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Analysis of Perinatal Outcomes of twin pregnancy in a Referral Hospital for High Risk

Open Journal of Obstetrics and Gynecology 2024年第7期14卷 983-995页

作者： Eduarda Paim Pedro Lucas Carneiro Ferreira Luciano Selistre Fernanda Grossi José Mauro Madi Gabriela Françoes Rostirolla Mdica Residente do Programa de Residncia em Ginecologia e Obstetrcia Hospital Geral de Caxias do Sul Rio Grande do Sul Brasil Faculdade de Medicina Universidade de Caxias do Sul Rio Grande do Sul Brasil Programa de Ps-Graduao Universidade de Caxias do Sul Rio Grande do Sul Brasil Servio de Ginecologia e Obstetrcia Hospital Geral de Caxias do Sul Rio Grande do Sul Brasil

Introduction: The incidence of twin pregnancies has increased significantly in recent decades. These pregnancies require more attention due to their worse outcomes than singleton pregnancies. Objective: To analyze the characteristics and perinatal outcomes of twin pregnancies at the Caxias do Sul General Hospital. Methods: This is a descriptive and retrospective study that included all births related to twin pregnancies between March 1998 and June 2018. Maternal and perinatal variables were analyzed. Descriptive analyses were carried out using measures of central tendency and dispersion for continuous variables (mean and standard deviation or median and interquartile range), according to a prior assessment of distribution using the Shapiro-Wilk test, and absolute (n) and relative (n%) frequencies for categorical variables. Results: 172 pairs of twins/21,972 births (0.8%) were identified. There was a high percentage of interpartum interval of less than 12 months, adherence and prenatal visits, body mass index, and need for neonatal intensive care. Stillbirth and neomortality rates were within acceptable parameters. Conclusion: The sample studied showed a percentage similar to that in the literature, a high rate of maternal and perinatal complications, characterizing it as a high-risk fetal pregnancy.

关键词： pregnancy twin pregnancy High Risk pregnancy Morbidity Perinatal Mortality Perinatal Results

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twin pregnancy with sudden heart failure and pulmonary hypertension after atrial septal defect repair: A case report

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World Journal of Clinical Cases 2023年第35期11卷 8350-8356页

作者： Chun-Xiao Tong Tao Meng Department of Obstetrical First Affiliated Hospital of China Medical UniversityShenyang 110000Liaoning ProvinceChina

BACKGROUND Pulmonary arterial hypertension(PAH)in pregnancy is one of the major obstetric complications and is considered a contraindication to pregnancy as it is classified as a class IV risk in the revised risk classification of pregnancy by the World Health ***,with its adaptive and expectant mechanical and hormonal changes,negatively affects the cardiopulmonary circulation in pregnant *** patients with repaired simple congenital heart disease(CHD)develop other pulmonary and cardiac complications during pregnancy?Can pregnant women with sudden pulmonary hypertension be treated and managed in time?In this paper,we present a case of a 39-year-old woman who underwent cesarean section at 33 wk'gestation and developed PAH secondary to repaired simple *** research began by a PubMed search for"pulmonary hypertension"and"pregnancy"and"CHD"case *** cases were selected to review PAH in pregnancy after correction of CHD *** studies were reviewed,coupled with our own clinical *** SUMMARY Herein,a case involving a woman who underwent atrial septal defect repair at the age of 34,became pregnant five years later,and had a sudden onset of PAH and right heart failure secondary to symptoms of acute peripheral edema in the third trimester of her *** a result,the patient underwent a cesarean section and gave birth to healthy *** three days after cesarean delivery,her cardiac function deteriorated as the pulmonary artery pressure ***-tive postpartum management,including diuresis,significant oxygen uptake,vasodilators,capacity and anticoagulants management,led to improvements in cardiac function and *** patient was discharged from hospital with a stable recovery and transferred to local hospitals for further PAH *** This case served as a reminder to obstetricians of the importance of pregnancy after repair of *** is crucial for patients with CHD to receive early co

关键词： Congenital heart defects Pulmonary hypertension Right heart failure twin pregnancy Perioperative management Case report

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Acute myocardial infarction in twin pregnancy after assisted reproduction:A case report

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World Journal of Clinical Cases 2021年第17期9卷 4294-4302页

作者： Ni-Ni Dai Rong Zhou Yan-Ling Zhuo Li Sun Ming-Yue Xiao Si-Jing Wu Hai-Xu Yu Qiu-Yu Li Department of Respiratory and Critical Care Medicine Peking University Third HospitalBeijing 100191China Department of Sleep Medicine Peking University Sixth HospitalBeijing 100191China Department of Rehabilitation Beijing United Family Rehabilitation HospitalBeijing 100016China Department of Cardiology Beijing Anzhen hospitalBeijing 100029China Department of Cardiology Peking University Third HospitalBeijing 100191China

BACKGROUND Acute myocardial infarction(AMI)during pregnancy is rare,especially in twin pregnancy,and it can endanger the lives of the mother and *** for conventional cardiovascular risk factors,pregnancy and assisted reproduction can increase the risk of AMI during *** develops secondary to different etiologies,such as coronary spasm and spontaneous coronary artery *** SUMMARY A 33-year-old woman,with twin pregnancy in the 31st week of gestation,presented to the hospital with intermittent chest tightness for 12 wk,aggravation for 1 wk,and chest pain for 4 *** with the electrocardiogram and hypersensitive troponin results,she was diagnosed with acute ST-elevation myocardial *** the patient had no related medical history,she presented several risk factors,such as age greater than 30 years,assisted reproduction,and *** diagnosis,the patient received antiplatelet and anticoagulant *** section and coronary angiography performed 7 d later showed stenosis and thrombus shadow of the right coronary *** receiving medication,the patient was in good *** This case suggests that,with the widespread use of assisted reproductive technology,more attention should be paid to perinatal healthcare,especially when chest pain occurs,to facilitate early diagnosis and intervention of AMI,and the etiology of AMI in pregnancy needs to be differentiated,especially between coronary spasm and spontaneous coronary artery dissection.

关键词： Acute myocardial infarction twin pregnancy Assisted reproduction Coronary spasm Spontaneous coronary artery dissection Case report

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twin pregnancy and partial hydatidiform mole following in vitro fertilization and embryos transfer： a novel case of placental mosaicism

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Chinese Medical Journal 2012年第24期125卷 4517-4519页

作者： SUN Cheng-juan ZHAO You-ping YU Song FAN Ling, WU Qing-qing LI Guang-hui ZHANG Wei-yuan Department of Obstetrics and Gynecology Department of Ultrasonography Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China

twin pregnancy with mosaic partial hydatidiform mole （PHM） and survival of two healthy fetuses following in vitro fertilization and embryos transfer （IVF-ET） is a rare situation and is considered a challenge for management. A 32-year-old Chinese woman conceived twin pregnancy following IVF-ET. At 22 weeks＇ gestation, an additional intrauterine echogenic mass with features of PHM were shown by successive ultrasound examinations. At 35 weeks＇ gestation, two live male infants and two placentas were delivered by caesarean section （CS）. Histologic examination of the abnormal placenta confirmed mosaic PHM. Genetic study showed the abnormal placental mosaicism （expressed in molar-69XXY and normal vili-46XY）, co-existing with a hypospadia new-born （46XY） in one amniotic sac. However, the other one was normal. Serial serum β-hCG levels showed a declining trend and serum β-human chorionic gonadotropin （hCG） were undetectable at 6 months after delivery. The case demonstrated that it is possible to prolonged gestation by PHM under close surveillance during the entire pregnancy.

关键词： hydatidiform mole in vitro fertilization mosaicism partial hydatidiform mole twin pregnancy

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twin pregnancy with Omphalocele: Challenges in Detection and Management

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Open Journal of Obstetrics and Gynecology 2022年第6期12卷 515-519页

作者： Aditya Wibowo Muhammad Alamsyah Aziz Adhi Pribadi Akhmad Yogi Pramatirta Herman Sumawan Aria Yusti Kusuma Department of Obstetrics and Gynecology Universitas Padjadjaran Dr. Hasan Sadikin General Hospital Bandung Indonesia Department of Obstetrics and Gynecology Universitas Jendral Soedirman Prof. Margono Soekarjo General Hospital Purwokerto Indonesia

twins are more likely to have congenital anomalies than singletons. Omphalocele is still a life-threatening congenital abnormality that requires adequate antenatal diagnosis and early treatment. A 31-year-old woman presented with labor pains in the eighth pregnancy month. There was a clear, watery discharge from the birth canal 4 hours before admission. She was previously diagnosed with twins, with one cotwin having suffered omphalocele through a 6-month-ultrasound examination. At admission, the condition was diagnosed as monochorionic-diamniotic twins at 32 - 33 weeks in the 2nd stage of labor: the first baby cephalic presentation;second breech presentation with omphalocele. She vaginally gave birth to twin infants, with those having Apgar 5’ of 6/7, respectively. Both infants were admitted to the intensive care unit and under treatment.

关键词： Spontaneous Delivery twin pregnancy 2nd Baby Breech Presentation Monochorionic Diamniotic Omphalocele on 2nd Baby Case Report

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Single vs. Double Dose Iron Supplementation for Prevention of Iron Deficiency Anemia in twin pregnancy: A Randomized Controlled Clinical Trial

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Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1788-1802页

作者： Ahmed Mohammed Abbas Manal Mahmoud Elhalwagy Khaled Afifi Khaled Ibrahim Mohamed Samir Sweed Obstetrics & Gynecology Ain Shams University Cairo Egypt Obstetrics & Gynecology Helwan General Hospital Cairo Egypt

Introduction: It is estimated that about 18% of pregnant women suffer from iron deficiency anemia throughout their whole pregnancy. In twin pregnancy, owing to the relatively greater feto-placental requirements and greater expansion in maternal plasma volume and red cell mass, iron requirements are magnified 1.8 times compared to singleton pregnancies. However, for prevention of iron deficiency in twin pregnancy, only sparse data exist regarding the sufficiency of the standard antenatal iron supplementation dose used in singleton pregnancies to meet the increased iron demand. In this study, we investigate the effect of single and double dose iron supplementation for prevention of iron deficiency anemia in twin pregnancy. Methods: A randomized controlled clinical trial was conducted at our center in the period between February 2019 and October 2020, and included 450 eligible healthy non-anemic women aged 18 - 35 year

关键词： Iron Supplementation Iron Deficiency Anemia twin pregnancy Hepcidin Mucosal Block

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Sonography Cervical Assessment in twin pregnancy Correlation with Gestational Age at Delivery

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Open Journal of Obstetrics and Gynecology 2022年第2期12卷 169-179页

作者： Mahrous Areej Wesam Kurdi Mylene Martins Lavado Department of Obstetrician and Gynecologists King Salman Hospital. Riyadh Saudi Arabia Department of Obstetrician and Gynecologists King Faisal specialist Hospital and Research Centre Riyadh Saudi Arabia Department of Medicine Faculty at Univali University Universidade do Vale do Itajai Itajai State of Santa Catarina South of Brazil Brazil

Objective: Observe and correlate the funneling of upper cervical canal by ultrasound and likelihood of cervical incompetence and premature delivery in twin pregnancy. Materials and methods: Retrospective study in twin pregnancies deliveries in 1997, in king Faisal specialist hospital and research center, Riyadh, Saudi Arabia. A total of 67 twin pregnancies underwent routine ultrasound for fetal assessment, when the cervix closed, long;and short, funneling. The time of ultrasound was divided in three groups by gestational age: from 18 to 22 weeks;from 22 to 26 weeks and from 26 to 30 weeks. The gestational age at delivery was our outcome parameter and subdivided the patients in 4 groups, group 1: patients delivered before 24 weeks (n = 4);group 2: delivered between 24 and 34 weeks (n = 16);group 3: delivered between 34 weeks and 36 weeks and 6 days (n = 18);and group 4: delivered with gestational age equal or above 37 weeks (n = 29). The data was analyzed statistically using Pearson chi square method and p value below 0.05 was considered significant. Results: There was no significant difference among the 4 subgroups in maternal age, body mass index, parity, previous history of preterm delivery or presence of urinary/vaginal infection in actual pregnancy. There was stronger history of mid trimester abortion in patients delivered before 34 weeks of gestational age. Considering the cervical sonographic findings, the diagnosis of funneling between 18 - 22 weeks was higher among the group delivered before 34 weeks of gestational age (1 and 2) comparing to other groups (3 and 4) with p value equal to 0.016. The finding in ultrasound justifies the results of higher aggressive management in patients from groups 1 and 2 comparing with groups 3 and 4;admission to hospital (p = 0.007);emergency cerclage (p = 0.04), complete hospital bed rest (p = 0.002). Conclusion: Cervical assessment during routine ultrasound in twins pregnancy seems to be useful for prediction of preterm del

关键词： Cervix twin pregnancy Ultrasonography Cervical Assessment Delivery

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Retained Placenta Creta After Selective Fetal Reduction in twin pregnancy:A Case Report

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Maternal-Fetal Medicine 2021年第4期3卷 281-284页

作者： Weiran Zheng Xinrui Yang Yuchun Zhu Jie Yan Huixia Yang Department of Obstetrics and Gynaecology Peking University First HospitalBeijing 10034China Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus Beijing 10034China

Placenta accreta spectrum(PAS)disorders are severe obstetric complications and can cause life-threatening hemorrhage,hysterectomy,or even *** disorders in one of dichorionic diamniotic twins are rare to be seen in clinical practice and lack of standard management *** reported a case of retained placenta creta after selective fetal reduction in one of dichorionic diamniotic twins.A 32-year-old woman with a history of cesarean section was diagnosed with placenta increta in one of dichorionic diamniotic twins at 16 weeks of *** discussion,the couple required to be hospitalized for selective fetal *** received selective termination by ultrasound-guided single fetal intracardiac injection of potassium *** follow-up prenatal ultrasound examinations detected the placenta of the reduced fetus did not stop invade the myometrium of the uterus but developed from placenta increta to placenta *** patient was diagnosed with placental percreta by prenatal ultrasound signs and surgical *** patient underwent scheduled cesarean delivery at 34^(+5)gestational *** outcome of maternal and fetal was satisfactory for our elaborate operation and optimal *** disorders are severe obstetric complications with an increasing *** with twin pregnancy makes PAS disorders more *** should learn that selective fetal reduction probably cannot solve it *** and standard management is essential to promote maternal and fetal outcomes.

关键词： Placenta accreta Placenta previa Selective fetal reduction twin pregnancy

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Evaluation on the Influence of the Timing of twin pregnancy Termination on the Outcome of Mother and Infants

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Journal of Advances in Medicine Science 2021年第2期4卷 16-19页

作者： Yuying Chen Department of Obstetrics and Gynecology Binzhou People’s HospitalBinzhouShandong256610China

Objective:Objective:To observe the maternal and infant outcomes of pregnant women with twins terminating their pregnancy at different ***:Among the twin pregnant women admitted to our hospital from August 2019 to August 2020,50 primiparous women who opted to terminate their pregnancies at 5 different timings of“34--34^(+6) weeks”,“35--35^(+6) weeks”,“36--36^(+6) weeks”,“37--37^(+6) weeks”,“38--38^(+6) weeks”were selected as the research *** to the timing of pregnancy termination,they were divided into 5 groups,each with 10 cases of pregnant women,and the impact of the timing of pregnancy termination on the outcome of the mothers and infants were ***:The“37--37^(+6) weeks”group had the largest amount of postpartum hemorrhage,and the difference in Hb level before and after delivery was the *** the increase in gestational week,the weight of both large and small fetuses *** terms of neonatal diseases,the comparison between“34--34^(+6) weeks”,“35--35^(+6) weeks”,“36--36^(+6) weeks”and“37--37^(+6) weeks”,“38--38^(+6) weeks”,P***:The extension of the gestational week of twin pregnancies has no effect on postpartum hemorrhage,but it can improve the outcome of infants.

关键词： twin pregnancy Termination of pregnancy Timing Maternal and infant outcome Impact

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Maternal weight,blood lipids,and the offspring weight trajectories during infancy and early childhood in twin pregnancies

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World Journal of Pediatrics 2023年第10期19卷 961-971页

作者： Wei Zheng Ke-Xin Zhang Xian-Xian Yuan Jin-Ying Luo Jia Wang Wei Song Sheng-Nan Liang Xiao-Xin Wang Cui-Mei Guo Guang-Hui Li Division of Endocrinology and Metabolism Department of ObstetricsBeijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing 100026China Beijing Maternal and Child Health Care Hospital Beijing 100026China Obstetrics and Gynecology Department Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics&Gynecology and PediatricsFujian Medical UniversityFuzhou 350001China

Background The intrauterine environment has a profound and long-lasting influence on the health of the ***,its impact on the postnatal catch-up growth of twin children remains ***,this study aimed to explore the maternal factors in pregnancy associated with twin offspring *** This study included 3142 live twin children born to 1571 mothers from the Beijing Birth Cohort Study conducted from 2016 to 2021 in Beijing,*** and corrected weight-for-age standard deviation scores of the twin offspring from birth to 36 months of age were calculated according to the World Health Organization Child Growth *** corresponding weight trajectories were identified by the latent trajectory *** factors in pregnancy associated with the weight trajectories of the twin offspring were examined after adjustment for potential *** Five weight trajectories of the twin children were identified,with 4.9%(154/3142)exhibiting insufficient catch-up growth,30.6%(961/3142),and 46.8%(1469/3142)showing adequate catch-up growth from different birth weights,and 15.0%(472/3142)and 2.7%(86/3142)showing various degrees of excessive catch-up *** short stature[adjusted odds ratio(OR)=0.691,95%confidence interval(CI)=0.563–0.848,P=0.0004]and lower total gestational weight gain(GWG)(adjusted OR=0.774,95%CI=0.616–0.972,P=0.03)were associated with insufficient catch-up growth of the *** stature(adjusted OR=1.331,95%CI=1.168–1.518,Ppregnancy body mass index(BMI)(adjusted OR=1.230,95%CI=1.090–1.387,Ppregnancy were associated with excessive growth of the *** pattern of weight trajectories was similar bet

关键词： Maternal weight Multifetal Offspring growth twin pregnancy

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