ObjectiveTo characterize differences in the prenatal detection of congenital anomalies (CAs) associated with singleton and multiple births.MethodsThis observational study covered all births registered in the CA surveillance system in Zhejiang Province of China during 2012–2018. Differences in the incidence and characteristics between singletons and multiple births with CAs were tested. Multivariate logistic regression models were performed to explore the associations of prenatal detection rate of CAs with multiple births.ResultsTotals of 49 872 singletons and 3324 multiple births with CAs were analyzed. The mean incidences of CA for single and multiple births were 27.12 and 54.42 per 1000 births, respectively. After adjustment for covariates, CAs associated with multiple births were less likely to be diagnosed prenatally (adjusted odds ratio [OR] 0.38, 95% confidence interval [CI] 0.34–0.43), as were congenital heart defects, congenital hydrocephalus, cleft lip with cleft palate, cleft lip without cleft palate, limb reduction defects, congenital diaphragmatic hernia, trisomy 21 syndrome, congenital malformation of the urinary system, and other chromosomal malformation, compared with singletons with CAs.ConclusionMultiple birth is associated with a significantly higher risk of CA, but a significantly lower prenatal diagnosis rate. Therefore, the healthcare of women with multiple pregnancy and their fetuses should be strengthened.
Fetal inguinal hernia is quite rare and here we report two cases of prenatally diagnosed inguinoscrotal hernia to add to the limited understanding of this rare condition. The disappearance of blood flow signal in the scrotum may be helpful in detecting fetal incarcerated inguinoscrotal hernia that may progress to strangulation. If bowel dilatation was observed in such cases, the physician should be alert to identify primary intestinal obstruction caused by congenital digestive tract malformation and secondary intestinal obstruction caused by incarceration.
Selective intrauterine growth restriction (sIUGR) accounts for approximately 10%-15% of monochorionic diamniotic (MCDA) twins and is one of the most severe complications. 1 Selective IUGR is associated with increased perinatal mortality rate, poor neurological outcome, and higher incidence of endocrine and metabolic diseases, as well as cardiovascular dysfunction in adulthood. 2 The pathogeneses of sIUGR rely not only on the presence of gross placental structure factors, such as abnormal placental sharing and aberrant cord insertion, but also on the magnitude and direction of blood-flow interchange through the placental anastomoses. 3 The umbilical artery (UA) Doppler flow pattern of the smaller twin has been used for classifying
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