Prevalence of Congenital Heart Defects in Monochorionic/Diamniotic Twin Gestations

Bahtiyar, Mert Ozan; Dulay, Antonette T.; Weeks, Bevin; Friedman, Alan H.; Copel, Joshua A.

doi:10.7863/jum.2007.26.11.1491

Cited by 140 publications

(116 citation statements)

References 19 publications

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“…There was only one pair with TTT syndrome, in which the donor had coarctation of the aorta. In a literature meta-analysis of the prevalence of heart defects among MC,DA twins, the frequency was higher in twins with TTT syndrome than without [Bahtiyar et al, 2007]. Atrial and ventricular septal defects and pulmonary stenosis were the common defects.…”

Section: Major and Regional Malformationsmentioning

confidence: 96%

Non‐identical monozygotic twins, intermediate twin types, zygosity testing, and the non‐random nature of monozygotic twinning: A review

Machin

2009

American J of Med Genetics Pt C

138

102

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Monozygotic twins (MZ) are rarely absolutely “identical.” This review discusses the types of genetic/epigenetic and prenatal environmental post‐zygotic mechanisms that cause discordance within such twin pairs. Some of these mechanisms—ranging from heterokaryotypia to skewed X‐chromosome inactivation—may cause extreme discordance, but these extremes are merely the more emphatic examples of discordance that, to some degree, underlies the majority of MZ twin pairs. Because of the entrenched misconception that MZ twins are necessarily identical, many MZ twin pairs are mistakenly designated as dizygotic (DZ). Clinical benefits to accurate zygosity determination include correct solid organ transplantation matching, if one twin requires donation for a non‐genetically mediated disease; the opportunity of preventive management for disorders that do not manifest synchronously; and better counseling to parents regarding their individually unique, and often psychologically puzzling, twin offspring. In twin pairs with complex and confusing biological origins, more detailed zygosity testing may be required. For example, intermediate trigametic and tetragametic chimeric dizygotic twins are reviewed, some of whom are, nevertheless, monochorionic (MC). Because of inter‐fetal vascular anastomoses in MC twins, genetic results from blood samples may not accurately reflect discordance in solid organs. Previously, it was thought that MZ twinning was some sort of embryological fluke. However, familial monozygotic twinning is more common than suggested by the literature. Seven new families are presented in an accompanying paper. Despite the difficulties and dangers of twin pregnancy (especially so for MC twins), human twinning persists, and continues to both challenge and fascinate parents, clinicians and geneticists. © 2009 Wiley‐Liss, Inc.

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Section: Major and Regional Malformationsmentioning

confidence: 96%

Non‐identical monozygotic twins, intermediate twin types, zygosity testing, and the non‐random nature of monozygotic twinning: A review

Machin

2009

American J of Med Genetics Pt C

138

102

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“…In addition the frequency of cardiac malformations is about 2.5 times higher in the case of twin pregnancies complicated with pathology [12][13][14]. Therefore followup of twin monochorionic pregnancies requires special care in assessing the cardiovascular system [15,16]. In case of the presented newborn lack of specific secondary haematological changes, respectively association of anaemia-polycythaemia does not support the existence of a specific feto-fetal transfusion like syndrome, only intrauterine growth restriction of the donor fetus being present, with severe discordance between twins (above 30%).…”

Section: Discussionmentioning

confidence: 99%

Drug Closure of a Patent Ductus Arteriosus in An Extremely Low Birth Weight Premature Newborn. A Case Report

Moldovan

Cucerea

2015

The Journal of Critical Care Medicine

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Introduction: Patent ductus arteriosus involves maintaining the permeability of the vascular ductus located between the pulmonary artery and the descending aorta, due to the failure of transition from foetal to adult type circulation. This malformation is characteristic to premature newborns with extremely low birth weight. The main pathophysiological factors identified in this pathology are immaturity of the smooth muscles, presence of vasodilator mediators and persistent hypoxaemia. Ductal-dependent cardiac malformations require drug therapy for keeping the permeability of the ductus arteriosus until the time of corrective surgery. Case presentation: We present the case of an extremely low birth weight premature newborn, derived from twin pregnancy with suspected specific pathology, respectively feto-fetal transfusion syndrome, admitted to the Regional Centre of Neonatal Intensive Care Unit Tîrgu-Mureş.

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“…Major congenital defects are found in about 6% of twin pregnancies and usually, only one twin is affected . Cardiac anomalies are significantly prevalent amongst monochorionic twins (Manning et al, 2006 andBahtiyar et al, 2007). The incidence of congenital malformations was 3.2% among monozygotic and 2.2% among dizygotic twins.…”

Section: Congenital Malformationsmentioning

confidence: 99%

“…The risk is more than 30% in those pregnancies with discordance in nuchal translucency of 20% or more, compared to less than 10% in those with a smaller discordance (Kagan et al, 2007). Nuchal translucency enlargement may also be attributable to the presence of fetal structural defects especially cardiac defects (Bahtiyar et al, 2007). When enlarged nuchal translucency is found in both fetuses, the presence of an abnormal karyotype may be the underlying pathological condition.…”

Section: Nuchal Translucency (Nt)mentioning

confidence: 99%

See 1 more Smart Citation

Perinatal Mortality in Multiple Pregnancy

Steenhaut¹,

Hubinont²

2012

Perinatal Mortality

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Prevalence of Congenital Heart Defects in Monochorionic/Diamniotic Twin Gestations

Cited by 140 publications

References 19 publications

Non‐identical monozygotic twins, intermediate twin types, zygosity testing, and the non‐random nature of monozygotic twinning: A review

Non‐identical monozygotic twins, intermediate twin types, zygosity testing, and the non‐random nature of monozygotic twinning: A review

Drug Closure of a Patent Ductus Arteriosus in An Extremely Low Birth Weight Premature Newborn. A Case Report

Perinatal Mortality in Multiple Pregnancy

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