23 results on '"Fetal Loss"'
Search Results
2. Cordocentesis‐associated fetal loss and risk factors: single‐center experience with 6650 cases.
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Tanvisut, R., Wanapirak, C., Piyamongkol, W., Sirichotiyakul, S., Tongprasert, F., Srisupundit, K., Luewan, S., Traisrisilp, K., Jatavan, P., and Tongsong, T.
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FETAL anoxia , *PREGNANCY outcomes , *ABORTION , *CHORIONIC villus sampling , *FETAL growth retardation , *INSTITUTIONAL review boards - Published
- 2020
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3. Increased nuchal translucency at 11-13 weeks' gestation and outcome in twin pregnancy.
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Cimpoca, B., Syngelaki, A., Litwinska, E., Muzaferovic, A., and Nicolaides, K. H.
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FETOFETAL transfusion , *FETOSCOPY , *PREGNANCY , *LASER endoscopy , *PREGNANCY tests , *FETAL abnormalities , *FETAL development , *RESEARCH , *FIRST trimester of pregnancy , *RESEARCH methodology , *DISEASE incidence , *RETROSPECTIVE studies , *MEDICAL cooperation , *EVALUATION research , *RISK assessment , *FETAL diseases , *PREGNANCY outcomes , *COMPARATIVE studies , *RESEARCH funding , *MULTIPLE pregnancy , *FETAL ultrasonic imaging , *LONGITUDINAL method - Abstract
Objective: To investigate the value of increased fetal nuchal translucency thickness (NT) at the 11-13-week scan in the prediction of adverse outcome in dichorionic (DC), monochorionic diamniotic (MCDA) and monochorionic monoamniotic (MCMA) twin pregnancies.Methods: This was a retrospective analysis of prospectively collected data on twin pregnancies undergoing routine ultrasound examination at 11-13 weeks' gestation between 2002 and 2019. In pregnancies with no major defects or chromosomal abnormalities, we examined the value of increased NT ≥ 95th percentile in one or both fetuses in the prediction of, first, miscarriage or death of one or both fetuses at < 20 and < 24 weeks' gestation in DC, MCDA and MCMA twin pregnancies, second, death of one or both fetuses or neonates at ≥ 24 weeks in DC, MCDA and MCMA twin pregnancies, third, development of twin-twin transfusion syndrome (TTTS) or selective fetal growth restriction (sFGR) treated by endoscopic laser surgery at < 20 and ≥ 20 weeks' gestation in MCDA pregnancies, and, fourth, either fetal loss or laser surgery at < 20 weeks' gestation in MCDA pregnancies.Results: The study population of 6225 twin pregnancies included 4896 (78.7%) DC, 1274 (20.5%) MCDA and 55 (0.9%) MCMA pregnancies. The incidence of NT ≥ 95th percentile in one or both fetuses in DC twin pregnancies was 8.3%; in MCDA twins the incidence was significantly higher (10.4%; P = 0.016), but in MCMA twins it was not significantly different (9.1%; P = 0.804) from that in DC twins. In DC twin pregnancies, the incidence of high NT was not significantly different between those with two survivors and those with adverse outcome. In MCMA twin pregnancies, the number of cases was too small for meaningful assessment of the relationship between high NT and adverse outcome. In MCDA twin pregnancies with at least one fetal death or need for endoscopic laser surgery at < 20 weeks' gestation, the incidence of NT ≥ 95th percentile was significantly higher than in those with two survivors (23.5% vs 9.8%; P < 0.0001). Kaplan-Meier analysis in MCDA twin pregnancies showed that, in those with NT ≥ 95th percentile, there was significantly lower survival at < 20 weeks' gestation than in those with NT < 95th percentile (P = 0.001); this was not the case for survival at ≥ 20 weeks (P = 0.960). The performance of screening by fetal NT ≥ 95th percentile for prediction of either fetal loss or need for endoscopic laser surgery at < 20 weeks' gestation was poor, with a detection rate of 23.5% at a false-positive rate of 8.9%, and the relative risk, in comparison to fetal NT < 95th percentile, was 2.640 (95% CI, 1.854-3.758; P < 0.0001). In MCDA twin pregnancies, the overall rate of fetal loss or need for laser surgery at < 20 weeks' gestation was 10.7% but, in the subgroups with NT ≥ 95th and NT ≥ 99th percentiles, which constituted 10.4% and 3.3% of the total, the rates increased to 24.1% and 40.5%, respectively.Conclusions: In MCDA twin pregnancies with no major fetal abnormalities, measurement of NT at the 11-13-week scan is a poor screening test for adverse pregnancy outcome. However, the finding in one or both fetuses of NT ≥ 95th percentile, and more so ≥ 99th percentile, is associated with a substantially increased risk of fetal loss or need for endoscopic laser surgery at < 20 weeks' gestation. The extent to which closer monitoring and earlier intervention in the high-risk group can reduce these complications remains to be determined. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR] more...- Published
- 2020
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4. Intertwin discordance in fetal size at 11-13 weeks' gestation and pregnancy outcome.
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Litwinska, E., Syngelaki, A., Cimpoca, B., Sapantzoglou, I., and Nicolaides, K. H.
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PREGNANCY , *LASER endoscopy , *CHILDBIRTH , *PREGNANCY tests , *PREMATURE labor , *RESEARCH , *PREMATURE infants , *RESEARCH methodology , *FETAL development , *TWINS , *RETROSPECTIVE studies , *GESTATIONAL age , *MEDICAL cooperation , *EVALUATION research , *PREGNANCY outcomes , *RISK assessment , *PERINATAL death , *COMPARATIVE studies , *BIRTH weight , *RESEARCH funding , *MULTIPLE pregnancy , *FETAL ultrasonic imaging , *SMALL for gestational age , *LONGITUDINAL method - Abstract
Objective: To investigate the value of intertwin discordance in fetal crown-rump length (CRL) at the 11-13-week scan in the prediction of adverse outcome in dichorionic (DC), monochorionic diamniotic (MCDA) and monochorionic monoamniotic (MCMA) twin pregnancies.Methods: This was a retrospective analysis of prospectively collected data on twin pregnancies undergoing routine ultrasound examination at 11-13 weeks' gestation between 2002 and 2019. In pregnancies with no major abnormalities, we examined the value of intertwin discordance in fetal CRL in DC, MCDA and MCMA twins in the prediction of fetal loss at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm delivery at < 32 and < 37 weeks, birth of at least one small-for-gestational-age (SGA) neonate with birth weight < 5th percentile and intertwin birth-weight discordance of ≥ 20% and ≥ 25%.Results: First, the study population of 6225 twin pregnancies included 4896 (78.7%) DC, 1274 (20.4%) MCDA and 55 (0.9%) MCMA twin pregnancies. Second, median CRL discordance in DC twin pregnancies (3.2%; interquartile range (IQR), 1.4-5.8%) was lower than in MCDA twins (3.6%; IQR, 1.6-6.2%; P = 0.0008), but was not significantly different from that in MCMA twins (2.9%; IQR, 1.2-5.1%; P = 0.269). Third, compared to CRL discordance in DC twin pregnancies with two non-SGA live births at ≥ 37 weeks' gestation, there was significantly larger CRL discordance in both DC and MCDA twin pregnancies complicated by fetal death at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm birth at < 32 and < 37 weeks, birth of at least one SGA neonate and birth-weight discordance ≥ 20% and ≥ 25%, and in MCDA twin pregnancies undergoing endoscopic laser surgery. Fourth, the predictive performance of CRL discordance for each adverse pregnancy outcome was poor, with areas under the receiver-operating-characteristics curves ranging from 0.533 to 0.624. However, in both DC and MCDA twin pregnancies with large CRL discordance, there was a high risk of fetal loss. Fifth, in DC twin pregnancies, the overall rate of fetal loss at < 20 weeks' gestation was 1.3% but, in the small subgroup with CRL discordance of ≥ 15%, which constituted 1.9% of the total, the rate increased to 5.3%. Sixth, in MCDA twin pregnancies, the rate of fetal loss or endoscopic laser surgery at < 20 weeks was about 11%, but, in the small subgroups with CRL discordance of ≥ 10%, ≥ 15% and ≥ 20%, which constituted 9%, < 3% and < 1% of the total, the risk was increased to about 32%, 49% and 70%, respectively. Seventh, in MCMA twin pregnancies, there were no significant differences in CRL discordance for any of the adverse outcome measures, but this may be the consequence of the small number of cases in the study population.Conclusions: In both DC and MCDA twin pregnancies, increased CRL discordance is associated with an increased risk of fetal death at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm birth at < 37 and < 32 weeks, birth of at least one SGA neonate and birth-weight discordance ≥ 20% and ≥ 25%, but CRL discordance is a poor screening test for adverse pregnancy outcome. However, in DC twins, CRL discordance of ≥ 15% is associated with an increased risk of fetal loss at < 20 and < 24 weeks' gestation and, in MCDA twins, CRL discordance of ≥ 10%, and more so discordance of ≥ 15% and ≥ 20%, is associated with a very high risk of fetal loss or endoscopic laser surgery at < 20 and < 24 weeks and this information is useful in counseling women and defining the timing for subsequent assessment and possible intervention. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR] more...- Published
- 2020
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5. Risk of miscarriage following amniocentesis or chorionic villus sampling: systematic review of literature and updated meta-analysis.
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Salomon, L. J., Sotiriadis, A., Wulff, C. B., Odibo, A., and Akolekar, R.
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CHORIONIC villus sampling , *META-analysis , *MISCARRIAGE , *AMNIOCENTESIS - Abstract
Objective: To estimate the procedure-related risk of miscarriage after amniocentesis and chorionic villus sampling (CVS) based on a systematic review of the literature and an updated meta-analysis.Methods: A search of MEDLINE, EMBASE and The Cochrane Library was carried out to identify studies reporting complications following CVS or amniocentesis. Eligible for inclusion were large controlled studies reporting data for pregnancy loss prior to 24 weeks' gestation. Study authors were contacted when required to identify additional necessary data. Data for cases that had an invasive procedure and controls were inputted into contingency tables and the risk of miscarriage was estimated for each study. Summary statistics based on a random-effects model were calculated after taking into account the weighting for each study included in the systematic review. Procedure-related risk of miscarriage was estimated as a weighted risk difference from the summary statistics for cases and controls. Subgroup analyses were performed according to the similarity in risk levels for chromosomal abnormality between the invasive-testing and control groups. Heterogeneity was assessed using the I2 statistic. Egger's bias was estimated to assess reporting bias in published studies.Results: The electronic search yielded 2943 potential citations, from which 12 controlled studies for amniocentesis and seven for CVS were selected for inclusion in the systematic review. A total of 580 miscarriages occurred following 63 723 amniocentesis procedures, resulting in a weighted risk of pregnancy loss of 0.91% (95% CI, 0.73-1.09%). In the control group, there were 1726 miscarriages in 330 469 pregnancies with a loss rate of 0.58% (95% CI, 0.47-0.70%). The weighted procedure-related risk of miscarriage following amniocentesis was 0.30% (95% CI, 0.11-0.49%; I2 = 70.1%). A total of 163 miscarriages occurred following 13 011 CVS procedures, resulting in a risk of pregnancy loss of 1.39% (95% CI, 0.76-2.02%). In the control group, there were 1946 miscarriages in 232 680 pregnancies with a loss rate of 1.23% (95% CI, 0.86-1.59%). The weighted procedure-related risk of miscarriage following CVS was 0.20% (95% CI, -0.13 to 0.52%; I2 = 52.7%). However, when studies including only women with similar risk profiles for chromosomal abnormality in the intervention and control groups were considered, the procedure-related risk for amniocentesis was 0.12% (95% CI, -0.05 to 0.30%; I2 = 44.1%) and for CVS it was -0.11% (95% CI, -0.29 to 0.08%; I2 = 0%).Conclusions: The procedure-related risks of miscarriage following amniocentesis and CVS are lower than currently quoted to women. The risk appears to be negligible when these interventions were compared to control groups of the same risk profile. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR] more...- Published
- 2019
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6. Influence of chorionicity and gestational age at single fetal loss on risk of preterm birth in twin pregnancy: analysis of STORK multiple pregnancy cohort.
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D'antonio, F., Thilaganathan, B., Dias, T., Khalil, A., and Southwest Thames Obstetric Research Collaborative (STORK)
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CHORION , *FETAL ultrasonic imaging , *GESTATIONAL age , *PREMATURE infants , *MISCARRIAGE , *MULTIPLE pregnancy , *PERINATAL death , *REFERENCE values , *TWINS , *DISEASE incidence , *RETROSPECTIVE studies - Abstract
Objective: Single intrauterine death (sIUD) in twin pregnancy is associated with a significant risk of cotwin demise and preterm birth (PTB), especially in monochorionic (MC) twins. However, it is yet to be established whether the gestational age at loss may influence the pregnancy outcome. The aim of this study was to explore the risk of PTB according to the gestational age at diagnosis of sIUD.Methods: This was a cohort study of all twin pregnancies booked for antenatal care in a large regional network of nine hospitals over a 10-year period. Ultrasound data were matched to hospital delivery records and to a mandatory national register for stillbirth and neonatal loss provided by the Centre for Maternal and Child Enquires. Cases with double fetal loss at the time of the scan and cases of sIUD occurring at or after 34 weeks of gestation were not included in the analysis. The relative risk (RR) of PTB at < 34, < 32 and < 28 weeks of gestation in twin pregnancies complicated by sIUD was assessed and compared with that in twin pregnancies without fetal loss. The risk of PTB at < 34 weeks was stratified according to the gestational age at diagnosis of sIUD. The risk of PTB in twin pregnancy after sIUD according to the gestational age at death was also explored.Results: The analysis included 3013 twin gestations (2469 dichorionic (DC) and 544 MC). Median gestational age at birth was lower in the pregnancies complicated by sIUD compared with those that were not (32.0 weeks: interquartile range (IQR), 29.0-34.3 weeks vs 36.7 weeks: IQR, 35.0-37.6; P < 0.001) and this difference persisted when stratifying the data according to chorionicity (P < 0.0001 for both MC and DC pregnancies). The risk of PTB at < 34 weeks (RR, 4.3 (95% CI, 3.5-5.2)), < 32 weeks (RR, 6.1 (95% CI, 4.6-8.1)) and < 28 weeks (RR, 12.4 (95% CI, 6.9-22.2)) of gestation was higher in pregnancies complicated by sIUD compared with those which did not experience fetal loss. This association was observed both in MC and DC twin gestations. When compared with DC pregnancies, MC twins affected by sIUD were not at significantly increased risk of PTB before either 34, 32 or 28 weeks of gestation. The risk of PTB at < 34 weeks of gestation was higher when the sIUD occurred at a later gestational age (chi-square test for trend, P < 0.001).Conclusions: Twin pregnancies complicated by sIUD, regardless of the chorionicity, have a significantly higher risk of PTB at < 34, < 32 and < 28 weeks of gestation. The risk of PTB at < 34 weeks of gestation was higher when the sIUD occurred in the second half of the pregnancy. Large prospective multicenter studies with shared protocols for prenatal management are needed to ascertain the actual risk of spontaneous PTB in twin pregnancies affected by sIUD. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR] more...- Published
- 2017
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7. Total pregnancy loss after chorionic villus sampling and amniocentesis: a cohort study.
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Bakker, M., Birnie, E., Robles de Medina, P., Sollie, K. M., Pajkrt, E., and Bilardo, C. M.
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CHORIONIC villus sampling , *AMNIOCENTESIS , *GESTATIONAL age , *FIRST trimester of pregnancy , *ULTRASONIC imaging , *CLINICAL competence , *COMPARATIVE studies , *DATABASES , *LONGITUDINAL method , *RESEARCH methodology , *EVALUATION of medical care , *MEDICAL cooperation , *PERINATAL death , *PREGNANCY , *RESEARCH , *EVALUATION research , *RETROSPECTIVE studies - Abstract
Objectives: To identify maternal-, operator- and procedure-related variables that affect procedure-related pregnancy loss after transcervical (TC) and transabdominal (TA) chorionic villus sampling (CVS) and amniocentesis and to estimate the rates of spontaneous and procedure-related loss in comparable subgroups of women.Methods: This was a retrospective cohort study conducted at the University Medical Center Groningen and the Academic Medical Center, The Netherlands. Databases of both centers were searched to identify singleton pregnancies that had undergone a combined test and/or anomaly scan at around 20 weeks' gestation, or an invasive procedure (CVS and/or amniocentesis) between January 2001 and December 2011. Maternal characteristics, obstetric history, technical aspects of the invasive procedure, ultrasound examinations and fetal and neonatal outcomes were available for 29 201 cases. Women were categorized, according to the type of examination they had received, into the following five groups: first-trimester combined test (and 20-week anomaly scan); 20-week anomaly scan only; CVS; amniocentesis; amniocentesis after unsuccessful CVS. Rates of fetal loss were compared between groups.Results: Variables significantly associated with a higher rate of fetal loss were, for CVS, repeat attempts during the procedure, use of TC cannula instead of biopsy forceps, gestational age at procedure ≥ 13 weeks and a pregnancy after assisted reproductive techniques, and, for amniocentesis, if indication was fetal anomaly or family history of anomalies and repeat attempts during the procedure. In women aged ≥ 36 years who did not undergo an invasive procedure, spontaneous fetal loss rate (FLR) after first-trimester combined test was 1.40%, whereas after CVS, FLR was 2.76% and 2.43% for a TC and TA approach, respectively. The additional risk of fetal loss with TC-CVS was therefore 1.36% (1 : 74), which varied according to the instrument used (0.27% for forceps and 3.12% for cannula), and with TA-CVS was 1.03% (1 : 97). In women aged ≥ 36 years who underwent a 20-week anomaly scan only, spontaneous FLR was 0.63%. In women who underwent amniocentesis solely because of advanced maternal age, FLR was 1.11%. The additional risk of fetal loss with amniocentesis was 0.48% (1 : 208).Conclusion: The total rate of procedure-related fetal loss after TA- and TC-CVS and amniocentesis appears lower than the risks on which women are currently counseled. There was a trend for a decrease in risk when the level of experience of the operator increased. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR] more...- Published
- 2017
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8. Risk of fetal loss associated with invasive testing following combined first-trimester screening for Down syndrome: a national cohort of 147,987 singleton pregnancies.
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Wulff, C. B., Gerds, T. A., Rode, L., Ekelund, C. K., Petersen, O. B., Tabor, A., Zingenberg, H., Jørgensen, F. S., Sundberg, K., Shalmi, A. ‐C., Näslund Thagaard, I., Skibsted, L., Fabricius, M., Sperling, L., Mogensen, H., Ibsen, M., Brendstrup, L., Jensen, H. S., Kamper, C. H., and Vase, L. more...
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DOWN syndrome , *COHORT analysis , *FIRST trimester of pregnancy , *CHORIONIC villus sampling , *MEDICAL databases , *DIAGNOSIS of Down syndrome , *AMNIOCENTESIS , *CHORIONIC gonadotropins , *FETAL ultrasonic imaging , *LONGITUDINAL method , *MISCARRIAGE , *PERINATAL death , *PREGNANCY proteins , *PROBABILITY theory , *RELATIVE medical risk , *RETROSPECTIVE studies , *CASE-control method , *METABOLISM , *DIAGNOSIS - Abstract
Objective: To assess prospectively the risk of fetal loss associated with chorionic villus sampling (CVS) and amniocentesis (AC) following combined first-trimester screening (cFTS) for Down syndrome.Methods: This was a nationwide population-based study (Danish Fetal Medicine Database, 2008-2010) including 147,987 women with singleton pregnancy who underwent cFTS. Propensity score stratification was used to assess the risk of fetal loss with and without invasive testing. Analyses were performed between 3 and 21 days after cFTS for CVS and between 28 and 42 days after cFTS for AC. Results are reported as average risk differences with 95% CIs.Results: The risks of miscarriage and stillbirth were not higher in women exposed to CVS or AC compared with unexposed women, independent of the analysis time-point. The average effect of CVS on risk of miscarriage was -0.08% (95% CI, -0.64; 0.47) at 3 days and -0.21% (95% CI, -0.58; 0.15) at 21 days after cFTS, while the effect on risk of stillbirth was -0.18% (95% CI, -0.50; 0.13) at 3 days and -0.27% (95% CI, -0.58; 0.04) at 21 days after cFTS. Regarding the effect of AC on risk of miscarriage, the analysis at 28 days after cFTS showed an average effect of 0.56% (95% CI, -0.21; 1.33), while the effect on risk of stillbirth was 0.09% (95% CI, -0.39; 0.58) at 42 days after cFTS.Conclusion: Neither CVS nor AC was associated with increased risk of miscarriage or stillbirth. These findings indicate that the procedure-related risk of CVS and AC is very low. [ABSTRACT FROM AUTHOR] more...- Published
- 2016
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9. Crown−rump length discordance in the first trimester: a predictor of adverse outcome in twin pregnancies?
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Johansen, M. L., Oldenburg, A., Rosthøj, S., Maxild, J. Cohn, Rode, L., and Tabor, A.
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FIRST trimester of pregnancy , *FETUS , *MULTIPLE pregnancy , *BIRTH weight , *PREMATURE labor - Abstract
ABSTRACT Objectives To evaluate the usefulness of first-trimester crown−rump length ( CRL) discordance in predicting adverse outcome in twin pregnancies. Methods This retrospective study included a large cohort retrieved from local ultrasound databases at 14 obstetric departments in Denmark, comprising all twin pregnancies with two live fetuses scanned between 11 and 14 weeks' gestation during the period 1 January 2004 to 31 December 2006. The association between CRL discordance ≥ 10 % and adverse outcome was evaluated. Results Among 1993 twin pregnancies, 1733 were dichorionic (156 (9%) discordant; 1577 (91%) concordant) and 260 were monochorionic (32 (12%) discordant; 228 (88%) concordant). In dichorionic twin pregnancies we found an association between CRL discordance ≥ 10% and preterm delivery before 34 weeks' gestation (P = 0.007), birth weight discordance (P = 0.001) and mean birth weight (P = 0.033). In monochorionic twin pregnancies we found an association between CRL discordance ≥ 10% and birth weight discordance (P = 0.02) and mean birth weight (P = 0.03). To evaluate CRL discordance as a predictor of fetal loss and preterm delivery before 34 weeks' gestation, receiver−operating characteristics curves were created for each outcome. For CRL discordance ≥ 10% as a predictor of fetal loss and preterm delivery in dichorionic twin pregnancies, sensitivity was 0.17 (95% CI, 0.06−0.28) and 0.14 (95% CI, 0.10−0.18), respectively, and in monochorionic twin pregnancies it was 0.10 (95% CI, 0.03−0.22) and 0.16 (95% CI, 0.06−0.26), respectively. Conclusions CRL discordance in twin pregnancies is associated with, but is not a strong predictor of, adverse outcome. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd [ABSTRACT FROM AUTHOR] more...
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- 2014
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10. Early fetal loss in monochorionic and dichorionic twin pregnancies: analysis of the Southwest Thames Obstetric Research Collaborative ( STORK) multiple pregnancy cohort.
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D'Antonio, F., Khalil, A., Dias, T., Thilaganathan, B., Bahamie, Arash, Bhide, Amar, Breeze, Andrew, Deans, Anne, Egbor, Michael, Ellis, Cheryl, Gandhi, Hina, Hamid, Rosol, Hutt, Renata, Matiluko, Adetunji, Pakarian, Faz, Papageorghiou, Aris, and Peregrine, Elisabeth more...
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FETAL death , *TWINS , *PREGNANCY , *RETROSPECTIVE studies , *MISCARRIAGE , *NEONATAL death - Abstract
ABSTRACT Objectives Monochorionic ( MC) twins are at increased risk of early fetal loss secondary to vascular complications such as twin-twin transfusion syndrome ( TTTS). This study compared the early perinatal loss rates between MC and dichorionic ( DC) twins in an era of invasive treatment for TTTS. METHODS This was a retrospective study of all twin pregnancies of known chorionicity from a large regional cohort of nine hospitals over a 10-year period. Ultrasound data were matched to hospital delivery records and to a mandatory national register of pregnancy losses. Prospective risk of pregnancy loss from 14 to 24 weeks' gestation was calculated and the survival trend of MC and DC twins was analyzed using Kaplan-Meier survival analysis. Results The analysis included 3117 twin pregnancies (605 MC and 2512 DC). The total risk of early pregnancy loss (miscarriage and neonatal death) before 24 weeks was significantly higher in MC twins (60.3 per 1000 fetuses) than in DC twins (6.6 per 1000 fetuses), with a relative risk of 9.18 (95% CI, 6.0-13.9). Survival analysis showed a significant difference in overall and early mortality between MC and DC twins (log-rank test, P < 0.0001), while no difference was noted after 24 weeks' gestation (log-rank test, P = 0.08). Conclusions Early pregnancy loss is significantly more common in MC than in DC twins, but no difference in the prospective risk of mortality between MC and DC twins is evident after 24 weeks' gestation. The observed early mortality rate has almost halved in comparison with previous studies in the published literature. Early detection and prompt treatment of complications in MC twins are likely to have contributed to this improvement in outcome. Copyright © 2012 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR] more...
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- 2013
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11. OP06.08: Prediction of single and double fetal loss by discordancy in CRL, NT and AC at the 11 +0 –13 +6 week scan in dichorionic and monochorionic twin pregnancies
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V. Acharya, M. Kunapareddy, R. Sahana, A. Shettikeri, and P. Radhakrishnan
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medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,Obstetrics ,business.industry ,medicine ,Obstetrics and Gynecology ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Fetal loss ,business - Published
- 2021
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12. Naturally conceived twins with monochorionic placentation have the highest risk of fetal loss.
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Sperling, L., Kiil, C., Larsen, L. U., Qvist, I., Schwartz, M., Jørgensen, C., Skajaa, K., Bang, J., and Tabor, A.
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PERINATAL death , *DISEASES in twins , *PREGNANCY complications , *PREMATURE labor , *INFANT mortality , *MULTIPLE pregnancy , *MISCARRIAGE , *DIAGNOSTIC ultrasonic imaging - Abstract
Objective The aim of this study was to estimate the rate of fetal loss in dichorionic (DC) and monochorionic (MC) twin pregnancies stratified according to zygosity and method of conception. Methods In a prospective multicenter observational study women with a twin pregnancy had an ultrasound scan before 14 + 6 weeks' gestation in order to determine chorionicity. The fetal loss rate, the perinatal, neonatal and infant mortality rates and the frequency of very preterm labor were estimated for the different types of twin. Results Among the 495 pregnancies (421 DC and 74 MC) 229 (46%) were conceived naturally and 266 (54%) by assisted reproduction (AR). Outcome data for 945 liveborn babies were obtained. The spontaneous miscarriage rate before 24 weeks' gestation was 10.9% (7⁄64) among naturally conceived MC compared to 3.0% (5⁄165) for naturally conceived DC twins (P < 0.05). For twins conceived by AR the corresponding figures were 0% (0⁄10) and 0.4% (1⁄256). The odds ratio (OR) for very preterm birth—before 28 weeks' gestation—was 4.2 for MC twins compared to DC twins. The relative risk of fetal loss or death among DC twins was 20% of the risk for DC twins. Conclusion The risk of fetal loss, very preterm delivery and neonatal/infant death is significantly higher among twins with MC compared to DC placentation. Twins conceived by AR have a much lower risk of MC placentation. The risk of losing one or both twins seems higher among naturally conceived twins compared to twins conceived by AR, despite the fact that the maternal age was higher among the mothers of the AR twins. [ABSTRACT FROM AUTHOR] more...
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- 2006
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13. Fetal loss following ultrasound diagnosis of a live fetus at 6-10 weeks of gestation.
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Makrydimas, G., Sebire, N. J., Lolis, D., Vlassis, N., and Nicolaides, K. H.
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PREGNANCY , *FETUS , *ULTRASONIC imaging , *HEART beat , *CIGARETTE smokers , *DIAGNOSIS - Abstract
Objective To examine prospectively the value of demographic characteristics and ultrasound findings in the prediction of subsequent fetal loss in pregnancies with live fetuses at 6–10 weeks of gestation. Methods Transvaginal ultrasound examination was performed in 866 pregnancies at 6–10 weeks of gestation. The relation of demographic data and ultrasound findings at the time of the initial assessment to subsequent fetal loss was examined. Results In the 668 singleton pregnancies with live fetuses and complete follow-up there were 50 (7.5%) fetal losses. The incidence of fetal loss increased significantly with maternal age and decreased with gestation. In the pregnancies resulting in fetal loss, compared to those with live births, the incidence of vaginal bleeding and cigarette smoking was higher, the fetal heart rate was significantly lower and the gestation sac diameter was smaller but the yolk sac diameter was not significantly different. Conclusion In pregnancies with a live fetus at 6–10 weeks' gestation the rate of subsequent fetal loss is related to maternal age, gestation, cigarette smoking, history of vaginal bleeding and the ultrasound findings of small gestation sac diameter and fetal bradycardia, relative to crown—rump length. [ABSTRACT FROM AUTHOR] more...
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- 2003
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14. P20.10: Risk of fetal loss in pregnancies undergoing mid-trimester amniocentesis after inconclusive chorionic villus sampling
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Francesca Romana Grati, Paolo Volpe, Nicola Persico, Mattia Gentile, Ginevra Salsi, Giuseppe Simoni, F. Bellussi, T. Fanelli, M. Orsi, Eva Pompilii, Francesco D'Ambrosi, Gianluigi Pilu, G. Rembouskos, and Federico Maggi more...
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,Obstetrics ,business.industry ,Obstetrics and Gynecology ,Chorionic villus sampling ,General Medicine ,Reproductive Medicine ,medicine ,Amniocentesis ,Mid trimester ,Radiology, Nuclear Medicine and imaging ,Fetal loss ,business - Published
- 2018
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15. OP11.08: The influence of chorionicity on miscarriage and fetal loss in triplet pregnancies
- Author
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Baskaran Thilaganathan, Aris T. Papageorghiou, Amar Bhide, Asma Khalil, and Francesco D'Antonio
- Subjects
medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Fetal loss ,business ,medicine.disease ,Miscarriage - Published
- 2014
- Full Text
- View/download PDF
16. P01.08: Risk factors associated to fetal loss after chorionic villus sampling
- Author
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Elena Contro, A. Piastra, Gianluigi Pilu, Tullio Ghi, Nicola Rizzo, R. Pini, Ginevra Salsi, M. Di Giovanni, Sandro Gabrielli, G. Pacella, L. Cariello, Elisa Montaguti, I. Cataneo, and F. Bellussi
- Subjects
Andrology ,Reproductive Medicine ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Medicine ,Chorionic villus sampling ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Fetal loss ,business - Published
- 2014
- Full Text
- View/download PDF
17. OC23.03: The influence of gestational age at loss on preterm birth and co-twin death after single fetal loss in twin pregnancies: The STORK multiple pregnancy cohort
- Author
-
T. D. Dias, Asma Khalil, Amar Bhide, Aris T. Papageorghiou, Francesco D'Antonio, and Baskaran Thilaganathan
- Subjects
Pregnancy ,medicine.medical_specialty ,Radiological and Ultrasound Technology ,biology ,Obstetrics ,business.industry ,Obstetrics and Gynecology ,Gestational age ,General Medicine ,Stork ,medicine.disease ,biology.organism_classification ,Reproductive Medicine ,Cohort ,medicine ,Radiology, Nuclear Medicine and imaging ,Fetal loss ,business - Published
- 2014
- Full Text
- View/download PDF
18. P19.04: Spontaneous fetal loss throughout gestation in singleton, twin and triplet pregnancies
- Author
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Y. Uhm, Sangmoon Lee, Suhnggwon Kim, Jinseon Lee, J. K. Jun, Byung-Woo Yoon, Jisuk Park, and Junghoan Park
- Subjects
medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Singleton ,Obstetrics ,Obstetrics and Gynecology ,Medicine ,Gestation ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Fetal loss ,business - Published
- 2014
- Full Text
- View/download PDF
19. OP31.03: Trends in fetal loss following second trimester amniocentesis - what women need to know
- Author
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A. J. Thomson, P. Tripathi, M. Patel, G. Thomas, W. M. Hair, and P. Khanolkar
- Subjects
medicine.medical_specialty ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,General Medicine ,Reproductive Medicine ,Second trimester ,Need to know ,Amniocentesis ,medicine ,Radiology, Nuclear Medicine and imaging ,Fetal loss ,business - Published
- 2009
- Full Text
- View/download PDF
20. OC22.01: Embryonic growth discordance and early fetal loss in twins: the STORK multiple pregnancy cohort
- Author
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Baskaran Thilaganathan, Asma Khalil, E. Mantovani, and Francesco D'Antonio
- Subjects
medicine.medical_specialty ,Pregnancy ,Radiological and Ultrasound Technology ,biology ,Obstetrics ,business.industry ,Embryogenesis ,Obstetrics and Gynecology ,General Medicine ,Stork ,medicine.disease ,biology.organism_classification ,Endocrinology ,Reproductive Medicine ,Internal medicine ,Cohort ,medicine ,Radiology, Nuclear Medicine and imaging ,Fetal loss ,business - Published
- 2013
- Full Text
- View/download PDF
21. P09.01: Amniocentesis and the risk of second trimester fetal loss in twin pregnancies: results from a prospective observational study
- Author
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J. Bello-Muñoz, Lluis Cabero, N. Campos, J. Sagala Martin, María Ángeles Sánchez-Durán, and N. Lenis Cordoba
- Subjects
medicine.medical_specialty ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,General Medicine ,Reproductive Medicine ,Second trimester ,Amniocentesis ,Medicine ,Radiology, Nuclear Medicine and imaging ,Observational study ,Fetal loss ,business - Published
- 2012
- Full Text
- View/download PDF
22. P20.08: Ultrasonographic findings among transferred intrauterine fetal loss
- Author
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Tark Kim, Sochung Chung, Hyeok-Gyu Lee, Sung Yul Lee, and Wooseok Lee
- Subjects
medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,Obstetrics ,business.industry ,medicine ,Obstetrics and Gynecology ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Fetal loss ,business - Published
- 2012
- Full Text
- View/download PDF
23. OC02.06: Repeated invasive procedures for prenatal diagnosis. What is the total fetal loss?
- Author
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K. Blanas, Spyros Mesogitis, V. Maritsa, N. Papantoniou, Georgios Daskalakis, Marianna Theodora, and Aristidis Antsaklis
- Subjects
medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Prenatal diagnosis ,General Medicine ,Fetal loss ,business - Published
- 2011
- Full Text
- View/download PDF
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