Document Detail

Impact of cord entanglement on perinatal outcome of monoamniotic twins: a systematic review of the literature.
MedLine Citation:
PMID:  23371346     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To review the current literature concerning perinatal outcome of monoamniotic pregnancies with cord entanglement.
METHODS: A search in PubMed, EMBASE and MEDLINE for articles published between January 2000 and December 2011 was performed, using the following keywords: monoamniotic/monochorionic pregnancy(ies); twins; cord entanglement; fetal ultrasound/surveillance. Inclusion criteria for the study were: monoamniotic twins with documented cord entanglement at delivery, and perinatal outcome reported as proportional rates. Exclusion criteria were: higher-order multiple pregnancy; selective feticide; presence of twin reversed arterial perfusion sequence; conjoined twins; fewer than four cases in the series; and non-English language publication. Survival rates were stratified for method of prenatal management, sonographic diagnosis of cord entanglement and delivery mode. A meta-analysis was also performed using data from articles that stratified outcome according to the presence or absence of cord entanglement at birth. Comparison between neonates with cord entanglement and controls was deemed significant if the 95% CI of the pooled odds ratios did not encompass 1. MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines were followed.
RESULTS: Nine articles met the inclusion criteria for this review, including a total of 114 monoamniotic twin sets (228 fetuses) with cord entanglement. The overall survival rate was 202/228 (88.6%). Perinatal mortality occurred in 26 (11.4%) fetuses; of these, 17 (65%) died in utero and nine (35%) died at birth. Five neonatal deaths occurred as a result of prematurity, two were related to structural abnormalities and two were caused by cord entanglement. Sonographic visualization of cord entanglement did not improve outcome. Four articles were included in the meta-analysis, with no significant difference in mortality between controls (n = 66 fetuses) and twins with cord entanglement (n = 82 fetuses), and higher morbidity in controls.
CONCLUSIONS: Cord entanglement does not contribute to prenatal morbidity and mortality in monoamniotic twin pregnancies.
A C Rossi; F Prefumo
Related Documents :
15459936 - Sonographic features of decidualized ovarian endometriosis suspicious for malignancy.
24055096 - On the autistic spectrum disorder concordance rates of twins and non-twin siblings.
23369936 - Significance of growth discordance in appropriately grown twins.
1734246 - Ovarian pregnancy with ipsilateral mature cystic teratoma of the ovary: case report.
1603506 - Anticardiolipin antibodies and pregnancy outcome in women with human immunodeficiency v...
16618046 - Acupuncture prior to and at embryo transfer in an assisted conception unit--a case series.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  41     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  131-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Department of Obstetrics and Gynaecology, University of Bari, Bari, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Induced Formation and Maturation of Acetylcholine Receptor Clusters in a Defined 3D Bio-Artificial M...
Next Document:  Analgesic effect of the neuropeptide cortistatin in arthritic inflammatory pain.