Cyclic changes in the umbilical arterial flow in mono-chorionic, di-amniotic twin pregnancy

Nakai, Yuichiro; Ishiko, Osamu; Nishio, Junko; Suzuki, Shin ichiro; Mine, Makiko; Imanaka, Makoto; Ogita, Sachio

doi:10.1016/s0301-2115(01)00530-9

Cited by 17 publications

(12 citation statements)

References 4 publications

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“…7,17,21 More importantly, they seem to be strongly associated with important differences in clinical evolution and outcome. 17,21,22 In the rest of the chapter we will discuss in separate sections the clinical evolution and options for management of the different clinical forms of sFGR. According to this classification, pregnancies are defined as type I (normal umbilical artery Doppler), type II (persistent absent or reversed end-diastolic velocity flow, AREDF) or type III (intermittent AREDF).…”

Section: The Potential Contribution Of Umbilical Artery Doppler To DImentioning

confidence: 99%

Diagnosis and Management of Selective Fetal Growth Restriction in Monochorionic Twins

Gratacós

Eixarch

Crispi

2009

Fet. Matern. Med. Rev.

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Selective fetal growth restriction (sFGR) has been reported to occur in about 10–15% of monochorionic (MC) twins. The diagnosis of sFGR has been based on variable criteria including estimated fetal weight (EFW), abdominal circumference and/or the degree of fetal weight discordance. Recent studies tend to use a simple definition which includes the presence of an EFW less than the 10th percentile in the smaller twin. Some would argue that the intertwin fetal weight discordance should be included in the definition. Indeed this factor plays a major role in the complications presented by these cases. While the majority of cases with one fetus below the 10th percentile usually will also present with a large intertwin EFW discordance, the contrary is not always true. Thus, it is possible to find MC twins with remarkable intertwin EFW discordance but the EFW of both fetuses are still within normal ranges. Although it appears to be common sense that a large intertwin discrepancy might represent a higher risk for some of the complications described later in this review, there is no consistent evidence to support this notion. Therefore, due to its simplicity, a definition based on an EFW below 10th percentile in one twin is probably the most useful for clinical and research purposes.

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Section: The Potential Contribution Of Umbilical Artery Doppler To DImentioning

confidence: 99%

Diagnosis and Management of Selective Fetal Growth Restriction in Monochorionic Twins

Gratacós

Eixarch

Crispi

2009

Fet. Matern. Med. Rev.

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“…The umbilical arterial flow velocity waveform sometimes revealed cyclic change [37]. This change was suspected to be caused by arterio-arterial anastomosis.…”

Section: Umbilical Arterial Blood Flowmentioning

confidence: 97%

Accurate diagnosis of umbilical circulation

Nakai

Tachibana

Yamamasu

2006

The Ultrasound Review of Obstetrics & Gynecology

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Umbilical arterial flow velocity has been widely used for the estimation of fetal status. This is clinically useful, but affected by physiological characteristics or other factors such as maternal drug administration. Otherwise, umbilical venous pulsation is also used for fetal estimation. But, this particular pattern appeared not only from fetal cardiac problems, but from umbilical cord characteristics. We summarized the various factors which affect the umbilical circulation.

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“…No se ha determinado cual es el mejor método para evaluar el bienestar fetal en gemelos monocoriales con RCF selectiva; la velocimetría Doppler de la arteria umbilical no tiene el mismo valor pronóstico en gemelos monocoriales que en gestaciones únicas o gemelos bicoriales. El registro basal no estresante (RBNE) y el perfil biofísico impresionan actualmente como los mejores métodos disponibles para evaluar el bienestar fetal, aunque el óbito de uno de los gemelos puede ocurrir inesperadamente, a pesar de un RBNE y perfil biofísico normales (35).…”

Section: Parto Prematurounclassified

Pautas De Manejo Clínico De Embarazos Gemelares

Becker

2009

Rev. chil. obstet. ginecol.

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RESUMENEl embarazo gemelar conlleva un elevado riesgo de morbilidad y mortalidad perinatal. Teniendo el control prenatal una reconocida utilidad en disminuir la morbimortalidad perinatal, decidimos elaborar pautas de manejo clínico, basadas en evidencia, que orienten el seguimiento prenatal de embarazos gemelares. Realizamos una revisión de las publicaciones recientes, guías clínicas y textos clásicos de obstetricia obteniendo la información necesaria. Presentamos un listado de las recomendaciones y la calidad de evidencia que las sustenta, respecto de seis ítems: a. Reproducción asistida; b. Diagnóstico de embarazo gemelar; c. Manejo general del embarazo gemelar; d. Parto prematuro; e. Complicaciones específicas de embarazos gemelares; y f. Momento de interrupción y manejo del trabajo de parto. PALABRAS CLAVE: Embarazo múltiple, embarazo gemelar, guías clínicas SUMMARYMultiple pregnancy has high risk of perinatal morbidity and mortality. Since antenatal care has been demonstrated as a useful tool in reducing perinatal risk, we decided to elaborate evidence based clinical guidelines, to facilitate antenatal care of women carrying multiple pregnancies. We reviewed recent publications, clinical guidelines and text books to obtain necessary information. Here we present a list of recommendations, and the quality of supporting evidence, about six items: a. Assisted reproduction; b. Diagnosis of multiple pregnancy; c. General care of multiple pregnancy; d. Preterm Labor; e. Specific complications of multiple pregnancy; f. Timing of delivery and labor management. KEY WORDS: Multiple pregnancy, twin pregnancy, guidelines INTRODUCCIÓNLa incidencia de embarazos múltiples ha aumentado dramáticamente en las últimas décadas en los países desarrollados, desde 1 por 100 nacidos vivos a 1 por 70 nacidos vivos, con un aumento de un 40% en la tasa de embarazos gemelares y un aumento de 3 a 4 veces en embarazos múlti-ples de alto orden. Este aumento en el número de embarazos múltiples es atribuible en mayor parte a la utilización de técnicas de reproducción asistida, pero también se explica por un aumento en la edad materna, ya que existe asociación entre la edad materna y la tasa de gestaciones múltiples concebidas espontáneamente (1).El embarazo múltiple es un embarazo de alto riesgo fetal, pues tiene, entre otros problemas, mayor incidencia de prematurez, restricción del crecimiento fetal, malformaciones congénitas y muerte fetal in útero comparado con las gestaciones úni-cas. Existen además, complicaciones propias del embarazo gemelar como: crecimiento discordante, muerte in útero de alguno de los gemelos, síndrome de transfusión feto-fetal, gemelos monoamnióticos

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Cyclic changes in the umbilical arterial flow in mono-chorionic, di-amniotic twin pregnancy

Cited by 17 publications

References 4 publications

Diagnosis and Management of Selective Fetal Growth Restriction in Monochorionic Twins

Diagnosis and Management of Selective Fetal Growth Restriction in Monochorionic Twins

Accurate diagnosis of umbilical circulation

Pautas De Manejo Clínico De Embarazos Gemelares

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