Lesioni cutanee stellate e simmetriche in un gemello “rimasto solo”

2021 ◽  
Vol 40 (7) ◽  
pp. 383-385
Author(s):  
Claudia Sciarotta ◽  
Gregorio Serra ◽  
mandy Schierz ◽  
Giovanni Corsello
Keyword(s):  
Twin Pregnancy ◽  
Assisted Reproductive Technologies ◽  
Multiple Pregnancy ◽  
Reproductive Technologies ◽  
Intrauterine Death ◽  
Second Trimester ◽  
Aplasia Cutis Congenita ◽  
Multiple Gestations ◽  
Vanishing Twin Syndrome ◽  
Twin Pregnancies

The incidence of multiple pregnancy has increased, particularly because of the advances in assisted reproductive technologies. Multiple gestations are high risk pregnancies, especially the monochorionic ones. Two/thirds of initially twin pregnancies result in singles at birth, a condition defined as vanishing twin syndrome. The intrauterine death of one of the twins can cause direct fetal damage to the surviving one on several levels. The paper describes the case of a child born from twin pregnancy that was interrupted for one of the co-twins at early second trimester of gestation who presented with aplasia cutis congenita.

Lesioni cutanee stellate e simmetriche in un gemello “rimasto solo”

2021 ◽  
Vol 40 (6) ◽  
pp. 383-385
Author(s):  
Claudia Sciarrotta ◽  
Gregorio Serra ◽  
Mandy Schierz ◽  
Giovanni Corsello
Keyword(s):  
Twin Pregnancy ◽  
Assisted Reproductive Technologies ◽  
Multiple Pregnancy ◽  
Reproductive Technologies ◽  
Intrauterine Death ◽  
Second Trimester ◽  
Aplasia Cutis Congenita ◽  
Multiple Gestations ◽  
Vanishing Twin Syndrome ◽  
Twin Pregnancies

The incidence of multiple pregnancy has increased, particularly because of the advances in assisted reproductive technologies. Multiple gestations are high risk pregnancies, especially the monochorionic ones. Two/thirds of initially twin pregnancies result in singles at birth, a condition defined as vanishing twin syndrome. The intrauterine death of one of the twins can cause direct fetal damage to the surviving one on several levels. The paper describes the case of a child born from twin pregnancy that was interrupted for one of the co-twins at early second trimester of gestation who presented with aplasia cutis congenita.

scholarly journals The assessment of twin pregnancies delivered in our clinic: three-year experience

2020 ◽  
Vol 28 (3) ◽  
pp. 170-175
Author(s):  
Cengiz Şanlı ◽  
Salih Burçin Kavak ◽  
Melike Aslan ◽  
Ebru Çelik Kavak ◽  
İbrahim Batmaz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Preterm Labor ◽  
Twin Pregnancy ◽  
Very Low Birth Weight ◽  
Assisted Reproductive Technologies ◽  
Multiple Pregnancy ◽  
Reproductive Technologies ◽  
Twin Pregnancies

Objective: Twin pregnancies constitute 1–2% of all pregnancies. With the recent developments in assisted reproductive technologies, the incidence of multiple pregnancy has increased. Preterm labor is held responsible for the poor neonatal outcomes primarily. In our study, we aimed to assess fetal-maternal outcomes of twin pregnancies seen in our clinic. Methods: One hundred and thirty twin pregnancy cases out of 4241 pregnant women who delivered in our clinic between 01.01.2017 and 01.01.2020 were included in the study. The labor records of the patients were reviewed retrospectively and their data for age, week of gestation, delivery type, birth weight, fetal sex, chorionicity characteristics and laboratory parameters were recorded. Definitive statistics and SPSS 21.0 for statistical analyses were used to evaluate the data obtained from the study. The data were presented as mean ± SD (standard deviation). Results: The incidence of twin pregnancy was found 3%. In the ultrasonographic imaging evaluated during diagnosis, 27.7% of the cases were monochorionic and 72% of them were dichorionic. Of the pregnant women, 12.3% were at term and 87.7% were at preterm period. When the preterm fetuses were evaluated, 37.7% of 114 preterm fetuses were delivered at late preterm period, 29.2% of them at mid-preterm period and 20.8% at premature preterm period. The rates of treatment pregnancy (pregnancy provided by ovulation induction and assisted reproductive technologies) and spontaneous twin pregnancy were 20% and 80%, respectively. Mean maternal age was found 31.3. When evaluated in terms of maternal morbidity, preterm labor and premature rupture of membrane were the most common problems. Mean newborn weight was 1832g and 59.3% of the newborns had low birth weight and 21.8% of them had very low birth weight. While one fetus had transverse presentation in 12.5% of the patients, at least one fetus had breech presentation in 53.1% of the cases and 34.4% of the cases had head-head presentation. Conclusion: Twin pregnancies are characterized by the increased feto-maternal risks. Therefore, both antenatal and intrapartum management should be maintained diligently.

scholarly journals Twin pregnancy a complicating journey for both mothers and babies: elaborate review

2020 ◽  
Vol 9 (4) ◽  
pp. 674
Author(s):  
Pallavi Sitaram Shelke ◽  
Pradnya Nilesh Jagtap
Keyword(s):  
Twin Pregnancy ◽  
Multiple Pregnancy ◽  
Reproductive Technology ◽  
Identical Twins ◽  
Safe Abortion ◽  
Abortion Care ◽  
Vanishing Twin Syndrome ◽  
Twin Pregnancies ◽  
The U.S ◽  
In Pregnancy

Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy can occur by sexual intercourse or assisted reproductive technology. A pregnancy may end in a live birth, abortion, or miscarriage, though access to safe abortion care varies globally. Research shows that 10 percent to 15 percent of all singleton births may have started off as twins; often one is lost early in pregnancy in a phenomenon known as "vanishing twin syndrome." Multiple pregnancy occurs when two or more ova are fertilized to form dizygotic (non-identical) twins or a single fertilised egg divides to form monozygotic (identical) twins. In the U.S, about three in every 100 pregnant women give birth to twins or triplets, according to the Mayo Clinic in Rochester, Minn. And by many accounts, twin pregnancies are on the rise. This review provides a blessful information to understand what happening when expecting twins and also help to cope with pregnancy related complications and give twins the best start in life.

scholarly journals Twin pregnancy, fetal reduction and the 'all or nothing problem’

2020 ◽  
pp. medethics-2020-106938
Author(s):  
Joona Räsänen
Keyword(s):  
Moral Theory ◽  
Twin Pregnancy ◽  
Assisted Reproductive Technologies ◽  
Multiple Pregnancy ◽  
Reproductive Technologies ◽  
In Vitro Fertilisation ◽  
Singleton Pregnancy ◽  
Fetal Reduction ◽  
Health Related

Fetal reduction is the practice of reducing the number of fetuses in a multiple pregnancy, such as quadruplets, to a twin or singleton pregnancy. Use of assisted reproductive technologies increases the likelihood of multiple pregnancies, and many fetal reductions are done after in vitro fertilisation and embryo transfer, either because of social or health-related reasons. In this paper, I apply Joe Horton’s all or nothing problem to the ethics of fetal reduction in the case of a twin pregnancy. I argue that in the case of a twin pregnancy, there are two intuitively plausible claims: (1) abortion is morally permissible, and (2) it is morally wrong to abort just one of the fetuses. But since we should choose morally permissible acts rather than impermissible ones, the two claims lead to another highly implausible claim: the woman ought to abort both fetuses rather than only one. Yet, this does not seem right. A plausible moral theory cannot advocate such a pro-death view. Or can it? I suggest ways to solve this problem and draw implications for each solution.

scholarly journals Relapse of Human Chorionic Gonadotropin-Induced Hyperthyroidism and Severe Hyperemesis Gravidarum Secondary to Twin-Twin Transfusion Syndrome, With Rapid Recovery Following Fetoscopic Laser Coagulation: Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Faiza Lamine ◽  
Chiara Camponovo ◽  
David Baud ◽  
Dominique Werner ◽  
Laura Marino ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Twin Pregnancy ◽  
Assisted Reproductive Technologies ◽  
Hyperemesis Gravidarum ◽  
Reproductive Technologies ◽  
Laser Coagulation ◽  
Monochorionic Twin ◽  
Fetoscopic Laser Coagulation ◽  
Twin Pregnancies

BackgroundLimited data have shown that, compared to uncomplicated twin pregnancies, pregnancies complicated by twin-twin transfusion syndrome (TTTS), a life-threatening condition, are associated with higher maternal serum levels of both human chorionic gonadotropin (hCG) and thyroid hormones. With the continuing expansion of assisted reproductive technologies, the rate of twin pregnancies, including those complicated by TTTS and associated hyperemesis gravidarum, is expected to increase further. Therefore, detailed descriptions of the maternal and fetal clinical outcomes of maternal thyrotoxicosis linked to TTTS can be useful for timely diagnosis and management. However, such descriptions are currently lacking in the literature.Case PresentationWe report the case of a 30-year-old woman carrying a monochorionic twin pregnancy complicated by TTTS that induced a relapse of severe hyperemesis gravidarum with overt non-autoimmune hyperthyroidism at 17 weeks of gestation. Following fetoscopic laser coagulation (FLC), both hyperemesis and hyperthyroidism improved within 1 week.ConclusionsThe present experience contributes to the knowledge base on maternal thyrotoxicosis linked to TTTS and can be useful in the diagnosis and treatment of future cases; it also emphasizes the need for a high degree of clinical suspicion and for close collaboration between endocrinologists and obstetricians. Another key point is that TTTS-associated hyperemesis gravidarum and maternal hyperthyroidism should be considered in the differential diagnosis of refractory or relapsing hyperemesis gravidarum in women with monochorionic twin pregnancy, because this condition may require more stringent supportive treatment before and during the FLC procedure when the mother is overtly hyperthyroid.

scholarly journals Follitropin Delta as a State-of-the-Art Incorporated Companion for Assisted Reproductive Procedures: A Two Year Observational Study

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 379
Author(s):  
Bogdan Doroftei ◽  
Ovidiu-Dumitru Ilie ◽  
Ana-Maria Dabuleanu ◽  
Roxana Diaconu ◽  
Radu Maftei ◽  
...  
Keyword(s):  
Observational Study ◽  
Ovarian Hyperstimulation Syndrome ◽  
Twin Pregnancy ◽  
Assisted Reproductive Technologies ◽  
State Of The Art ◽  
Follicle Stimulating Hormone ◽  
Exact Result ◽  
Reproductive Technologies ◽  
The Other ◽  
Ovarian Hyperstimulation

Background and objectives: The latest reports suggest that follitropin delta is a highly efficient recombinant human follicle-stimulating hormone (r-hFSH) that became a part of the current assisted reproductive technologies (ARTs). Therefore, the present study aims to assess a series of parameters (follicles, oocytes, and embryos) and further by the outcomes in women following the administration of follitropin delta. Materials and methods: This observational study included 205 women. They were aged between 21 and 43 years (mean 33.45) and an anti-Müllerian hormone (AMH) level ranging from 0.11 to 16.00 ng/dL (mean 2.89). Results: In accordance with the established methodology and following the centralization of data, a total of fifty-eight pregnancies (28.29%) were achieved; forty-five (36.88%) were achieved in women under 35 years and thirteen (15.66%) in women above 35 years. These figures are positively correlated with women’s age considering that the number of follicles >18 mm, oocytes fertilized and embryo(s) varies among groups. Regarding the interest parameters, we noted n = 1719 follicles > 18 mm, n = 1279 retrieved oocytes, and n = 677 embryos at day 3. On the other hand, the following figures have been registered in women above 35 years: 814–follicles > 18 mm, 612 oocytes retrieved and 301 embryos at day 3. During this study, we registered only three cases of abortions (n = 1–0.81% in women under 35 years and n = 2–2.40% in women above 35 years). Nine pregnancies (7.37%) were stopped from evolution in females under 35 years, and twelve pregnancies (n = 8–6.55% in women under 35 years, while n = 4 in women above 35 years) were unsuccessful. A twin pregnancy has been confirmed (1.20%) in women above 35 years, six ongoing pregnancies (4.91%) in those under 35 years, and two in both groups (one per group–n = 1–0.81%, and 1.20%–n = 1) in which we did not know the exact result were registered at the end of the established studied interval. However, there were also situations in which the treatment cause an over-reactivity or had no effect; n = 2 were non-responders, and n = 1 exhibited moderate ovarian hyperstimulation syndrome (OHSS). Conclusions: Based on our results, we strongly encourage the use of this recombinant gonadotropin on a much larger scale.

Clinical and statistical analysis of obstetrics and perinatal complications in singleton and multiple pregnancy after assisted reproductive technology

2018 ◽  
pp. 67-73
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
S.O. Ovcharenko ◽  
◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Assisted Reproductive Technologies ◽  
Multiple Pregnancy ◽  
Fetal Distress ◽  
Reproductive Technologies ◽  
Fetal Growth Retardation ◽  
Multiple Pregnancies ◽  
Perinatal Complications

The objective: conduct a comparative clinical and statistical analysis of obstetric and perinatal complications in singleton and multiple pregnancies after assisted reproductive technologies (ART) according to archival documents (pregnancy observation data and birth history) and identify features of multiple pregnancy. Materials and methods. During the period 2017–2019, 522 women gave birth in maternity hospital «Leleka» after assisted reproductive technologies, 331 women were observed in the maternity hospital «Leleka». 445 women gave birth with a singleton pregnancy and 77 with a multiple pregnancy. A clinical and statistical analysis of 150 pregnancy and childbirth histories was performed. All pregnant women were divided into two groups: Group I – 75 pregnant women with singleton pregnancies after ART; Group II – 75 pregnant women with multiple pregnancies after ART. The selection criteria for comparative clinical and statistical analysis were women whose pregnancies occurred as a result of ART, namely by in vitro fertilization (IVF) using five-day frozen embryos. Mathematical research methods were performed in accordance with the recommendations of O.P. Minzer (2013). The reliability of the cancellation of the mean pairs was calculated using the Student’s and Fisher’s criteria. Graphs were designed using the program «Microsoft Excel». Results. Complications of early pregnancy in multiple pregnancies were: anemia (47.8% vs. 22.9%; p<0.01), placental dysfunction (43.3% vs. 22.9%; p<0.01), the threat of abortion (41.8% vs. 28.6%; p<0.01). Complications of the second half of pregnancy: preeclampsia (52.7% vs. 20.6%; p<0.01), fetal growth retardation (20.0% vs. 7.4%; p<0.01), gestational anemia (76,4% vs. 32.4%; p<0.01), placental dysfunction (47.3% vs. 22.1%; p<0.05). Complications in childbirth in women with multiple pregnancies were as follows: premature rupture of membranes (30.9% vs. 10.3%; p<0.05), anomalies of labor activity (16.4% vs. 5.9%; p>0.05), fetal distress (29.1% vs. 14.7%; p<0.05), premature placental abruption (3.6% vs. the absence of this indicator in group I). In patients of group II with multiple pregnancies 3.7 times more often the pregnancy ended prematurely compared with singleton (21.8% vs. 5.9%; p<0.05). Early preterm births predominated, of which births occurred in 3.6% of cases at 22–28 weeks, 7.3% at 28–32 weeks, and 6.4% at 32–34 weeks. Significant increase in the frequency of 32.7% of abdominal births in multiple pregnancies against 11.8% of patients in pregnancy with a single fetus (p<0.01). The structure of indications in patients of group II was as follows: severe preeclampsia 27.8%, development of fetal growth retardation and fetal distress of 11.1%, respectively, premature placental abruption 16.7%, the following single indications (pelvic presentation of the fetus, transverse or oblique position of the fetus, clinically narrow pelvis, abnormalities of labor, scar on the uterus) – 33.3%. Significant increase in the total frequency of neonatal asphyxia of varying severity in multiple pregnancies (35.0% vs. 5.9%; p<0.05), fetal growth retardation (27.3% vs. 11.8%; p<0.01). Conclusions. Multiple pregnancies are a high risk factor for gestational anemia, preeclampsia, placental dysfunction, early fetal growth retardation, and fetal distress during pregnancy and childbirth. This causes a high level of abdominal delivery. Therefore, further research to predict and prevent obstetric and perinatal complications in multiple pregnancies after ART is relevant today. Keywords: obstetric and perinatal complications of pregnancy, multiple pregnancy, assisted reproductive technologies.

Spontaneous heterotopic triplet pregnancy with intrauterine monochorionic-monoamnionic twins

2016 ◽  
Vol 5 (2) ◽  
pp. 117-119
Author(s):  
Alexander Kotlyar ◽  
Jennifer Eaton ◽  
Katherine Singh ◽  
Uma Perni
Keyword(s):  
Abdominal Pain ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Heterotopic Pregnancy ◽  
Second Trimester ◽  
Triplet Pregnancy ◽  
Intrauterine Pregnancy ◽  
Chorionic Villi ◽  
Prior Use ◽  
Unusual Phenomenon

Abstract Heterotopic pregnancies are an unusual phenomenon, which have recently become more prevalent with assisted reproductive technologies (ART). Triplets that are part of a heterotopic pregnancy are exceedingly rare. Here, we describe a case of a woman who presented at 15+1 weeks of gestational age with a known monochorionic-monoamniotic intrauterine pregnancy with several days of abdominal pain with an otherwise unremarkable gastrointestinal (GI) assessment. Salpingectomy was performed, and pathology revealed chorionic villi within the fallopian tube consistent with a heterotopic triplet pregnancy. This pregnancy was conceived spontaneously. Even without the prior use of ART, physicians need to be aware of the risk of heterotopic pregnancy in a patient with a known twin gestation. In addition, this case highlights how heterotopic triplets can present even within the second trimester.

scholarly journals Aplasia cutis congenita with fetus papyraceus: an uncommon case report

2020 ◽  
Vol 6 (6) ◽  
pp. 809
Author(s):  
Vivekananda Ittigi ◽  
Aparna Anto
Keyword(s):  
Reproductive Technologies ◽  
In Utero ◽  
Multiple Gestation ◽  
Aplasia Cutis Congenita ◽  
Multiple Gestations ◽  
Symmetrical Distribution ◽  
Associated Conditions ◽  
Uncommon Case ◽  
Type V ◽  
Aplasia Cutis

<p class="abstract">Aplasia cutis congenita is a condition characterized by congenital absence of all skin layers in a localized or widespread area. Frieden's classification recognized a rare subtype, type V, that is associated with multiple gestations in which there is the in-utero demise of a twin with resultant fetus papyraceus or mummification. A twin pregnancy was complicated by in-utero death of one twin at 5 months. On full term birth of the other twin with fetus papyraceus large defects in the skin of knees were noted bilaterally. Conservative management with topical antibiotics and emollients helped in complete re-epithelialization in few months. As the use of reproductive technologies increase the incidence of multiple gestation and associated conditions are expected to increase. This type is clinically unique in that it is characterized by stellate lesions in a symmetrical distribution over the trunk and extremities, differing from other subtypes, which are typically localized to scalp (70%-85% of cases) or extremities. Management ranges from conservative to surgical grafts.</p>

scholarly journals MATERNAL COMPLICATIONS OF MULTIPLE GESTATIONS IN SECOND AND THIRD TRIMESTER OF PREGNANCY.

1969 ◽  
Vol 5 (1) ◽  
pp. 591-596
Author(s):  
SAIMA KHATTAK ◽  
MUHMMAD BILAL AWAN ◽  
MUHMMAD DANYAL AWAN
Keyword(s):  
Twin Pregnancy ◽  
Reproductive Technologies ◽  
High Order ◽  
Multiple Gestation ◽  
Third Trimester ◽  
Triplet Pregnancy ◽  
Maternal Complications ◽  
Multiple Gestations ◽  
Risk Pregnancy

BACKGROUND: In recent times, the incidence of multiple pregnancies has significantly increased dueto medication for induced ovulation and other reproductive technologies. The present study is designedto see the maternal complication of multiple gestations in pregnancy.OBJECTIVE: To determine the maternal complications associated with multiple gestation in secondand third trimester of pregnancy.METHODOLOGY: This descriptive study was carried out in the department of obstetrics andGynaecology unit at Lady Reading Hospital Peshawar. Duration of the study was 06 months from 1stJanuary 2012 to 1st July 2012. All patients with twin gestations, triplets and high order multiples visitingobstetrics and Gynaecology unit at Lady Reading Hospital Peshawar and who were admitted in wardwere included in the study and after taking informed consent their characteristics were recorded byfilling proforma.RESULTS: Sixty patients with multiple gestations were included in the study. Fifty four (90%) of themhad twin pregnancy and 06 (10%) had triplet pregnancy. The antenatal complications detected in thesepatients were preterm labour 23(32.3%), anaemia 18(30%), pregnancy induced hypertension, preeclamptic toxaemia, eclampsia 13(21.7%), Malpresentation 13(21.7%), Antepartum Haemorrhage 5(8.3%), 5 patients (8.3%) had PROM, 4 (6.7%) had polyhydramnios, 3(5%) had miscarriages, 5 (8.3%)had postpartum haemorrhage, 44(73.3%) patients had spontaneous vaginal delivery and 15(25%)underwent caesarean section. In 28(46.7%) patients cephalic/cephalic was the most commonpresentation.CONCLUSION: Multiple gestation is a high risk pregnancy and is associated with both maternal andfetal complications. Patient needs to be educated about the importance and advantages of early antenatalbooking and regular antenatal follow-up to reduce the risks to the mother and the babies.KEY WORDS: Twin pregnancy, Triplets, High-order multiplets; Complications-Second Trimester,Third trimester.

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