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Malou Barbosa, Rikke Bek Helmig, Lone Hvidman
INTRODUCTION: Multiple gestations are high-risk pregnancies associated with an increased risk of neonatal morbidity and mortality, mainly due to preterm births. Numerous interventions have been attempted in order to delay the time of delivery and subsequently, prevent preterm births in twin gestations. To date, no really effective intervention has been found. Use of cerclage in twin pregnancies has been controversial. Recently, however, small retrospective cohort studies have shown a potentially positive effect with the use of cerclage in twin pregnancies...
January 27, 2019: Journal of Maternal-fetal & Neonatal Medicine
Tanja Baltus, Maria Luisa Martin
Delayed-interval delivery in twin pregnancy is a rare occurrence. It is sometimes performed in twin pregnancies when the first twin is born at the limit of viabililty, to improve outcome for the second twin. It has been suggested that monochorionicity is a contraindication to delayed-interval delivery in multifetal pregnancy. The literature describes only a dozen cases over the last 20 years and only a handful of these reports specify success. We describe a case of a successful delayed-interval delivery of monochorionic diamniotic twins following prelabour rupture of membranes at 20 weeks of gestation...
January 2019: Case Reports in Women's Health
Yaqiong Liu, Yan Shen, Hong Zhang, Yi Tang, Guangxiu Lu, Ge Lin, Fei Gong
OBJECTIVE: To observe the pregnancy and perinatal outcomes of trichorionic triplet (TCT) and dichorionic triplet (DCT) pregnancies with or without multifetal pregnancy reduction (MFPR). MATERIALS AND METHODS: This was a retrospective study of 732 TCT and 118 DCT pregnancies after IVF/ICSI cycles between October 1999 and May 2014 at the Reproductive & Genetic Hospital of CITIC-Xiangya. The TCT and DCT groups were subdivided into three subgroups: MFPR to single fetus group, MFPR to twins group and expectant group...
January 2019: Taiwanese Journal of Obstetrics & Gynecology
(no author information available yet)
BACKGROUND: Infections acquired in hospital are an important cause of morbidity and mortality in very preterm infants. Several small trials have suggested that supplementing the enteral diet of very preterm infants with lactoferrin, an antimicrobial protein processed from cow's milk, prevents infections and associated complications. The aim of this large randomised controlled trial was to collect data to enhance the validity and applicability of the evidence from previous trials to inform practice...
January 8, 2019: Lancet
Catherine J Vladutiu, Elizabeth M Stringer, Veni Kandasamy, Jill Ruppenkamp, M Kathryn Menard
Objectives To estimate the rate of pregnancy-associated emergency care visits and identify maternal and pregnancy characteristics associated with high utilization of emergency care among pregnant Medicaid recipients in North Carolina. Methods A retrospective cohort study using linked Medicaid hospital claims and birth records of 107,207 pregnant Medicaid recipients who delivered a live-born infant in North Carolina between January 1, 2008 and December 31, 2009. Rates were estimated per 1000 member months of Medicaid coverage...
January 2, 2019: Maternal and Child Health Journal
J Giles, M Cruz, C González-Ravina, C Caligara, N Prados, J C Martínez, V Vergara, A Requena
RESEARCH QUESTION: Can predictors of twin and high-order multiple pregnancy among women with multiple cycles of ovarian stimulation intrauterine insemination (IUI) be identified? DESIGN: Retrospective cohort study of IUI cycles carried out between January 2014 and December 2015 in a private clinic in Spain. The 4879 women and 6552 cycles analysed in this study include single IUI with ovarian stimulation using recombinant FSH. RESULTS: Number of follicles and follicle size were the only factors with a significant effect (P < 0...
October 11, 2018: Reproductive Biomedicine Online
Liron Berkman, Tamar Wainstock, Eyal Sheiner, Daniella Landau, Gali Pariente
OBJECTIVE: While placental abruption is often associated with short-term adverse pregnancy outcomes, we sought to assess whether placental abruption increases the risk for long-term cardiovascular morbidity of the offspring. METHODS: To study the long-term cardiovascular hospitalizations of offspring of patients with and without placental abruption, cardiovascular morbidity was assessed up to the age of 18 years according to a predefined set of ICD-9 codes associated with hospitalization of the offspring...
November 26, 2018: Archives of Gynecology and Obstetrics
Ragaa Mansour, Mohamed Aboulghar, Nehal I Ghoneim, Toka A Ahmed, Ahmed El-Badawy, Sara M Ahmed, Samaa S Kamar, Maha Baleigh, Amal M Abbas, Hesham F Kayed, Mahmoud Gabr, Nagwa El-Badri
The multifetal reduction (MFR) procedure is usually reserved for high-order multiple pregnancies, and aspirated tissues are typically discarded. In this study, cells obtained from MFR tissue (termed multifetal reduction embryonic cells (MFR-ECs)), were characterized in vitro by genotypic and phenotypic analyses and tested in vivo by injection under the kidney capsule of nude mice. MFR-ECs were highly proliferative in culture and showed a normal karyotype by microarray CGH. Immunohistochemical analysis at day zero showed positive focal staining for desmin, S-100 protein, synaptophysin and chromogranin...
January 1, 2019: Frontiers in Bioscience (Elite Edition)
J Wells Logan, Elizabeth N Allred, Michael E Msall, Robert M Joseph, T T Michael O'Shea, Timothy Heeren, Alan Leviton, Karl C K Kuban
INTRODUCTION: Few studies have examined the relationship between birth plurality and neurocognitive function among children born extremely preterm. STUDY DESIGN: We compared rates of Z-scores ≤-2 on 18 tests of neurocognitive function and academic achievement at age 10 years in 245 children arising from twin pregnancies, 55 from triplet pregnancies, and 6 from a septuplet pregnancy to that of 568 singletons, all of whom were born before the 28th week of gestation...
November 21, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Raanan Meyer, Raoul Orvieto, Ariel Israel, Aya Mohr-Sasson, Yael Timerman, Tal Gorodesky, Shlomo Toussia-Cohen, Israel Hendler, Michal J Simchen, Ronit Machtinger
BACKGROUND: Pregnancies in the fifth and sixth decades of life have been increasing, but current data are limited regarding the outcomes of twin compared with singleton pregnancies in this age group and to twin pregnancies at younger age. OBJECTIVE: To compare obstetrical and neonatal outcomes of IVF conceived pregnancies, in twin gestations of women who were ≥45 years old at delivery to singletons at similar age and twin gestations at the age of <35 years, and to assess if the complications are mainly influenced by the very advanced maternal age or by the multifetal pregnancy...
December 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Giovanni Sisti, Mariarosaria Di Tommaso, Sara Paccosi, Astrid Parenti, Giulia Di Rienzo, Dante Campana, Steven S Witkin
PROBLEM: The influence of fetal sex on immune responses in multifetal pregnancies remains incompletely elucidated. The a2 isoform of vacuolar adenosine triphosphatase (a2V) is expressed on the cell membrane of maternal lymphoid cells and contributes to down regulation of pro-inflammatory immune responses during gestation. The association between fetal sex and a2V expression on peripheral blood mononuclear cells (PBMCs) from mothers with twin gestations was assessed. METHOD OF STUDY: Patients in this prospective study were 93 women with twin pregnancies in their mid second or early third trimester- 27 with two male, 30 with two female and 36 with one male and one female fetus...
November 12, 2018: American Journal of Reproductive Immunology: AJRI
Meabh Walsh, Linnea Bärebring, Hanna Augustin
BACKGROUND: Vitamin D status is hypothesised to play a role in gestational glucose control. No studies to date have examined vitamin D in relation to changes in blood glucose in pregnancy. Thus, the aim was to examine if vitamin D in early pregnancy and vitamin D trajectory associate with blood glucose trajectory over pregnancy in a Swedish cohort. We also investigated the relation between maternal vitamin D status and excessive fetal growth. METHODS: In 2013-2014, pregnant women were recruited to the GraviD cohort study when registering at the antenatal clinics in south-west Sweden...
October 8, 2018: Journal of Steroid Biochemistry and Molecular Biology
Hangying Lou, Fang Le, Minhao Hu, Xinyun Yang, Lejun Li, Liya Wang, Ning Wang, Huijuan Gao, Fan Jin
Given the higher risk of developing imprinting disorders in assisted reproductive technology (ART)-conceived children, we hypothesized that ART may affect DNA methylation of the insulin-like growth factor 2 (IGF2), H19, small nuclear ribonucleoprotein polypeptide N (SNRPN) differentially methylated regions (DMRs) at the fetal stage, which in turn may be associated with sperm abnormalities. A total of 4 patient groups were recruited, namely, multifetal reduction following in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI; n = 56), multifetal reduction following controlled ovarian hyperstimulation (COH; n = 42), male patients with normal semen parameters denoted as normozoospermia group (NZ) for IVF (n = 36), and male patients presenting with asthenozoospermia (OAZ) for ICSI (n = 38)...
October 1, 2018: Reproductive Sciences
Z Q Zhao, J Zhai
Objective: To evaluate the prognosis and complications after reduction of monochorionic multifetal pregnancies using bipolar umbilical cord coagulation (BCC) or radiofrequency ablation (RFA). Methods: A literature search were performed by using online databases including PubMed, Embase, and COCHRANE.The publications that described prognosis and complications after selective reduction of monochorionic twin pregnancies using either BCC or RFA for studies with clear outcome data were identified. Results: We identified five retrospective cohort studies for the meta-analysis and 231 cases of BCC and 174 cases of RFA...
September 18, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Necip Cihangir Yılanlıoglu, Altug Semiz, Resul Arisoy, Semra Kahraman, Ali Arslan Gürkan
OBJECTIVE: To review the results of fetal reduction procedures in our institution, evaluate its effects on the pregnancy outcome in terms of miscarriage, preterm delivery, taking home healthy babies and discuss the factors that may have contributed to the outcome. STUDY DESIGN: This is a retrospective study performed at the Fetal Medicine Unit of the Sisli Memorial Hospital in Istanbul after ART therapies in our unit from 2000 to 2011. RESULTS: The sample comprised 151 triplets, 35 quadruplets, 11 quintuplets, 3 twins, 1 sextuplet and 1 septuplet...
November 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Costin Berceanu, Claudia Mehedinţu, Sabina Berceanu, Nicoleta Loredana Voicu, Elvira Brătilă, Anca Maria Istrate-Ofiţeru, Dan Bogdan Navolan, Mihaela Niculescu, Florin Adrian Szasz, Răzvan Grigoraş Căpitănescu, Constantin Cristian Văduva
The incidence of multiple pregnancy has significantly increased over the past decades, reaching different statistics to double, triple, or even overcome these numerical orders globally. Zygosity and chorionicity are the key elements in the multiple pregnancy but the placentation issue should be correlated primarily with zygosity, unlike chorionicity that should be correlated with the outcome and complications of multifetal gestation. Multiple pregnancy is by itself a special maternal-fetal condition, and the monochorionic one, moreover, due to specific complications...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Osamu Motoyama, Ken Sakai, Kikuo Iitaka
A 35-year-old woman with membranoproliferative glomerulonephritis type I had quintuplet gestation after induced ovulation. Her serum creatinine level and estimated glomerular filtration rate were 0.86 mg/dL and 61.5 mL/min/1.73 m2 before pregnancy. Blood pressure was normal and urinary protein to creatinine ratio was 0.2 g/gCr. Prednisolone 10 mg on alternate-day administration was continued during pregnancy. At 10 weeks of gestation transvaginal selective embryo reduction was performed and five embryos were reduced to twins...
August 12, 2018: CEN Case Reports
Amihai Rottenstreich, Gabriel Levin, Geffen Kleinstern, Rani Haj Yahya, Misgav Rottenstreich, Simcha Yagel, Uriel Elchalal
INTRODUCTION: Previous reports have shown that suboptimal antenatal corticosteroids administration occurs in most cases. However, as multifetal gestations were either excluded or constituted a small proportion of the participants in these studies, little is known about the patterns of use of antenatal corticosteroids in twin pregnancies. MATERIAL AND METHODS: We reviewed the records of women who received antenatal corticosteroids and delivered between 240/7 and 346/7 weeks of gestation during 2015-2017 at 2 university hospitals...
August 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
Madhusudan Dey, Monica Saraswat
Background: Higher-order multiple (HOM) pregnancies are associated with increased incidences of pregnancy complications mainly abortions, pre-eclampsia, preterm delivery and fetal death. Multifetal reduction (MFR) during first trimester and subsequent delivery of twins can reduce pregnancy associated morbidities. This study was conducted to evaluate the maternal and fetal outcomes of MFR procedure in patients with HOMs those managed in a tertiary care hospital. Methods and Material: It was a prospective observational study carried out in a tertiary care military hospital, India, and all women with higher-order multiples (triplets or more) conceived spontaneously or after infertility treatment (ovulation induction, intra-uterine insemination, or in vitro fertilization) during the 3-year period from Jan 2014 to Dec 2016 were included for MFR...
August 2018: Journal of Obstetrics and Gynaecology of India
(no author information available yet)
Low-dose aspirin has been used during pregnancy, most commonly to prevent or delay the onset of preeclampsia. The American College of Obstetricians and Gynecologists issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin beginning in the late first trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks of gestation, or for women with more than one prior pregnancy complicated by preeclampsia. The U.S. Preventive Services Task Force published a similar guideline, although the list of indications for low-dose aspirin use was more expansive...
July 2018: Obstetrics and Gynecology
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