Investigation of the factors affecting the perinatal outcome of monochorionic diamniotic twins

Murakami, Masahiro; Iwasa, Takeshi; Kiyokawa, Machiko; Takahashi, Y.; Momoeda, Mikio

doi:10.1007/s00404-010-1549-3

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…The difference of chorionicity by the method of conception was consistent with a previous study (Murakami et al 2011). MD twins have a greater perinatal risk including twin-to-twin transfusion syndrome, growth discordance, and perinatal death (Dube et al 2002;Hack et al 2006;Skiadas et al 2008).…”

Section: Discussionsupporting

confidence: 90%

“…Considering this relative shortage of NICU beds in Shiga, population-based studies of regional perinatal medical circumstances are indispensable (Koshida et al 2015). Although there are some perinatal center-based studies related to multiple pregnancies in Japan (Murakami et al 2011;Nakayama et al 2012), there have been no population-based studies of multiple-birth infants associated with their occupation of regional NICU beds.…”

Section: Introductionmentioning

confidence: 99%

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Perinatal Backgrounds and NICU Bed Occupancy of Multiple-Birth Infants in Japan

Koshida

Ono

Tsuji

et al. 2016

Tohoku J. Exp. Med.

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Multiple pregnancies (twin, triplet, and higher-order pregnancy) are associated with an increased risk of resultant preterm and low birth weight infants. The increase of multiple pregnancies for several decades in Japan has been an important consideration in bed allocation planning for neonatal intensive care unit (NICU). The guideline of the Japan Society of Obstetrics and Gynecology (JSOG) in 2008 recommended that embryo transfer be limited to one. The epidemiological data of Japanese regional multiple pregnancies before the JSOG recommendation are valuable in assessing the perinatal effects after this recommendation. The aim of this study was to investigate regional backgrounds of multiple pregnancies and neonatal outcomes of multiple births including NICU admission before the JSOG recommendation. This is a retrospective population-based study for 20 months (January, 2007 through August, 2008 in Shiga Prefecture, Japan. Sending questionnaires to institutions treating multiple births in Shiga, we extracted relevant data from the responses of respective obstetricians and neonatologists. There were 245 multiple births including 241 twins and 4 triplets. We found more twin deliveries with higher risks such as monochorionic diamniotic twins or preterm twins less than 34 weeks in hospitals including perinatal centers than in primary obstetrics clinics. More than half of multiple-birth infants (57%) required NICU admission, and nearly 20% of NICU beds in Shiga are occupied with multiple-birth infants. Furthermore, half of multiple-birth infants were conceived with medical assistance. We conclude that multiple pregnancies resulting from medically assisted conception could have a significant impact upon the NICU bed occupancy in Japan.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Perinatal Backgrounds and NICU Bed Occupancy of Multiple-Birth Infants in Japan

Koshida

Ono

Tsuji

et al. 2016

Tohoku J. Exp. Med.

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“…As an incidental finding, this study showed a significantly higher prevalence of nulliparous women in the group complicated by late sIUGR or BW discordance. So far, only one small study, including 42 monochorionic twin pregnancies, reported this finding. In singletons, the association between parity and fetal growth restriction has been well demonstrated, and uterine artery Doppler is recommended for the screening of pre‐eclampsia and fetal growth restriction in high‐risk women.…”

Section: Discussionmentioning

confidence: 99%

Intertwin discrepancy in middle cerebral artery peak systolic velocity and third-trimester fetal growth restriction in monochorionic-diamniotic twin pregnancy

Stagnati

Pagani

Fichera

et al. 2016

Ultrasound Obstet Gynecol

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Objectives To assess the role of intertwin discrepancy in middle cerebral artery peak systolic velocity (MCA-PSV) for the prediction of late selective intrauterine growth restriction (sIUGR) at birth and birth weight discrepancy of > 25% (area under ROC curve (AUC), 0.73 (95% CI,) and 0.79 (95% CI,). The optimal cut-off point for 70% and specificity, 69% for sIUGR; sensitivity, 83% and specificity,

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Early prognostic factors of outcomes in monochorionic twin pregnancy: systematic review and meta-analysis

Mackie

Hall

Morris

et al. 2018

American Journal of Obstetrics and Gynecology

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Investigation of the factors affecting the perinatal outcome of monochorionic diamniotic twins

Abstract: Further FLP treatment can be performed on twins with TTTS so that prognosis may be improved. Since the risk of discordant growth is significantly greater in twins of nulliparous women, they should be monitored more carefully than multiparous women.

Cited by 4 publications

References 12 publications

Perinatal Backgrounds and NICU Bed Occupancy of Multiple-Birth Infants in Japan

Perinatal Backgrounds and NICU Bed Occupancy of Multiple-Birth Infants in Japan

Intertwin discrepancy in middle cerebral artery peak systolic velocity and third-trimester fetal growth restriction in monochorionic-diamniotic twin pregnancy

Early prognostic factors of outcomes in monochorionic twin pregnancy: systematic review and meta-analysis

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