Placental Growth Factor ◽  
Third Trimester ◽  
The Third ◽  
Placental Dysfunction ◽  
Immunological Markers ◽  
Pathological Conditions

The most effective method of screening for chromosomal abnormalities and evaluating the risk of pregnancy pathologies in the first trimester is combined screening. The algorithm of screening is based on the combination of maternal age, measuring of the nuchal translucency and the fetal heart rate and analysis of the placental products of free ß-hCG and PAPP-A. For the screening of preeclampsia, placental growth factor (PlGF) is added. To distinguish between preeclampsia and other pathologies caused by placental dysfunction it is recommended to also extend the screening with selected immunological markers. We concluded that elevated biochemical and immunological markers can help to predict the threat of preeclampsia in the third trimester. Some markers can probably predict the development of particularly severe pathological conditions.

scholarly journals Therapeutic levetiracetam monitoring during pregnancy: “mind the gap”

2019 ◽  
Vol 10 ◽  
pp. 204062231985165 ◽  
Author(s):  
Maya Berlin ◽  
Dana Barchel ◽  
Revital Gandelman-Marton ◽  
Nurit Brandriss ◽  
Ilan Blatt ◽  
...  
Keyword(s):  
Reference Range ◽  
Serum Levels ◽  
First Trimester ◽  
Second Trimester ◽  
Serum Concentrations ◽  
Third Trimester ◽  
The Third ◽  
Antiepileptic Medication ◽  
Apparent Clearance ◽  
Neurological Conditions

Background: Epilepsy is one of the most common chronic neurological conditions and its treatment during pregnancy is challenging. Levetiracetam (LEV) is an antiepileptic medication frequently used during pregnancy. Only a few small studies have been published on LEV monitoring during pregnancy, demonstrating decreased serum LEV levels during the first and second trimester; however, the most significant decrease was observed during the third trimester of pregnancy. In this study we aimed to evaluate LEV pharmacokinetics during different stages of pregnancy. Methods: We followed up and monitored serum levels of pregnant women treated with LEV for epilepsy. Results: Fifty-nine women with 66 pregnancies during the study period were included. The lowest raw LEV serum concentrations were observed during the first trimester. Compared with the pre-pregnancy period, raw serum concentration was lower by 5.76 mg/L [95% confidence interval (CI) (2.78, 8.75), p = 0.039] during the first trimester. Comparing the decrease in the first trimester with either the second or the third, no significant changes were observed ( p = 0.945, p = 0.866). Compared with pre-pregnancy measurements, apparent clearance was increased by 71.08 L/day [95%CI (16.34, 125.83), p = 0.011] during the first trimester. About 30% of LEV serum levels during pregnancy were below the laboratory quoted reference range. Conclusions: Raw LEV serum levels tend to decrease during pregnancy, mainly during the first trimester contrary to previous reports. Monitoring of LEV serum levels is essential upon planning pregnancy and thereafter if pre-pregnancy LEV levels are to be maintained. However, more studies are needed to assess the correlation with clinical outcome.

scholarly journals Yolk Sacs in Twin Pregnancy

1998 ◽  
Vol 47 (3-4) ◽  
pp. 177-181 ◽  
Author(s):  
W. Malinowski
Keyword(s):  
Ectopic Pregnancy ◽  
Twin Pregnancy ◽  
First Trimester ◽  
Yolk Sac ◽  
Thin Wall ◽  
Multiple Pregnancies ◽  
Monochorionic Twin ◽  
The Relationship ◽  
Twin Pregnancies ◽  
Efficient Recognition

AbstractOBJECTIVE. The purpose of this study was to evaluate the relationship between the yolk sacs separated or not separated by septum and chorionicity twin pregnancies scanned early in the first trimester, and the relation between size and morphologic features of the yolk sac and the outcome of twin pregnancies.RESULTS. In all 38 sets of twins two yolk sacs were identified. During the first trimester of a dichorionic twin pregnancy, the yolk sacs were always separated by a septum and not separated (“Eight” sign) in monochorionic twin pregnancy. In five cases, one of yolk sac was abnormally large (> 8mm) and had thin wall. Four of the five mothers spontaneously aborted during the next 2-3 weeks. In one case of monochorionic twin ectopic pregnancy two yolk sacs were seen normally.CONCLUSION. The sonographic identification of yolk sacs in multiple pregnancies allows an early and efficient recognition of presence and chorionicity of twin pregnancy, both in intra – and extrauterine. Identification of abnormal yolk sac or yolk sacs suggests death of one or all embryos.

Where There is No Ultrasound: Delay and Failure of Antenatal Diagnosis of Twin Pregnancy

2003 ◽  
Vol 33 (1) ◽  
pp. 5-7 ◽  
Author(s):  
M C Groot ◽  
E J Buchmann
Keyword(s):  
South Africa ◽  
Antenatal Care ◽  
Twin Pregnancy ◽  
Previous History ◽  
Third Trimester ◽  
Second Stage ◽  
The Third ◽  
Second Stage Of Labour ◽  
History Of ◽  
Twin Pregnancies

We investigate the problem of late diagnosis of twin pregnancy in Soweto, South Africa, where routine antenatal ultrasound is not available. One hundred consecutive pairs of twins were studied, using the notes of mothers who delivered twins at Chris Hani Baragwanath Hospital and the referring Soweto clinics. A positive history was found in 31 mothers (22 family history, nine previous history of twins). Six mothers did not attend for antenatal care. Twenty-five twin pregnancies were discovered at delivery, 15 of them in the second stage of labour, and 27 were diagnosed accidentally in the third trimester. Only 15 pregnancies were referred specifically for suspicion of twin pregnancy. Most twin pregnancies are detected only in the third trimester or at delivery. Until routine ultrasound is available to all pregnant women, the teaching of antenatal care in South Africa must give emphasis to clinical suspicion of twin pregnancy.

scholarly journals Effects of twin pregnancy chorionic properties on fetal outcomes: a comparative study

2020 ◽  
Vol 9 (9) ◽  
pp. 3802
Author(s):  
Gigi A. ◽  
Rachel Alexander ◽  
Radhamani K.
Keyword(s):  
Twin Pregnancy ◽  
Prospective Observational Study ◽  
Perinatal Outcomes ◽  
Fetal Outcomes ◽  
Monochorionic Twins ◽  
Monochorionic Twin ◽  
Medical College ◽  
Placental Membranes ◽  
The Mean ◽  
Twin Pregnancies

Background: Twins carry significant risks to both mothers and babies. The purpose of this study was to evaluate chorionicity and its impact on perinatal outcomes in twins.Methods: This prospective observational study was conducted in the department of obstetrics and gynecology, Government T. D. Medical College, Alappuzha, Kerala. A total of 106 cases of twin pregnancies were included in the prospective descriptive study. Based on the ultrasound results and methods of the postpartum pathologic examination of the placental membranes, the cases were divided into the twin group with monochorionic diamniotic (MCDA) and twin group with dichorionic diamniotic (DCDA group). The relationships of different chorionic properties and fetal outcomes were determined by comparing various fetal outcomes.Results: Among 106 twin pregnancies, 61.3% were DCDA twins, 38.7% were MCDA. Average maternal age of monochorionic twin was 25 and that of dichorionic twin was 27. Perinatal mortality of monochorionic twin was 14.7% when compared to 8.6% for dichorionic twin. The mean gestational age for monochorionic twin pregnancy was 34.78 weeks whereas it was 35.91 weeks for dichorionic pregnancy. Elective and emergency LSCS was done more for dichorionic twin pregnancies compared to monochorionic twin pregnancies. Low Apgar scores were seen in monochorionic twins compared to dichorionic twins.Conclusions: The incidence of fetal outcomes in the monochorionic group was inferior to those in the dichorionic group. The fetal outcomes may be improved by determining the chorionic properties in early pregnancy by using ultrasound and consequently planning for pregnancy monitoring and intervention.

scholarly journals The Incidence of Dichorionic Diamniotic Twin Pregnancy After Single Blastocyst Embryo Transfer and Zygosity: 8 Years of Single-Center Experience

2020 ◽  
Vol 23 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Hiroko Konno ◽  
Takeshi Murakoshi ◽  
Kiyonori Miura ◽  
Hideaki Masuzaki
Keyword(s):  
Embryo Transfer ◽  
Twin Pregnancy ◽  
Hormone Replacement ◽  
First Trimester ◽  
Frozen Embryo Transfer ◽  
The Other ◽  
Placental Pathology ◽  
Monochorionic Twin ◽  
Single Center Experience ◽  
Twin Pregnancies

AbstractDichorionic diamniotic (DCDA) twin pregnancies after single blastocyst embryo transfer have been reported recently, although a blastocyst ovum is generally believed to divide into monochorionic twin pregnancy. We investigated the incidence of DCDA twin pregnancy after single blastocyst embryo transfer and their zygosity. This prospective cohort study included 655 consecutive twin pregnancies that were managed from 2006 to 2014 at our institution. Chorionicity and amnionicity were determined using first-trimester ultrasonography and/or placental pathology. Zygosity was analyzed if the cases were DCDA twins after single blastocyst embryo transfer. Among 655 twin pregnancies, there were 348 DCDA cases, 295 monochorionic diamniotic (MCDA) cases and 12 monochorionic monoamniotic cases. Single blastocyst embryo transfer was performed in 43 cases. Six out of the 43 (14%) cases involved DCDA twin pregnancies and the other 37 cases involved MCDA twin pregnancies. Three DCDA twins born after single blastocyst embryo transfer, wherein frozen embryo transfer (FET) was performed in the natural cycle, were dizygotic, and the other three cases, wherein FET with hormone replacement therapy was performed, were monozygotic. DCDA twin pregnancy occurred in 14% (7% for monozygotic and 7% for dizygotic) of twin pregnancies after single blastocyst embryo transfer cases.

Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko
Keyword(s):  
First Trimester ◽  
Mean Value ◽  
Fetal Macrosomia ◽  
Entire Group ◽  
Third Trimester ◽  
The Third ◽  
Group I ◽  
Fetal Birth Weight ◽  
First Trimester Of Pregnancy ◽  
The Mean

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.

Yearly Changes in Stillbirth Rates of Zygotic Twins in Japan, 1975-1994

1998 ◽  
Vol 47 (1) ◽  
pp. 19-30 ◽  
Author(s):  
Y. Imaizumi ◽  
K. Nonaka
Keyword(s):  
Medical Care ◽  
Twin Pregnancy ◽  
Japanese Women ◽  
Stillbirth Rate ◽  
Monochorionic Twin ◽  
Mz Twins ◽  
Twin Pregnancies

AbstractThe stillbirth rates decreased to 2/3 for MZ male twins, 1/2 for MZ female twins, and under 1/2 for DZ twins for both sexes during the 19-year period from 1975 in Japan. The stillbirth rate was significantly higher in MZ males than MZ females in each year, whereas stillbirth rates of DZ twins for both sexes indicated similar values during that period. After 1986, stillbirth rates were more than 2 times higher in MZ twins than in singletons and in DZ twins. The higher stillbirth rate of MZ twins as opposed to DZ twins could be related to monochorionic twin pairs in MZ twins. The stillbirth rate decreased more drastically in twins for both zygosities than in singleton births during the 34-year period from 1960. However, declining rates of stillbirths may be attributed to medical care during twin pregnancies. Recommendation of an optimum day to give birth for twin pregnancy is 37-38 weeks for Japanese women.

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