We report on a diamniotic-dichorionic twin pregnancy after in vitro fertilization. The first twin was diagnosed with Down syndrome and spontaneously aborted at 24 weeks of gestation after intrauterine death at week 18. The second healthy twin was delivered by cesarean section 11 weeks later. We discuss management aspects and ...

Twin-twin transfusion syndrome (TTTS) complicates approximately 15% of monochorionic, diamniotic twin pregnancies and if untreated carries a high perinatal loss rate of between 80% and 100%, depending on the stage. The underlying pathology in TTTS appears to be an imbalanced intertwin perfusion difference, secondary to functional unidirectional arteriovenous anastomoses within ...

OBJECTIVE: To help develop an evidence-based approach to the best management of twin pregnancies discordant for anencephaly. METHODS: We retrospectively examined the management and outcome of 18 pregnancies discordant for anencephaly diagnosed at 11 + 0 to 13 + 6 weeks of gestation in our center. We combined these data ...

OBJECTIVES: Measuring the thickness of the membranes to determine chorionicity in twins using two-dimensional (2D) ultrasound may provide uncertain results, given the possibility of measuring in an oblique view. We aimed to determine whether chorionicity can be assessed during the second and third trimesters by measuring the thickness of the ...

OBJECTIVE: To assess the feasibility and outcome of fetoscopic laser coagulation in pregnancies with twin reversed arterial perfusion (TRAP) sequence. METHODS: In a prospective multicenter study, percutaneous fetoscopic laser coagulation of placental anastomoses (n = 18) or the umbilical cord of the acardiac twin (n = 42) was performed in ...

We present a case of a dichorionic/diamniotic twin pregnancy in which one twin presented with ultrasound findings suggestive of molar changes in the placenta. The placenta of twin A seemed to be grossly enlarged and cystic, and twin A was small for gestation. After an inevitable abortion, a detailed histological ...

OBJECTIVES: Increased perinatal mortality in monoamniotic twin pregnancies is attributed to cord accidents in utero and at delivery. We evaluated the following parameters in monoamniotic pregnancies: (1) the incidence of cord entanglement; (2) the effect of sulindac on amniotic fluid volume and stability of fetal lie; and (3) the perinatal ...

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 ...

We assess the impacts of operative delivery for the first twins with vertex presentation on neonatal outcomes in second twins using the 1995 to 1997 twin registry data of the United States. A total of 102,554 eligible twin pairs with vertex presentation for the first twin were included in the ...

Various studies have demonstrated an increased risk for adult diseases in newborns born small-for-gestational-age (SGA). Adiponectin and resistin can be detected in cord blood and are suggested to affect insulin resistance (IR). This might represent a link between metabolic syndrome and SGA birth. We investigated the relationship between the adipocytokines ...

Alcohol dependence (AD) and nicotine dependence (ND) have been shown to co-occur. Results from twin studies implicate the role of genetics in the etiology of both ND and AD with substantial, yet incomplete, overlap. To test for specificity of transmission of AD and ND in an offspring of twins sample ...

CONTEXT: Genes from the ovarian bone morphogenetic signaling pathway (GDF9 and BMP15) are critical for normal human fertility. We previously identified a deletion mutation in GDF9 in sisters with spontaneous dizygotic (DZ) twins, but the prevalence of rare GDF9 variants in twinning families is unknown. OBJECTIVE: The objective was to ...

OBJECTIVE: The objective of the study was to determine whether spontaneous reduction in in vitro fertilization pregnancies results in outcomes comparable with in vitro fertilization singleton pregnancies or ongoing twin pregnancies. STUDY DESIGN: Women with in vitro fertilization pregnancies from 2003 to 2005 who had first-trimester ultrasound and delivered in ...

Decreased fertility is one of the characteristics of Turner syndrome. Ovarian function in women with Turner syndrome is believed to be impaired because of an abnormal and very rapid maturation of oocytes and follicles. About 30% of mosaic Turner patients have partial ovarian function during puberty, but only 2-5% of ...

OBJECTIVE: We sought to determine the accuracy of antenatal diagnosis of twin chorionicity at a single tertiary care center and assess the consequences of incorrect diagnoses. STUDY DESIGN: Twins with chorionicity diagnosed by ultrasound < or = 24 weeks' gestation were retrospectively reviewed. Chorionicity was assigned by sonographic findings including ...

BACKGROUND: A monochorionic-diamniotic placenta (MCDAP) is rare in dizygotic (DZ) twinning. All reported cases have been documented in pregnancies achieved by the induction of ovulation alone or during the IVF cycle. METHODS AND RESULTS: We report a spontaneous pregnancy in a 39-year-old patient with evidence of MCDAP in DZ twins, ...

BACKGROUND: Term delivery of the second twin after miscarriage of the first twin is rare. There is always a risk of preterm delivery as well as infection leading to chorioamnionitis. CASE: The second twin was delivered at term after miscarriage of the first twin at 17 weeks'gestation. The pregnancy was ...

OBJECTIVE: To evaluate the relationship of maternal height to the rate of twinning and the possible connection of these parameters to the coexistent level of insulinlike growth factor (IGF). STUDY DESIGN: Since spontaneous multiple gestations in humans are relatively uncommon in general, it is reasonable to consider distin guishing physical ...

Low birth weight is associated with postnatal physiological changes, including impaired glucose tolerance and increased cortisol secretion, that may predispose to disease in adulthood. Twins are born lighter than singletons, but there are conflicting data regarding the association between birth weight and postnatal physiology in twins. We studied glucose tolerance ...

OBJECTIVE: We investigated the relationship between IGF-I-IGF binding protein (IGFBP)-1 and leptin levels with type 1 collagen markers of bone turnover in dichorionic twins with or without discordant birth weight of 20% or greater. METHODS: Maternal and cord bloods were collected from gestational age-matched dichorionic twins with (n = 16) ...

An algorithm is presented to derive the twin laws in non-merohedric twins through the systematic search for quasi-perpendicular lattice planes/directions. The twin lattice, i.e. the sublattice common to the whole crystalline edifice built by the twinned individuals, is based on a supercell of the individual defined by a pair of ...

The authors present a set of female diamnionic and dichorionic twins with different blood types and congenital oesophageal atresia (EA) in both. Surgical management was successful. It can be assumed that EA with tracheo-oesophageal fistula in twin B occurred during an early embryological stage whereas the isolated EA in twin ...

OBJECTIVE: To assess perinatal outcome in monochorionic twin pregnancies according to different stages of severe mid-trimester twin-twin transfusion syndrome managed by fetoscopic laser coagulation of the placental vascular anastomoses. METHODS: In a prospective study fetoscopic laser therapy was performed in 200 consecutive pregnancies with severe mid-trimester twin-twin transfusion syndrome at ...

Temporal variations in the stillbirth rate among singletons, twins and triplets in Sweden between 1869 and 1967 were studied. Both among single and multiple births there were marked secular decreasing trends in the stillbirth rates. Based on our long time series since 1869, this study confirms that among twins and ...

The basis of most twin studies is the ascertainment of twins, often through twin registries, and determination of zygosity. The current rate of twin births in many industrialized countries implies that in the near future around 3% or more of individuals will be a twin. Hence, there are and will ...

Sacrococcygeal teratomas are the most common tumors found in newborns and have a favorable outcome when diagnosed late in gestation. Solid, highly vascularized tumors diagnosed early in gestation have a higher incidence of hydrops fetalis and fetal demise. The following is a case report of a monochorionic twin gestation complicated ...

Differences in placental mass and vascularity exist between cows gestating single vs. multiple fetuses. Therefore, the association between fetal number and placental development or function was assessed by comparing concentrations of vascular endothelial growth factor (VEGF), pregnancy-associated glycoproteins (PAG), IGF-I, and progesterone in the maternal blood of cattle selected for ...

OBJECT: To evaluate the usefulness of sonographic prediction of significant birth weight discordance in twin pregnancies. STUDY DESIGN: Included in the study were live twin pairs with a gestational age of 24 weeks at birth who had received a sonographic examination within 28 days of delivery. Correlation tests and ROC ...

We assessed soluble fibrin polymer longitudinally in normal pregnancy, thrombophilic pregnancy and twin gestation Thirty-three thrombophilic pregnancies, 34 uncomplicated multiple gestations and 23 singleton normal pregnancies were studied. Maternal plasma samples were collected in the first (6-12 weeks), 2nd (13-25 weeks) and 3rd trimesters of pregnancy (26-40 weeks) and were ...

We report a single case study of concordant bilateral Duane's Retraction Syndrome (DRS) (type 1) in female monozygotic (MZ) twins aged 47 years. The twin pair were recruited through the Australian Twin Registry as part of a twin study on myopia. This twin pair were full term and had a ...

Hydranencephaly, a relatively rare malformation of the brain, is characterised by absence of the cerebral hemispheres and their replacement by sacs filled with cerebrospinal fluid. It is one of the recognised forms of intracranial malformations associated with intrauterine fetal demise of one of twins in monochorionic twin gestation. This report ...

It has recently been suggested that the measure of success of assisted reproductive technologies (ART) should be the birth of a singleton baby, whereas a twin pregnancy should be considered as a complication. Although the maternal and neonatal complications in twin pregnancies are significantly higher than those in singleton pregnancies, ...

BACKGROUND: The aim of this preliminary study was to estimate the accuracy of the zygosity determination in twin pregnancies. METHODS: Seventy-three sets of twin pregnancies were enrolled in this study, including 48 sets of twins resulting from assisted reproductive techniques (ART) and 25 sets of spontaneously conceived twins. Determination of ...

OBJECTIVE: This study was undertaken to compare uterine contraction frequency in twins versus singletons and to determine if contraction frequency can be an efficient predictor of spontaneous preterm birth in twin gestations. STUDY DESIGN: Fifty-nine twin and 306 singleton gestations were enrolled between 22 and 24 weeks at 11 centers. ...

Current early diagnosis, surveillance and intervention options make it hard to determine the natural course of twin pregnancies, especially regarding spontaneous preterm delivery and perinatal mortality. We studied the natural course in monochorionic (MC) and dichorionic (DC) twin pregnancies in a historical cohort. Twin pregnancies were studied in a unique ...

OBJECTIVES: As opposed to biochemical markers of Down syndrome, nuchal translucency (NT) was once thought to be a more reliable screening marker for high order multiple pregnancies and pregnancies conceived after assisted conception. Recent data suggested that NT in singleton fetuses from assisted reproduction technology (ART) was thicker than those ...

OBJECTIVE: To assess the rate of fetal losses in twin pregnancies undergoing genetic mid-trimester amniocentesis. METHODS: In the first part of this investigation, a retrospective cohort study compared a group of women . 32 years old with twin pregnancies who underwent amniocentesis with a similar group unexposed to amniocentesis. Data ...

There are only a few reports of fetal parvovirus infection in the circumstance of a twin pregnancy. We report a case of differential fetal infection following maternal parvovirus B19 infection in a dichorionic twin pregnancy culminating in a dual live-birth. A 32-year-old woman was diagnosed with parvovirus infection following exposure ...

The aim of this tertiary hospital-based cohort study was to determine and compare perinatal outcome and neonatal morbidities of pregnancies with twin-twin transfusion syndrome (TTTS) before and after the introduction of a treatment program with laser ablation of placental communicating vessels. Twenty-seven pregnancies with Stage II-IV TTTS treated with amnioreduction ...

Population-based studies in twins have been of insufficient size to explore the relationship between risk of cerebral palsy and intrauterine growth. Earlier studies in singletons have suggested an optimum size at birth for minimum cerebral palsy risk between the 75th and 90th percentiles of weight for gestational age. We aggregated ...

OBJECTIVE: To determine the interval to spontaneous delivery following discontinuation of continuous subcutaneous terbutaline (SQT). METHODS: Singleton and twin gestations receiving outpatient preterm labor management services with SQT were identified from a database. Patients having SQT discontinued at 33.0-35.9 weeks (in a stable condition, not hospitalized and with known cervical ...

The purpose of this study is to compare perinatal outcomes of twin pregnancies complicated by gestational diabetes (GDM) with those unaffected by GDM. A total of 1,154 twin pregnancies who delivered at Cheil General Hospital, between January 1998 and December 2002 were recruited to participate in a retrospective analysis. Out ...

OBJECTIVE: This study was undertaken to determine the accuracy of our previously published and prospectively validated institution-specific singleton transcerebellar diameter (TCD) nomogram in the prediction of gestational age (GA) in twin pregnancies. We further evaluated whether the prediction of GA in twin gestations using the singleton TCD nomogram differs between ...

OBJECTIVE: To generate reliable new reference ranges for symphysis-fundus height (SFH) in twin pregnancies using modern statistical methods and to evaluate whether small-for-gestational age (SGA) babies of women who had a SFH measurement after the 25th gestational week could be predicted by the SFH measurement in the reference curves and ...

OBJECTIVE: To analyse baby-feeding information needs and seeking described by Canadian women pregnant with twins. DESIGN: Qualitative; data were collected by in-depth semi-structured interviews. Transcripts provided the data for discourse analysis of the use of two interpretative repertoires. SETTING: Ontario, Canada. PARTICIPANTS: 19 women pregnant with twins. MEASUREMENTS AND FINDINGS: ...

The epidemic of multiple pregnancy continues albeit in a different form with twin pregnancies predominating. Determination of chorionicity is the key to management and regular monitoring by ultrasound is a hallmark of quality care. All multiple pregnancies should be offered first trimester screening by nuchal translucency for aneuploidy. MC twins ...

CONTEXT: Previous studies have demonstrated subtle neurologic dysfunction in chronic posttraumatic stress disorder (PTSD) manifest as increased neurologic soft signs (NSSs). The origin of this dysfunction is undetermined. OBJECTIVE: To resolve competing origins of increased NSSs in PTSD, namely, preexisting vulnerability factor vs acquired PTSD sign. DESIGN: Case-control study of ...

Unlike monozygotic (MZ) twins, dizygotic (DZ) twins develop from separate ova. The resulting twins can have different sires if the fertilizing sperm comes from different males. Routine paternity testing of a pair of same-sexed chimpanzee twins born to a female housed with two males indicated that the twins were sired ...

The monoamnionic placenta of this twin gestation had focal amnion necrosis, but this was present only over the fetal surface vessels of one twin; this twin also developed cerebral atrophy. We hypothesize that this degeneration is due to a more severely reduced oxygen tension in its vessels. The placental amnion ...

Exposure of the fetus to indomethacin by administration of the drug to the mother may cause many side effects, including premature closure of the ductus arteriosus. Hypoxia is a predisposing factor for premature ductal closure and often occurs after maternal indomethacin therapy. We present two sets of monozygotic twins with ...