Objective: The purpose of this study was to determine the incidence of ultrasonographically detected cerebral white matter lesions (WMLs) in preterm twins at birth in relation to chorionicity, discordant weight and tw...Objective: The purpose of this study was to determine the incidence of ultrasonographically detected cerebral white matter lesions (WMLs) in preterm twins at birth in relation to chorionicity, discordant weight and twin- twin transfusion syndrome (TTTS). Methods: In this retrospective study, perinatal, neonatal, and cranial scan data of 85 monochorionic (MC) and 94 dichorionic (DC) twin pregnancies (341 infants) delivered between 24 and 34 weeks of gestation were collected. Data were analysed according to chorionicity, discordant birth weight (>20% ), single intrauterine death and TTTS. Results: The cerebral WML was seen in 14% of preterm twins. Monochorionic infants had higher risks of WML than DC twin (odds ratio 7.1; 95% CI 3.28- 15.8). In MC group, discordant weight (37% )- , TTTS (38% ), single intrauterine death (67% ) had higher incidence of cerebral WML than concordant weight infants (7% ). Similarly, incidence of WML was higher in DC discordant compared with concordant weight infants (13% versus 2% ; P <.0.05). Conclusion: Monochorionic infants had a seven- fold higher incidence of cerebral WML than DC infants. Discordant birth weight, TTTS and survivor of co- twin demise are an independent risk of cerebral white matter lesion.展开更多
Objective: The purpose of this study was to determine the perinatal outcome of spontaneously conceived triplet pregnancies in relation to chorionicity. Study design: In this retrospective study, maternal, neonatal, an...Objective: The purpose of this study was to determine the perinatal outcome of spontaneously conceived triplet pregnancies in relation to chorionicity. Study design: In this retrospective study, maternal, neonatal, and chorionicity data were collected from 88 sets of triplet pregnancies that were delivered at >20 weeks of gestation from 3 tertiary referral centers in the United Kingdom. The data were collected between January 1986 and December 2000. There were 49 sets of trichorionic triamniotic triplet pregnancies and 39 sets of triplet pregnancies with a monochorionic pair (ie, dichorionic triamniotic triplets). The outcome of each pregnancy was assessed in relation to chorionicity. Results: The overall perinatal mortality rate was 151.5 per 1000 total births, with dichorionic triamniotic triplets having a 5.5-fold higher risk than trichorionic triamniotic gestations (odds ratio, 5.5; 95%CI, 2.5-12.2). The dichorionic triamniotic triplets have a higher risk of delivery at < 30 weeks of gestation (odds ratio, 4.6; 95%CI, 1.6-11.8; P < .05) and birth weight of < 1000 g (odds ratio, 53.6; 95%CI, 17.5-164; P < .05) than those of trichorionic triamniotic pregnancies. The neonatal morbidity in terms of respiratory distress syndrome (P < .001), anemia (P < .01), and intraventricular hemorrhage (P < .001) were higher in dichorionic triamniotic compared with trichorionic triamniotic triplets. The premature rupture of membrane (odds ratio, 7.5; 95%CI, 3.5-15.7) and twin-twin transfusion syndrome (odds ratio, 14.9; 95%CI, 6.6-40) were independent risk factors for perinatal death. Conclusion: In spontaneously conceived triplets, the incidence of dichorionicity was 44%. The dichorionic triamniotic triplets have a 5.5-fold higher risk of adverse perinatal outcome predominantly because of twin-twin transfusion syndrome and premature rupture of membranes.展开更多
文摘Objective: The purpose of this study was to determine the incidence of ultrasonographically detected cerebral white matter lesions (WMLs) in preterm twins at birth in relation to chorionicity, discordant weight and twin- twin transfusion syndrome (TTTS). Methods: In this retrospective study, perinatal, neonatal, and cranial scan data of 85 monochorionic (MC) and 94 dichorionic (DC) twin pregnancies (341 infants) delivered between 24 and 34 weeks of gestation were collected. Data were analysed according to chorionicity, discordant birth weight (>20% ), single intrauterine death and TTTS. Results: The cerebral WML was seen in 14% of preterm twins. Monochorionic infants had higher risks of WML than DC twin (odds ratio 7.1; 95% CI 3.28- 15.8). In MC group, discordant weight (37% )- , TTTS (38% ), single intrauterine death (67% ) had higher incidence of cerebral WML than concordant weight infants (7% ). Similarly, incidence of WML was higher in DC discordant compared with concordant weight infants (13% versus 2% ; P <.0.05). Conclusion: Monochorionic infants had a seven- fold higher incidence of cerebral WML than DC infants. Discordant birth weight, TTTS and survivor of co- twin demise are an independent risk of cerebral white matter lesion.
文摘Objective: The purpose of this study was to determine the perinatal outcome of spontaneously conceived triplet pregnancies in relation to chorionicity. Study design: In this retrospective study, maternal, neonatal, and chorionicity data were collected from 88 sets of triplet pregnancies that were delivered at >20 weeks of gestation from 3 tertiary referral centers in the United Kingdom. The data were collected between January 1986 and December 2000. There were 49 sets of trichorionic triamniotic triplet pregnancies and 39 sets of triplet pregnancies with a monochorionic pair (ie, dichorionic triamniotic triplets). The outcome of each pregnancy was assessed in relation to chorionicity. Results: The overall perinatal mortality rate was 151.5 per 1000 total births, with dichorionic triamniotic triplets having a 5.5-fold higher risk than trichorionic triamniotic gestations (odds ratio, 5.5; 95%CI, 2.5-12.2). The dichorionic triamniotic triplets have a higher risk of delivery at < 30 weeks of gestation (odds ratio, 4.6; 95%CI, 1.6-11.8; P < .05) and birth weight of < 1000 g (odds ratio, 53.6; 95%CI, 17.5-164; P < .05) than those of trichorionic triamniotic pregnancies. The neonatal morbidity in terms of respiratory distress syndrome (P < .001), anemia (P < .01), and intraventricular hemorrhage (P < .001) were higher in dichorionic triamniotic compared with trichorionic triamniotic triplets. The premature rupture of membrane (odds ratio, 7.5; 95%CI, 3.5-15.7) and twin-twin transfusion syndrome (odds ratio, 14.9; 95%CI, 6.6-40) were independent risk factors for perinatal death. Conclusion: In spontaneously conceived triplets, the incidence of dichorionicity was 44%. The dichorionic triamniotic triplets have a 5.5-fold higher risk of adverse perinatal outcome predominantly because of twin-twin transfusion syndrome and premature rupture of membranes.
