| Hypertensive disease in twin pregnancies: a review. | |
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MedLine Citation:
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PMID: 11893276 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Reports over the past seventy years show that twin gestations lead to an increased risk of hypertensive disorders. Numerous studies discuss the incidence of hypertensive disease in twin versus singleton gestations, as well as effects of parity, race, age, income level, smoking, zygosity and heritability on this condition. The range of relative risk of gestational hypertension, preeclampsia and eclampsia for twin compared to singleton gestations is 1.2 to 2.7, 2.8 to 4.4 and 3.4 to 5.1 respectively. Parity, African-American ethnicity, and young maternal age are all factors that increase the relative risk of acquiring hypertensive disease to 4.0, 1.8 and 1.5 in mothers of twin gestations. Factors such as maternal smoking, income level and zygosity have a negligible effect on the relative risk of acquiring hypertensive disease in twin gestations. In addition to twin mothers exhibiting a higher incidence of hypertensive disease compared to their singleton counterparts, they also exhibit an earlier onset of hypertensive disease at both 35 and 37 weeks of gestation comparatively. Uric acid levels measured at 30-31 weeks of gestation in twin mothers predicted the onset of preeclampsia with a sensitivity of 73% and a specificity of 74%. The range of risks presented in the literature is wide and the therapies avocated are diverse. We therefore decided to summarize the risks in a comparative fashion and to review current therapeutic strategies for the convenience of clinicians who confront increasing numbers of multiple pregnancies. The tables bring all recent published risks together in the first comparative analysis in which the data has been converted to relative risks and confidence intervals. Because the literature is relatively silent on specific management of hypertensive disease in twin pregnancies, general management recommendations for singleton gestations should be used by practitioners caring over twin gestations. |
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Authors:
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Stephan Krotz; Javier Fajardo; Sanjay Ghandi; Ashlesha Patel; Louis G Keith |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Twin research : the official journal of the International Society for Twin Studies Volume: 5 ISSN: 1369-0523 ISO Abbreviation: Twin Res Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-03-14 Completed Date: 2002-04-25 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 9815819 Medline TA: Twin Res Country: Australia |
Other Details:
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Languages: eng Pagination: 8-14 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, Northwestern University Medical School, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Eclampsia
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epidemiology,
etiology,
therapy Female Humans Hypertension / epidemiology*, etiology, therapy Incidence Pregnancy Pregnancy Complications, Cardiovascular / epidemiology*, therapy Pregnancy, Multiple* Risk Factors Twins Uric Acid / blood |
| Chemical | |
Reg. No./Substance:
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69-93-2/Uric Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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