Characteristics of hypertensive disorders in twin versus singleton pregnancies

Foo, J.Y.; Mangos, George; Brown, Mark

doi:10.1016/j.preghy.2012.05.005

Cited by 27 publications

(29 citation statements)

References 18 publications

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“…It is uncertain whether the cardiac changes observed among women carrying twin gestations of different chorionicity may have an impact on the occurrence of hypertensive disorders or other cardiovascular complications in pregnancy. Of note, the prevalence of hypertensive disorders and peripartum cardiomyopathy is much higher in twin compared to singleton pregnancies, particularly at late gestation [15][16][17][18][19][20][21][22][23]. Moreover, a higher incidence of hypertensive disorders has been demonstrated in DC compared to MC twin pregnancies [2,24,25].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Chorionicity on Maternal Cardiac Adaptation to Uncomplicated Twin Pregnancy: A Prospective Longitudinal Study

et al. 2018

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Objective: The objective of this study was to longitudinally evaluate maternal echocardiographic findings in uncomplicated twin gestations according to chorionicity. Methods: Healthy women with twin pregnancy were assessed with transthoracic echocardiography across the first, second, and third trimesters. Cardiac findings were compared within each group and between monochorionic (MC) and dichorionic (DC) pregnancies. Results: Overall, 19 MC and 48 DC uncomplicated twin pregnancies were included. In the MC group, no significant maternal haemodynamic changes were documented across gestation, with the exception of a decrease in ejection fraction. Compared to DC pregnancies, in the MC set lower cardiac output (second and third trimester, p = 0.001 and p = 0.006, respectively) and higher total vascular resistance (first trimester, p = 0.032) were observed. Regarding the diastolic function in MC twins, significantly higher values were observed for mitral E/A ratio (third trimester, p = 0.014), septal mitral E1/A1 ratio (third trimester, p = 0.030), lateral mitral E1 (second and third trimester, p = 0.014 and p = 0.029, respectively), and E1/A1 ratio (third trimester, p = 0.006). Conclusions: Maternal cardiac adaptation in twin pregnancy seems to differ significantly according to chorionicity. In particular, in MC pregnancies the impairment of diastolic function is less pronounced, presumably due to the lower circulating volume.

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Section: Discussionmentioning

confidence: 99%

The Effect of Chorionicity on Maternal Cardiac Adaptation to Uncomplicated Twin Pregnancy: A Prospective Longitudinal Study

et al. 2018

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“…Foo et al [17] observed a higher rate of SGA in twin pregnancies with PE, whereas Sibai et al [2] found no difference in SGA between twins and singletons with PE. In the current study, we observed a higher rate of SGA in the singleton as compared to the twin group (26.5 vs. 13.4%, p = 0.002).…”

Section: Discussionmentioning

confidence: 99%

“…The differentiation between PE in singletons versus twins in terms of maternal risk factors [8][9][10], pathogenesis [11][12][13][14], clinical manifestations [2,10,[15][16][17], and pregnancy outcome [2,10,15,16,18] have been investigated. Some of these studies are contradictive in their results, yet it seems that in many aspects, PE in twins significantly differs from PE in singletons.…”

Section: Introductionmentioning

confidence: 99%

Placental Component and Pregnancy Outcome in Singleton versus Twin Pregnancies Complicated by Preeclampsia

Weiner¹,

Feldstein²,

Schreiber

et al. 2017

Fetal Diagn Ther

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Objective: To compare placental histopathological lesions and pregnancy outcomes in singleton and twin pregnancies complicated by preeclampsia (PE). Methods: Maternal characteristics, neonatal outcomes, and placental histopathology reports of pregnancies complicated by PE between January 2008 and October 2016 were reviewed. Results were compared between singletons (singleton group) and dichorionic-diamniotic twins (twin group). Placental lesions were classified into maternal and fetal vascular supply lesions. Small for gestational age (SGA) was defined as birth weight ≤10th percentile. Composite adverse neonatal outcome was defined as one or more early neonatal complications. Results: Compared to the twin group (n = 67), the singleton group (n = 275) was characterized by lower maternal age (p = 0.003), higher gestational age (p < 0.001), higher rates of previous PE (p = 0.017), chronic hypertension (p = 0.036), and severe features (p < 0.001). Placentas from the singleton group were characterized by higher rates of maternal vascular malperfusion lesions (p < 0.001) and fetal vascular supply lesions (p = 0.002). Using multivariable regression analysis, composite maternal and fetal vascular malperfusion lesions were independently associated with singletons (aOR = 2.7, 95% CI = 1.2-7.8, p < 0.001, and aOR = 1.2, 95% CI = 1.2-5.6, p = 0.025, respectively). SGA was more common in the singleton group (p = 0.002). Neonatal outcome did not differ between the groups. Conclusion: Placentas from singleton pregnancies complicated by PE were characterized by higher rates of maternal and fetal vascular lesions compared to those from twin pregnancies, suggesting that different mechanisms participate in the development of PE in these two groups.

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“…The gestational age of twin pregnancy with PE was earlier (P < 0.001), and SGA was more. 69 When comparing mothers and neonates of twin pregnancies complicated to mothers and neonates of singleton pregnancies complicated by severe Preeclampsia, there does not appear to be a difference in morbidity and mortality. 70 ( Table 1 )…”

Section: Introductionmentioning

confidence: 99%

A Review of Research Progress of Pregnancy with Twins with Preeclampsia

Wang

Shen

2021

RMHP

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Preeclampsia has a significant long-term effect on the health of both mothers and babies. Preeclampsia-related pregnancy complications increase the morbidity and mortality of pregnant women and their fetuses by 5-8%. The recent advancement of assisted reproductive technology, combined with a rise in the number of elderly pregnant women, has resulted in pregnancy incidence with twins. Twins pregnant women have a 2-3 times greater risk of developing preeclampsia than singleton pregnant women, and it happens sooner and progresses faster. It is more severe and may appear in an atypical way. End-organ damage, such as renal failure, stroke, cardiac arrest, pulmonary edema, placental abruption, and cesarean section, are related maternal complications. Fetal growth retardation, stillbirth, and premature delivery with obstetric signs are all fetal complications. According to studies, all multiple pregnancies can take low-dose aspirin (60-150 mg) to minimize the risk of preeclampsia. To improve pregnancy outcomes and reduce the inherent risk of pregnancy with twins, twins should be handled as a high-risk pregnancy and treated differently than singletons. The literature on twin pregnancy with preeclampsia is the subject of this review. It will examine the current state of research on preeclampsia in pregnancy with twins, including the occurrence, diagnosis, and pathophysiological process. Moreover, the effect of pregnancy with twins on the perinatal outcome and pregnancy management of pregnancy with twins, including blood pressure management and preeclampsia prevention and treatment, is examined in this literature review. The goal is to figure out what kind of diagnosis and care you may need.

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Characteristics of hypertensive disorders in twin versus singleton pregnancies

Abstract: Women carrying twins with de novo hypertension are more likely to present earlier, have initial PE and to subsequently progress from GH to PE. Neonatal outcomes are worse in such pregnancies.

Cited by 27 publications

References 18 publications

The Effect of Chorionicity on Maternal Cardiac Adaptation to Uncomplicated Twin Pregnancy: A Prospective Longitudinal Study

The Effect of Chorionicity on Maternal Cardiac Adaptation to Uncomplicated Twin Pregnancy: A Prospective Longitudinal Study

Placental Component and Pregnancy Outcome in Singleton versus Twin Pregnancies Complicated by Preeclampsia

A Review of Research Progress of Pregnancy with Twins with Preeclampsia

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