Search

Your search keyword '"Discordant malformation"' showing total 3 results
Start Over Descriptor "Discordant malformation" Topic pregnancy
3 results on '"Discordant malformation"'

1. Expectant management in di-chorionic pregnancies complicated by discordant anomalous twin.

Author

Algeri, Paola, Russo, Francesca M., Incerti, Maddalena, Cozzolino, Sabrina, Pelizzoni, Francesca, Montanelli, Luca, Locatelli, Luca, Vergani, Patrizia, and Bernasconi, Davido P.

Subjects
*FETAL abnormalities, *ABORTION, *FETAL growth retardation, *LONGITUDINAL method, *EVALUATION of medical care, *MULTIPLE pregnancy, *PERINATAL death, *PREECLAMPSIA, *PREGNANCY, *TREATMENT effectiveness, *RETROSPECTIVE studies, *THERAPEUTICS
Abstract

Fetal malformations are more frequent in twins than in singletons. The aim of our study was to define the influence of a malformed twin on di-chorionic pregnancy outcomes. We performed a retrospective cohort study of di-chorionic pregnancies delivered between 2000 and 2015. Exclusion criteria were: both twins affected by fetal malformations, double intra-uterine fetal death in pregnancies without fetal malformation, selective feticide and therapeutic pregnancy termination. We compared maternal and fetal outcomes of di-chorionic pregnancies not complicated by fetal malformations with pregnancies affected by a single malformed fetus with conservative management. We included 642 di-chorionic pregnancies: 56 (case group, 8.7%) with one twin affected by a malformation (20 minor, 36 major ones), 586 (control group, 91.3%) without fetal malformation. No differences were found on maternal and not malformed co-twin outcomes when compared to pregnancies with no malformation; case vs control group presented similar rates of preeclampsia (8.9% vs. 10.8%, respectively), intrauterine growth restriction (7.1% vs. 9.4%) and composite adverse neonatal outcomes (19.6% vs. 15.1%). No case of fetal death in not malformed co-twin was reported. Expectant management could be a safe option for both mother and co-twin in case of di-chorionic twin pregnancy complicated by only one malformed fetus. [ABSTRACT FROM AUTHOR]

Published
2018
Full Text
View/download PDF

2. Risk Factors Associated with Preterm Prelabor Rupture of Membranes after Cord Occlusion in Monochorionic Diamniotic Twins

Author

J. M. Martinez-Crespo, Elisenda Eixarch, X. Torres, Jan Deprest, Mar Bennasar, Eduard Gratacós, and T. Micheletti

Subjects
Embryology, medicine.medical_specialty, Discordant malformation, Context (language use), Twin reversed arterial perfusion, Prom, Twin-to-twin transfusion syndrome, Selective fetal growth restriction, Pregnancy, Risk Factors, Monochorionic diamniotic twins, Medicine, Rupture of membranes, Humans, Radiology, Nuclear Medicine and imaging, Retrospective Studies, Preterm prelabor rupture of membranes, Fetus, Univariate analysis, business.industry, Obstetrics, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Infant, Retrospective cohort study, General Medicine, Fetofetal Transfusion, Twins, Monozygotic, medicine.disease, Pediatrics, Perinatology and Child Health, Pregnancy, Twin, Premature Birth, Female, business, Cord occlusion
Abstract

Introduction: Preterm prelabor rupture of membranes (PPROM) is a common complication after fetal surgeries. The aim of this study was to assess risk factors for and outcomes after PPROM following cord occlusion (CO) in monochorionic diamniotic (MCDA) pregnancies. Methods: This was a retrospective cohort study of 188 consecutive MCDA pregnancies treated by bipolar or laser CO, either primarily because of discordant malformation (dMF) or severe selective fetal growth restriction (sFGR), or secondarily when complete bichorionization was not possible in case of twin-to-twin transfusion syndrome (TTTS) or sFGR. Intentional septostomy was performed when needed. The procedure-related PPROM was defined as rupture of membranes Results: Between 2006 and 2017, 188 cases underwent CO. Diagnosis was TTTS in 28.2% (n = 53), severe sFGR in 49.5% (n = 93), and dMF in 22.3% (n = 42). PROM n = 40), resulting in worse perinatal outcomes, as preterm birth p = 0.000), procedure-to-delivery interval was 47.5 days (vs. 125, p = 0.000), gestational age (GA) at birth 30.0 weeks (vs. 37.7 weeks, p = 0.000), and survival 65.0% (vs. 91.1%, p = 0.000). In univariate analysis, indication, anterior placenta, cervical length, GA at surgery, operation time, amniodistention and drainage fluid volumes, chorioamniotic membrane separation, and septostomy were selected as relevant factors to be included in the regression model. In a multivariate analysis, TTTS was the only factor associated to PROM Conclusions: PROM

Published
2021

3. A Systematic Approach to the Differential Diagnosis and Management of the Complications of Monochorionic Twin Pregnancies

Author

Eduard Gratacós, Javier U. Ortiz, and J. M. Martínez

Subjects
Male, Embryology, medicine.medical_specialty, Pediatrics, Placenta, MEDLINE, Monochorionic twin pregnancy, Twin-twin transfusion syndrome, Twin anemia-polycythemia sequence, Acute feto-fetal transfusion, Selective intrauterine growth restriction, Discordant malformation, Congenital Abnormalities, Diagnosis, Differential, Pregnancy, medicine, Humans, Twin Anemia-Polycythemia Sequence, Placental anastomoses, Radiology, Nuclear Medicine and imaging, Twin Twin Transfusion Syndrome, Twin Pregnancy, Fetal Growth Retardation, Obstetrics, business.industry, Infant, Newborn, Obstetrics and Gynecology, Fetofetal Transfusion, General Medicine, medicine.disease, ddc, Pregnancy Complications, Perinatal morbidity, Pediatrics, Perinatology and Child Health, Pregnancy, Twin, Female, Neonatology, Differential diagnosis, business
Abstract

Monochorionic (MC) twins represent a significant proportion of perinatal morbidity and mortality. Overall, 1 of 3 MC twin pregnancies will develop complications in relation to the MC placenta and the presence of interfetal placental anastomoses. From a clinical standpoint, these complications can be grouped into four main types of clinical problems: chronic transfusion, acute transfusion, growth discordance, and discordant malformation. Differential diagnosis of MC twin complications is still challenging due to frequent overlap of their clinical signs and the complex relationships between them. Clinical experience demonstrates that most instances of wrong management derive from failure to comply with a basic set of rules for diagnosis and management. In this review, we propose a simplified approach to the understanding of MC twin pregnancy, its potential complications, and the key concepts allowing adequate differential diagnosis and targeted management.

Published
2012
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results