Role of ultrasonography in the management of twin gestation

Smith, Jessica; Treadwell, Marjorie C.; Berman, Deborah R.

doi:10.1002/ijgo.12483

Cited by 6 publications

(10 citation statements)

References 79 publications

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“…Four CPGs provided a reference range which varied from 10 weeks to 13+6 weeks gestation (32,39,40,49). Eight CPGs stated chorionicity should be determined before 13+6 (n=1), 14 (n=6) and 15 weeks gestation (n=1) (9,30,34,36,38,41,43) . The remainder varied between, " rst trimester", " rst trimester and early second trimester", " rst consultation" and "as early as possible" (27,28,34,35,41,44,47).…”

Section: Chorionicity and Datingmentioning

confidence: 99%

“…Three recommendations applied to dating a pregnancy when the optimal timing for dating had passed, two of these recommendations advised using the head circumference of the larger twin for dating pregnancies >14 weeks gestation, and one recommended using a combination of parameters rather than a single parameter beyond the rst trimester (9,29,33). Eleven recommendations across eight CPGs speci ed the requirements for establishing gestational age when a discordance of size exists, with all agreeing the larger twin should be used for estimation of gestational age (9,29,(32)(33)(34)41,48,49).…”

Section: Chorionicity and Datingmentioning

confidence: 99%

“…Four CPGs (eight recommendations) advised on cell free DNA (cfDNA) screening (34,35,40,46). SIGO was the only CPG that did not support the use of cfDNA, reporting there is no su cient data available (40).…”

Section: Screening For Fetal Anomaliesmentioning

confidence: 99%

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Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review

O’Connor

Leitão

et al. 2023

Preprint

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Objective: This review aimed to identify guidelines with recommendations applicable to the antenatal management of dichorionic diamniotic pregnancies within high-income countries, appraise their methodological quality, and discuss the similarities and variability across guidelines. Method: A systematic literature review of electronic databases was performed. Manual searches of guideline repositories and websites of professional organisations were performed to identify additional guidelines. The protocol for this systematic review was registered on PROSPERO(CRD42021248586, 25 June 2021). AGREE II and AGREE-REX tools were applied to assess the quality of eligible guidelines. A narrative and thematic synthesis described and compared the guidelines and their recommendations. Results: Twenty-four guidelines were included, from which 483 recommendations were identified across 4 international organisations and 12 countries. Guidelines addressed eight themes and recommendations were classified accordingly: chorionicity and dating (103 recommendations), fetal growth (105 recommendations), termination of pregnancy (12 recommendations), fetal death (13 recommendations), fetal anomalies (65 recommendations), antenatal care (65 recommendations), preterm labour (56 recommendations) and birth (54 recommendations). Guidelines showed significant variability in recommendations, with conflicting recommendations regarding non-invasive preterm testing, definitions surrounding selective fetal growth restriction, screening for preterm labour and the timing of birth. Guidelines lacked a focus on standard antenatal management of DCDA twins, management of discordant fetal anomaly and single fetal demise. Conclusions: Specific guidance for dichorionic diamniotic twins is overall indistinct and access to guidance regarding the antenatal management of these pregnancies is currently difficult. Management of discordant fetal anomaly or single fetal demise needs greater consideration.

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Section: Chorionicity and Datingmentioning

confidence: 99%

Section: Chorionicity and Datingmentioning

confidence: 99%

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Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review

O’Connor

Leitão

et al. 2023

Preprint

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“…Провідним критерієм в антенатальній ультразвуковій діагностиці зворотної артеріальної перфузії є виявлення ознак недорозвинення одного з плодів (плід-реципієнт), який помилково може бути прийнятий за загиблого, а виявлені зміни розцінені як посмертні [101]. Деякі дослідники рекомендують протягом вагітності проведення динамічного ультразвукового контролю за станом плода-донора, приділяючи особливу увагу виявленню ознак серцевої недостатності та затримки росту плода (ЗРП), оскільки вони є несприятливими прогностичними ознаками [106].…”

Section: акушерские и перинатальные аспекты многоплодной беременности вг сюсюка ад кирилюк ев бабинчук ню богуславская ои бачурина еа ершunclassified

Obstetric and perinatal aspects of multiple pregnancy

Syusyuka

Kyryliuk

Babinchuk

et al. 2021

RHW

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The article presents epidemiological data, modern terminology, features of the course of gestation, as well as obstetric and perinatal outcomes of childbirth in women with multiple pregnancy. The relevance of study this problem is due to the fact that the course of multiple pregnancy in almost all patients is accompanied by various complications, and their prognosis and prevention are of paramount importance. Despite the attention paid to multiple pregnancy, the complication rate remains high. Their treatment should be carried out in III level of perinatal care facilities. Attention is focused on the features of childbirth of pregnant women in accordance with the procedure for providing medical care to women with multiple pregnancies. An important issue remains to determine the time and tactic of delivery in multiple pregnancy. The choice of childbirth method depends on the obstetric anamnesis, gestational age, position and presentation of fetuses, estimated weight and size of fetuses, chorionicity, fetal and maternal condition, and the presence/absence of indications for caesarean section also matters. The optimal delivery time for uncomplicated twins is 37 weeks of pregnancy (monochorionic diamniotic twins — 36–37 weeks, dichorionic — 37–38 weeks), since in this period of pregnancy, the risks of antenatal fetal death and early neonatal death are minimal. Delivery of women with monochorionic monoamniotic twins is performed at the full 32 weeks of pregnancy by caesarean section. Among other indications for caesarean section are triplets and a larger number of fetuses, as well as conjoined twins, transverse or breech presentation of the first fetus, twins in combination with a scar on the uterus, an unsuccessful attempt of external-internal rotation of the second fetus in a transverse position after the birth of the first fetus, and others. An analysis of domestic and foreign publications was carried out in the article, which indicates the need for in-depth research in this direction, namely the elucidation of new pathogenetic links in multiple pregnancies, depending on the type of placentation, the search for new ways of management and the development of diagnostic criteria for the childbirth of this contingent of women.

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“…As gestações MCDA têm ainda mais riscos de apresentar complicações específicas, relacionadas ao compartilhamento da mesma massa placentária por dois fetos, como a STFF, a TAPS, a síndrome da perfusão arterial reversa (TRAP) e RCFs. A monocorionicidade é o principal fator de risco na gestação gemelar 46,47 .…”

Section: Corionicidadeunclassified

Avaliação do cordão umbilical em gestações gemelares monocoriônicas diamnióticas por meio de ultrassonografia

Nunes¹

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A meus pais, Eugênio e Leila, que, com muito amor e apoio incondicional, me proporcionaram as maiores riquezas de um ser humano, família, educação e princípios sólidos. Vocês são meus exemplos, meu orgulho, sou parte de vocês nesse mundo.A meu irmão Lucas. A vida e a distância privaram a nossa convivência diária. Nos meus anos de estudos e trabalho, em um piscar de olhos, você cresceu, foi de menino a homem. Obrigada por ser quem você é, e por com a sua grandeza e gentileza ter ocupado o meu espaço vazio de filha e irmã.A meu esposo Mário, meu maior incentivador e torcedor. Aquele que esteve nos bastidores finais dessa batalha, caminhando junto e me segurando em todos os momentos. A sua chegada, meu amor, renovou as minhas forças, me deu a certeza que faltava de que eu estava no caminho certo. Amo vocês! AGRADECIMENTO ESPECIAL À minha orientadora, Profa. Dra. Maria de Loudes Brizot, por ter sido o meu farol durante esta pesquisa. Obrigada por todos os ensinamentos, por toda a técnica e rigor, por seu exemplo e por todo carinho. Pegou em minha mão e me ensinou muito além que as etapas de uma pesquisa clínica. Com o seu apoio, tudo se tornou possível. Minha eterna gratidão. Ao Prof. Dr. Mário Henrique Burlacchini de Carvalho, que participou de muitas etapas deste trabalho, principalmente nas fases iniciais de sua construção ainda em forma de projeto de pesquisa, sendo fundamental para a sua excelência. Os meus agradecimentos vão além dessa dissertação. Obrigada por todos os ensinamentos, pelo apoio e pelas oportunidades dadas em todos esses anos. Minha mais sincera gratidão. AGRADECIMENTOS Esta dissertação de mestrado é uma grande conquista. É com grande alegria e satisfação que eu agradeço a todos que, direta ou indiretamente, participaram e foram fundamentais para que eu chegasse até aqui: A minha família -meus pais, irmão, meu esposo, meus sogros, meu cunhado, meus avós, meus tios e primos -por, mesmo a distância, serem sempre a minha referência e acalento. Por todos os incentivos, por demonstrarem o orgulho que sentem de mim. Obrigada por compreenderem minhas ausências e por aceitarem as minhas escolhas. Trago cada um de vocês em todas as minhas batalhas e conquistas. Agradeço, em especial, a nova família que formei no decorrer deste trabalho, quando uni minha vida a do meu esposo, a meus sogros Armando e Ângela Peixoto e a meu cunhado Armandinho, meu carinhoso agradecimento! Agradeço a minha formação no Instituto de Medicina Integral Professor Fernando Figueira -IMIP em Recife-PE, onde fiz residência médica em Ginecologia e Obstetrícia. Ali concretizei o meu fascínio pela obstetrícia e tive o primeiro contato com a subespecialidade que no futuro escolheria, a Medicina Fetal. Minha grande saudade e gratidão.

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Role of ultrasonography in the management of twin gestation

Cited by 6 publications

References 79 publications

Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review

Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review

Obstetric and perinatal aspects of multiple pregnancy

Avaliação do cordão umbilical em gestações gemelares monocoriônicas diamnióticas por meio de ultrassonografia

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