The objective was to determine whether timed artificial insemination (TAI) 56 h after removal of a Controlled Internal Drug Release (CIDR, 1.38 g of progesterone) insert would improve AI pregnancy rate in beef heifers compared to TAI 72 h after CIDR insert removal in a 5-days CO-Synch + CIDR protocol. ...

We sought to determine the effectiveness of continuous fetal monitoring in monoamniotic twins and assess the percentage of successful monitoring across gestation. This was a single-center retrospective cohort analysis of monoamniotic twins. Each subject's entire electronic fetal heart tracing was reviewed. The primary outcome measure was the percentage of time ...

The aim of this study was to evaluate the use of ultrasound assessment to predict risk of mortality in expectantly managed monochorionic twin fetuses with selective intrauterine growth restriction (sIUGR). This was a retrospective study of 101 monochorionic twin pregnancies diagnosed with sIUGR before 26 weeks of gestation. All patients ...

To determine the accuracy of dating twin pregnancies, of between 16 and 26 weeks' gestation, using singleton head circumference (HC) formulae. This was a retrospective study of 269 singleton and 119 twin non-anomalous pregnancies conceived by in-vitro fertilization (IVF) with a known embryo transfer date. Fetal ultrasound biometry data for ...

The aim of this study was to identify predictors of twin-to-twin transfusion syndrome (TTTS) and selective intrauterine growth restriction (sIUGR) in monochorionic diamniotic (MCDA) twin pregnancies with moderate amniotic fluid discordance (mAFD). Monochorionic twins with mAFD (n = 45; gestational age, 15-29 weeks) were assessed for extent of fluid discordance, ...

Twin pregnancy is associated with a high risk of congenital malformations. This review covers the risk of such anomalies in both dizygotic and monozygotic twin pregnancies, and discusses current insights into the associations relating to zygosity, chorionicity and genetic factors. The pathological basis of specific malformations unique to the monochorionic ...

To investigate the outcomes of singleton and twin pregnancies that were complicated by spontaneous preterm labor and received nifedipine tocolysis. We identified the following subjects from a computerized, hospital database: 58 singleton and 32 twin pregnancies that were between 24 and 34 weeks of gestation, admitted for spontaneous preterm labor ...

Ultrasonographic features of the underlying hemodynamic changes in twin-twin transfusion syndrome (TTTS) may be present at the first trimester scan. To investigate the value of intertwin discordance in nuchal translucency (NT) thickness and crown-rump length (CRL) to predict TTTS and other adverse outcomes. Cohort study. One hundred and thirty-five unselected ...

Middle cerebral artery-peak systolic velocity (MCA-PSV) has been reported to predict fetal anemia with similar accuracy as amniotic ΔOD450 assay. Alloimmunized dizygotic twin pregnancy allows us to compare anemic and non-anemic twins in the same intrauterine environment. We herein present a case of Rh (E)-incompatible dizygotic twin pregnancy, where MCA-PSV ...

In last years, owing to the widespread availability of assisted-reproduction technology, multiple pregnancy rates in Western countries have increased. In twin pregnancies, an increased rate of gestational complications, intrauterine growth restriction (IUGR), preterm birth and severe perinatal conditions is present. These complications are more frequent in monozygotic twins compared to ...

The purpose of this study was to determine the association between discordant crown-rump length (CRL) measurements in structurally normal euploid dichorionic twins and adverse pregnancy outcomes. This retrospective cohort study included women with dichorionic twins who underwent chorionic villus sampling and delivered in our facility from January 2000 to September ...

To assess neonatal outcome and delivery mode in dichorionic twin delivery at term with a cephalic-presenting first twin. A retrospective cohort study of 308 twin deliveries after 37 completed weeks of gestation with a cephalic-presenting first twin undertaken in one perinatal center with active management of second twin delivery. The ...

  To evaluate the effects of operator experience on perinatal outcome in a single centre.   Prospective consecutive cohort study.   Regional tertiary referral Fetal Medicine Centre in the UK.   Pregnant women with monochorionic twin pregnancies complicated by severe twin-to-twin transfusion syndrome (TTTS) (at ≤26 completed weeks of gestatiuon) ...

The objective of this study was to evaluate the impact of one abnormal fetus in a twin pregnancy, to compare impact of chorionicity and clinical outcome of intervention and expectant management. Thirty-seven dichorionic (DC) twins and 18 monochorionic (MC) twins complicated with one malformed fetus were evaluated for gestational age, ...

OBJECTIVE: To study perinatal outcomes of pregnancies complicated by twin-twin transfusion syndrome (TTTS), which were treated with the authors' intervention modalities. Maternal outcomes of these populations were also explored. MATERIAL AND METHOD: All pregnancies diagnosed TTTS that delivered in King Chulalongkorn Memorial Hospital between January 2000 and November 2009 were ...

Monochorionic twins are subjected to specific complications which originate in either imbalance or abnormality of the single placenta serving two twins. This unequal placental sharing can cause complications including twin-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), selective intrauterine growth restriction or twin reversed arterial perfusion sequence (TRAP). Monochorionicity also ...

The incidence of central nervous system malformations is higher among twins. Our aim was to summarize information about these malformations in twin pregnancies. Based on a sample originating from the biggest genetic centre in Hungary between January 1990 and December 2008, we examined the data of 42 twin pregnancies associated ...

The exact determination of amnionicity is a major issue for the clinical management of monochorionic twin pregnancies, due to the high risk of perinatal mortality and morbidity in monochorionic monoamniotic (MCMA) twins. Counting the number of yolk sacs is believed to be a good indicator of amnionicity in the early ...

The management of monochorionic (MC) twin pregnancies varies in different medical centers. This paper compares screening methods to predict the complications of the MC twin pregnancy and different treatment methods. We performed a literature search without language restriction in Cochrane library and PubMed (1970-2009). Case series and cohort screening studies, ...

We report a case of a 26-year-old woman, gravida 2, para 1, with a dichorionic diamniotic twin pregnancy at 33 weeks of gestation with a 1-day history of mild vaginal bleeding and irregular uterine activity. Ultrasonography showed 18 x 15 x 3-cm-sized complex hypoechoic mass located in the dividing intertwin ...

The objective of this study was to determine the association of crown-rump length (CRL) discrepancy in monochorionic and dichorionic twins with subsequent pregnancy outcomes. A retrospective analytical study was performed among 660 twin pregnancies over 12 years in one fetal medicine tertiary referral center in the United Kingdom. A literature ...

The main objective of this study was to determine whether fetal thymic measurements could be obtained in twins, with a secondary goal to determine whether thymic measurements from uncomplicated singleton and twin pregnancies are comparable. The transverse diameter and perimeter of the fetal thymus were measured prospectively in 678 singleton ...

OBJECTIVE: Women with twin pregnancies may have higher rates of isolated proteinuria than do those with singletons. We compared protein-to-creatinine (P:C) ratios longitudinally through gestation in uncomplicated twin and singleton pregnancies. STUDY DESIGN: P:C ratios were compared at 3 times points in 102 (51 twins, 51 singletons) healthy gravid patients ...

Selective intrauterine growth restriction (sIUGR) in monochorionic twins is associated with a substantial increase in perinatal mortality and morbidity for both twins. Clinical evolution depends on the combination of the effects of placental insufficiency in the IUGR twin with inter-twin blood transfer through placental anastomoses. Classification of sIUGR into types ...

BACKGROUND: It has been accepted practice to use yolk-sac number to predict amnionicity in twin pairs. Two yolk sacs in a single chorionic sac were thought to confirm diamniotic pregnancy, and a single yolk sac with two fetal poles was thought to indicate monoamniotic twins. Thus, basic ultrasonography could confirm ...

To evaluate the influence of gestational diabetes mellitus on weight discrepancy in twin pregnancies. 200 twin pregnancies were included in the study. 157 nondiabetic pregnant women with twin gestations and 43 twin pregnancies with gestational diabetes mellitus (GDM) with viable fetuses born after 24 weeks of gestation were enrolled. Influence ...

To review the perinatal outcome of monochorionic twin pregnancies treated by fetoscopic laser coagulation for twin-twin transfusion syndrome. Retrospective study. A university teaching hospital in Hong Kong. Thirty consecutive cases of fetoscopic laser coagulation of placental anastomoses for twin-twin transfusion syndrome performed in a single centre. Operative complications and perinatal ...

Twins achieved through in-vitro fertilisation often undergo a viability ultrasound at 6-9 weeks of gestation. The presence of inter-twin crown-rump length discordance at this stage is not an uncommon finding; however the clinical significance of this is unknown. We analyzed 218 dichorionic twin pregnancies, producing two live fetuses > 24 ...

BACKGROUND: Retained viable intrauterine pregnancy is an infrequent complication of vacuum aspiration. We report a case of a retained single intrauterine pregnancy after an elective vacuum aspiration of a dichorionic-diamniotic twin gestation. CASE: A patient presented to the emergency department reporting vaginal spotting, breast engorgement, and lower abdominal cramping for ...

To describe the longitudinal changes in canal length at 16-35 weeks' gestation in cases of twin pregnancy with preterm labor and delivery. We studied 22 cases of twin pregnancy that were delivered at < 36 weeks and/or that underwent preterm labor requiring tocolysis. We also studied 44 cases of twin ...

To compare maternal and perinatal outcome in non-spontaneously and spontaneously conceived dichorionic twin pregnancies. We report a retrospective study of all 350 twin pregnancies delivered ≥22 weeks of gestation between January 1, 2001 and December 31, 2005 in a tertiary maternity unit. We compared maternal outcome, perinatal morbidity and neonatal ...

Multiple pregnancies, the majority of which are twins, are at substantially higher risk of fetal morbidity and mortality when compared with singleton pregnancies. Single fetal demise occurs in up to 6.2% of all twin pregnancies. It may cause considerable risk for the co-twin including increased risk of fetal loss, premature ...

This study aimed to evaluate the perinatal outcome of twin pregnancies delivered in a tertiary teaching hospital according to chorionicity. A retrospective study involving 289 twin pregnancies delivered from January 2003 to December 2006 was carried out. Maternal and perinatal data were obtained from hospital charts and delivery logs. Chorionicity ...

To investigate the prognostic value of cardiac function assessment by the previously reported CHOP (Children's Hospital of Philadelphia) cardiovascular score in twin-twin transfusion syndrome (TTTS). All consecutive monochorionic pregnancies presenting with TTTS over a 24-month period were evaluated by preoperative echocardiography before percutaneous laser coagulation of chorionic vessels. Each of ...

Twin anemia?polycythemia sequence (TAPS) is an atypical form of twin?twin transfusion syndrome (TTTS) that presents as a large intertwin hemoglobin difference with one twin developing anemia and the other developing polycythemia, without oligohydramnios?polyhydramnios sequence (Lopriore et al., Placenta 2007;28:47?51). The prenatal diagnostic criteria for TAPS require that the middle cerebral ...

OBJECTIVE: We sought to investigate outcomes of contemporaneously managed monochorionic diamniotic (MCDA) twins, stratified by pregnancy complication. STUDY DESIGN: Four hundred eighteen MCDA pregnancies from 2001 through 2008 were retrospectively reviewed. RESULTS: There were 236 ongoing pregnancies at 24 weeks' gestation. The likelihood of progressing from 24 weeks to 2 ...

We examined the relationship between serum uric acid levels and changes in renal circulation in women with twin pregnancy compared with those in women with singleton pregnancy. The Doppler waveforms of the bilateral maternal main renal arteries were obtained from 15 women at 37-38 weeks of nonpreeclamptic twin pregnancy and ...

OBJECTIVE: The aim of this study was to document the mortality of twin reversed arterial perfusion (TRAP) sequence from the first trimester to planned intervention at 16-18 weeks. STUDY DESIGN: A retrospective review was performed of the outcome of monochorionic twin pregnancies diagnosed with twin reversed arterial perfusion sequence in ...

OBJECTIVE: The previous studies of monochorionic monoamniotic (MCMA) twins reported perinatal mortality rates as high as 70-80%. The recent trends have been towards significantly improved outcomes, though results from all studies have not been consistent. METHOD: A retrospective cohort analysis of all MCMA pregnancies > or =20 weeks delivered in ...

Presents a 55-word story about efforts to conceive, pregnancy, giving birth to twins, and the neonatal intensive care unit. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

OBJECTIVE: The aim of this study was to assess the performance of validated singleton crown-rump length (CRL) formulae in dating twin pregnancies at 11-14 weeks of gestation. DESIGN: Retrospective cohort study. SETTING: Fetal medicine unit of a London teaching hospital. SAMPLE: Three hundred and eighty-four pregnancies with known dates of ...

We attempt here to identify the maternal characteristic factors most strongly associated with the increased risk of very pre-term delivery in dichorionic twin deliveries. Data were collected from 24 dichorionic twin pregnancies who were born at <32 weeks' gestation (very pre-term delivery) and 245 dichorionic twin pregnancies, who were born ...

OBJECTIVES: To study the distributions of pregnancy-associated plasma protein A (PAPP-A), the free beta subunit of human chorion gonadotrophin (fbeta-hCG), A Disintegrin and Metalloprotease 12 (ADAM12) and Placental Protein 13 (PP13) in first trimester twin pregnancies. METHODS: Serum marker concentrations were measured in monochorionic and dichorionic twin pregnancies and singleton ...

OBJECTIVE: To assess parameters associated with perinatal and neonatal morbidity and mortality in monochorionic (MC) diamniotic twin pregnancies after 25 weeks of gestation. METHODS: Neonatal outcomes after 25 weeks' gestational age were retrieved for all twin pregnancies between the years 2001 and 2007 and documented according to chorionicity. The features ...

OBJECTIVES: To describe the prevalence, management and outcome of spontaneous twin anemia polycythemia sequence (TAPS) diagnosed in the prenatal period. METHOD: Retrospective analysis of 142 consecutive monochorionic twin pregnancies not diagnosed with twin to twin transfusion syndrome. TAPS cases were identified based on the presence of discordant middle cerebral artery ...

Studies comparing the outcome of spontaneous versus IVF twin pregnancies report heterogeneous results. This may depend on differences in the studied populations and/or in the management approach to twin pregnancy. The aim of the present study was to compare both maternal and perinatal outcomes in dichorionic diamniotic twin pregnancies who ...

BACKGROUND: Delivery of the second twin is one of the most challenging events for practicing obstetricians. Due to the increased incidence of twin gestations and lack of well-designed clinical trials, evidence-based recommendations are lagging behind clinical demand. OBJECTIVE: The present review examines the practice of second nonvertex twin deliveries. METHODS: ...

We report extremely preterm twins who developed late-onset Escherichia coli sepsis in the second postnatal week within a short time of each other. The asymptomatic twin was not treated initially, and within 2 days developed life-threatening septicemia and meningitis, followed by other serious morbidity. Occurrence of late-onset sepsis in a ...

OBJECTIVES: The aims of this study were (1) to assess the accuracy of estimated fetal weight (EFW) in twins and (2) to assess the accuracy of sonographic examination to predict birth weight discordance (BWD). METHODS: We retrospectively analyzed collected data on twin pregnancies between 2004 and 2007. All twin pregnancies ...

BACKGROUND: A disintegrin and metalloprotease 12s (ADAM12s) is a potential first trimester serum marker for fetal trisomy and adverse pregnancy outcome in singletons. In this study, ADAM12s levels in first trimester serum of uncomplicated and complicated twins were evaluated. METHODS: ADAM12s was studied in maternal serum of 215 twin pregnancies, ...