Management of Multiple Pregnancy: Prenatal Care???Part I

Ayres, Allen; Johnson, Timothy R.B.

doi:10.1097/01.ogx.0000172088.29348.e4

Cited by 16 publications

(13 citation statements)

References 66 publications

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“…Onethird of twins born in Great Britain have been reported as monozygotic and 2/3 as dizygotic (Rao et al, 2004). The monozygotic twin rate is almost consistent around the world (0.3-0.5%) (Rao et al, 2004;Ayres & Johnson, 2005), whereas dizygotic twinning frequency varies with maternal age, parity and ethnic group and ART was found to increase both dizygotic and monozygotic twinning (Rao et al, 2004). Research findings in Turkey reveal that the multiple birth rate is 0.8-3.7% and that the incidence of twin births is in the range of 0.6-3.4%.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of cesarean section in twin pregnancies rose from 28% in 1980-1985 to 59% in the 2000s (Taylor, 2006). Traditional practice calls for the planning of vaginal birth in the event of the vertex presentation of the first twin, provided there is no other accompanying complication (Ayres & Johnson, 2005). The recommended mode of delivery is by cesarean section when the first twin is nonvertex.…”

Section: Discussionmentioning

confidence: 99%

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Perinatal and Neonatal Outcomes of Twin Pregnancies in Turkey

et al. 2011

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This study was conducted for the purpose of assessing, in the light of results of other research carried out in the present researchers' clinic and in Turkey, the status of twin pregnancies in Turkey, the incidence of twin births, perinatal and mortality rates associated with twin pregnancies, and the problems experienced in Turkey in cases of multiple and twin pregnancies.Materials and Methodology:The outcomes of twin births that occurred at the researchers' clinic during the period 2001–2009 were studied retrospectively. Seventeen studies conducted in Turkey on multiple and twin pregnancies during the years 1991–2010 were included in the study.Findings:It was observed that the mean multiple pregnancy rate in Turkey is 1.9% and the mean twin birth rate is 1.7%. It was also observed that a large majority (80–97.3%) of multiple pregnancies in Turkey are twin pregnancies. It was noted from Turkish literature that the mean gestational age of twins at birth varies between 33–36.2 weeks and that mean birthweights are 2065–2327 grams for the first-born twin and 1887–2262 grams for the second-born. These findings were observed to be lower than what is indicated in the literature. Perinatal and neonatal mortality, at 58–156/1000 and 40–98/1000 respectively, were seen to be higher than in the literature.Conclusion:It can be seen that preterm birth rates for twin pregnancies in Turkey are higher than what is indicated in the literature and that prenatal and neonatal mortality rates are also similarly higher.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Perinatal and Neonatal Outcomes of Twin Pregnancies in Turkey

et al. 2011

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“…As large proportion of triplets occur after ovulation induction or assisted reproduction, strict compliance to existing national and international guidelines for ovulation induction and assisted reproduction, 15,16 proper counseling of the couple, and early prenatal diagnosis are important facets related to prevention and management of these high-risk pregnancies. [1][2][3] Although early diagnosis is an important issue to reduce complications of triplet gestation, most cases in the current study were diagnosed beyond 20 weeks. In multifetal pregnancies, zygocity and/or chorionicity are important prognosticators for perinatal complications, and these information are vital for proper planning of prenatal care and counseling.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Higher-order multiple births (3 or more) are now increasingly common as a result of ovulation induction and artificial reproductive technologies (ART). [1][2][3][4] Almost 50-60% of all triplets, 75% of all quadruplets and virtually all quintuplets now follow these treatments. 2 Currently, the technology is widely available in many developing countries.…”

Section: Introductionmentioning

confidence: 99%

Triplet gestation: current scenario in a teaching hospital of Eastern India

Das¹,

Mukhopadhyay²,

Rakshit³

et al. 2013

Int Jour of Biomed Res

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“…Ultrasound antepartum surveillance is the mainstay for monitoring fetal wellbeing and is essential for early diagnosis; vaginal ultrasound reveals the number of gestational sacs with accuracy (Ayres & Johnson, 2005). Ultrasound assessment of fetal growth and amniotic fluid volume should be scheduled every two weeks including nonstress tests and biophysical profiles later into the pregnancy and Doppler velocimetry in case of complications such as hypertension or fetal hypotrophy (Gregic et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Variable Outcome in Quintuplets Pregnancy Based on Obstetric Care

et al. 2011

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The incidence of multiple pregnancies has increased dramatically over the last few years in developed countries, largely attributed to delayed childbearing and the increasing use of assisted reproduction technologies and ovulation inducing hormones. Relatively few countries have population-based statistics covering birth statistics. Of those that do, the numbers of quintuplet pregnancies rose sharply in the nineties while, at the same time, their delivery rates decreased greatly because of the use of fetal reduction. Fetal reduction is not possible or legal in some countries, Poland being one of them, and therefore obstetricians are faced with the challenges of quintuplet deliveries. Conservative treatment and management is difficult, and outcomes often vary greatly. Despite this, expert care provided at tertiary care centers can positively influence outcomes. The objective of this article is to present different care options and their consequences in two illustrative cases, as well as to establish a set of obstetric care and management goals that would allow prolongation of the gestation time. Quintuplet pregnancy is rare but poses relevant clinical problems to both the obstetrician and the neonatologist. It should be managed with close cooperation between all concerned. Due to the extreme and invariable risk of premature delivery associated with quintuplet pregnancies, we recommend early diagnosis, adequate prenatal care at one tertiary medical center, routine hospitalization and bed rest, repeated ante partum ultrasound surveillance with tests of fetal well-being, tocolytic therapy at first signs of the risk of premature labor, and specialized neonatology care after delivery.

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Management of Multiple Pregnancy: Prenatal Care???Part I

Cited by 16 publications

References 66 publications

Perinatal and Neonatal Outcomes of Twin Pregnancies in Turkey

Perinatal and Neonatal Outcomes of Twin Pregnancies in Turkey

Triplet gestation: current scenario in a teaching hospital of Eastern India

Variable Outcome in Quintuplets Pregnancy Based on Obstetric Care

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