Acardiac twin pregnancies part II: Fetal risk of chorangioma and sacrococcygeal teratoma predicted by pump/acardiac umbilical vein diameters

Gemert, Martin J. C. van; Nikkels, Peter G. J.; Paarlberg, K.M.; Wijngaard, Jeroen P. H. M. van den; Gardiner, Helena M.

doi:10.1002/bdra.23531

Cited by 4 publications

(2 citation statements)

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“…This study, the fourth on acardiac twinning (van Gemert et al, , , ), aims to investigate whether Benirschke's hypothesis of an uneven embryonic splitting combined with AA‐VV anastomoses may indeed lead to onset of acardiac twinning. We hypothesized that the cell volume ratio at embryonic splitting remains unaltered during the subsequent splitting sequences and thus causes the same ratio of the two embryonic/fetal blood volumes.…”

Section: Introductionmentioning

confidence: 99%

Acardiac twin pregnancies part IV: Acardiac onset from unequal embryonic splitting simulated by a fetoplacental resistance model

Gemert

Wijngaard

Paarlberg

et al. 2017

Birth Defects Research

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Our analysis supports Benirschke's hypothesis. The smaller twin has to share its placental perfusion with the larger twin, which is a novel finding. The AA size is essential for the future of both fetuses but complicates easy understanding of (pseudo-)acardiac clinical presentations. Late acardiac onset occurs infrequently. Using nonpulsating circulations may have caused our extensive predictions of late onset. An improved model requires including hypoxemia in the smaller twin from chronic placental hypoperfusion. Birth Defects Research 109:211-223, 2017. © 2016 Wiley Periodicals, Inc.

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Section: Introductionmentioning

confidence: 99%

Acardiac twin pregnancies part IV: Acardiac onset from unequal embryonic splitting simulated by a fetoplacental resistance model

Gemert

Wijngaard

Paarlberg

et al. 2017

Birth Defects Research

Self Cite

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“…Interestingly, van Gemert et al recently published on a hypothesis that the use of umbilical/chorionic venous flows could identify CA that could have serious circulatory consequences on the fetus [13]. The present study includes too few cases with big CAs to accurately study this hypothesis.…”

Section: Discussionmentioning

confidence: 94%

Clinical Outcome in Singleton and Multiple Pregnancies with Placental Chorangioma

et al. 2016

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IntroductionChorangiomas (CAs) are the most common non-trophoblastic tumor-like-lesions of the placenta. Although the clinical significance of small CAs is unknown, the large lesions are often associated with maternal and fetal complications. The aim of our study was to assess the maternal clinical characteristics and neonatal outcome in singleton and multiple pregnancies with placental CA.Materials and MethodsAmong 15742 selected placentas 170 CAs were diagnosed. Pregnancy and neonatal outcomes were analyzed in singleton (n = 121) and multiple (n = 49) pregnancy groups including 121 and 100 neonates, respectively.ResultsThe frequency of APGAR score <7 at 5 minutes (p = 0,012), abnormal pulsatility index (p = 0,034), and abnormal blood flow class (p = 0,011) were significantly higher in neonates from singleton compared to multiple pregnancies. Significantly smaller CAs in singleton pregnancies were related to small for gestational age neonates (p = 0,00040) and neonates admitted to the neonatal care unit (p = 0,028). In singleton pregnancies, significantly smaller CAs were associated to maternal preeclampsia (p = 0,039) and larger CAs to multiparity (p = 0,005) and smoking (p = 0,001) groups. The frequency of preeclampsia was high in both singleton and multiple pregnancy groups (41,32% vs 26,53%, respectively), however, the difference did not reach the level of statistical significance.DiscussionA high incidence of preeclampsia in cohort of placental CA might lead to a possible recognition of CAs as potential morphologic indicator of placental hypoxia.ConclusionA more favorable pregnancy outcome in multiple gestations compared to the singleton gestations with CAs might reflect an adaptive mechanism for increased demand of oxygen and associated placental tissue hypoxia in this group.

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Acardiac twin pregnancies part III: Model simulations

Gemert

Ross

Nikkels

et al. 2016

Birth Defects Research

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Our simulations support clinical results which show that UVD ratios aid in the prediction of pump twin risk. The AA anastomosis controls the future of both the pump and the acardiac. Correlation between acardiac size and pump twin risk is secondary to the AA size but remains clinically usable. These factors may aid in the development of methods for pump twin prognosis and the promotion of selective clinical interventions.Birth Defects Research (Part A), 2016.© 2016 Wiley Periodicals, Inc. Birth Defects Research (Part A) 106:1008-1015, 2016. © 2016 Wiley Periodicals, Inc.

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Acardiac twin pregnancies part II: Fetal risk of chorangioma and sacrococcygeal teratoma predicted by pump/acardiac umbilical vein diameters

Abstract: Risk prediction of these rare fetal tumors may be possible based on application of data on excess cardiac output fractions from pump/acardiac UVD ratios and will require future clinical validation. Birth Defects Research (Part A) 106:733-738, 2016. © 2016 Wiley Periodicals, Inc.

Cited by 4 publications

References 25 publications

Acardiac twin pregnancies part IV: Acardiac onset from unequal embryonic splitting simulated by a fetoplacental resistance model

Acardiac twin pregnancies part IV: Acardiac onset from unequal embryonic splitting simulated by a fetoplacental resistance model

Clinical Outcome in Singleton and Multiple Pregnancies with Placental Chorangioma

Acardiac twin pregnancies part III: Model simulations

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