Objective. Our objective was to estimate degree and rate of discordant growth and its impact on perinatal outcome in dichorionic twin pregnancies conceived by in vitro fertilization (IVF) compared to those conceived spontaneously. Study Design. Growth discordance was defined as 90th percentiles for the study population. Adverse perinatal outcome was defined as 5-minute Apgar score <7 and/or admission to neonatal intensive care unit. Results. In the total study population of dichorionic twins (176 conceived by IVF and 215 spontaneously), 30% discordant growth represented the 90th percentile. After adjusting for gestational age, discordant twins conceived by IVF or spontaneously were at higher risk for adverse perinatal outcome (hazard ratio 4.4; 95% CI 2.4–8.3, P < 0.0001; hazard ratio 2.5; 95% CI 1.5–4.4, P = 0.001, resp.). Similar rates of 5-minute Apgar score <7, admission to neonatal intensive care unit, and delivery <34 weeks were found between discordant twins conceived by IVF and those conceived spontaneously. Conclusion. Dichorionic twins conceived by IVF are at similar risk for the rate and degree of discordant growth and adverse perinatal outcome compared to dichorionic twins conceived spontaneously.
Our study suggests that the strategy of first-trimester combined screening of biochemical values and ultrasonographic parameters at 12 gestational weeks identifies higher percentage of aneuploidies with a lower false-positive rate than a single parameter strategy.
Termination of pregnancy before completed 39 weeks does not decrease maternal morbidity. The major impact on maternal complications has the number of previous cesarean deliveries (≥ 3), as well as emergency cesarean section. Patients should be informed about potential risks for maternal health with increasing number of cesarean deliveries, especially after the first cesarean section when counseling in elective repeat cesarean vs trial of labor.
Oral communication abstracts OC14.05: malformations were excluded. The accuracy of each model for prediction of macrosomia was calculated using several thresholds: 4000 g (or 360 mm for AC), the threshold obtained from the inflexion point in the ROC curve, and the threshold associated with the highest overall accuracy. The models were rank ordered from 1 (most accurate) to 22 (least accurate) using a composite score.Results: 1) There was a considerable variation in the accuracy of the different models (in Table 1 values are presented as mean (range) of all models), 2) The use of different types of threshold resulted in significant differences in the performance of the different models ( Objectives:To assess the possible advantage on the rate of complications of the addition of NO donors and liquid assumption to standard antihypertensive therapy in women with early appearance (between 20 and 27 weeks gestation) of moderate gestational hypertension (systolic blood pressure 150-169 mmHg and diastolic blood pressure 100-109) (MGH). Methods: A group of 400 MGH were enrolled in a case-control study and underwent maternal echocardiography with the calculation of total vascular resistance (TVR). One hundred patients were treated with nifedipine alone (group A); 100 patients were treated with nifedipine (group B) and NO donors; 100 patients were treated with nifedipine, and were invited to assume 2.0-3 liters of liquids per day (Group C); and 100 patients were treated with nifedipine, NO donors and were invited to assume 2.0-3 liters of liquids per day (Group D). Echocardiographic examination was repeated every 7-10 days to calculate TVR. The 4 groups were followed until term, and severe maternal and fetal complications were noted (fetal growth restriction, appearance of preeclampsia, etc). Results: 51 patients of group A, 48 patients of group B and 53 patients of group C had complications, whereas only 35 of group D had complications (51%, 48%, a and 53% vs. 35%, P < 0.001). In each group complications where mainly confined to patients with TVR > 1400 dyn who did not show a reduction of at least 10% during therapy. The reduction of at least 10% of TVR was more frequent in group D, and patients who showed this hemodynamic pattern had less severe or no complications.Conclusions: NO donors and liquid assumption associated to standard antihypertensive therapy appear to be effective in reducing TVR and the rate of severe complications in moderate gestational hypertension. Objectives: The aim of this study is to examine the value of preinduction transvaginal sonographic measurement of cervical length combined with maternal factors in prediction of duration of labor and the need for Caesarian section. Methods: In 84 singleton pregnancies medically indicated induction of labor was carried out at 37-42 weeks of gestation. Inclusion criteria were: singleton pregnancy, live fetus in cephalic presentation, no previous history of uterine surgery, intact membranes. The cervical length was measured by transvaginal sonography before...
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