Managing twins discordant for fetal anomaly

Rustico, Mariangela; Baietti, M. G.; Coviello, D.; Orlandi, Emanuela; Nicolini, Umberto

doi:10.1002/pd.1260

Cited by 84 publications

(58 citation statements)

References 46 publications

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“…Different choices can be considered in managing these multiple pregnancies: termination of pregnancy, selective embryo reduction of the affected twin, anticipation of delivery or natural course of the pregnancy. Each choice hides difficult clinical and legal implications because it may directly or indirectly involve and compromise the healthy twin as well as the mother [31].…”

Section: Twin Discordance and Ethical Issuesmentioning

confidence: 99%

Prematurity and twinning

Giuffrè

Piro

Corsello

2012

The Journal of Maternal-Fetal & Neonatal Medicine

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Aim of the study: Newborns from multiple pregnancies are increasing in number and demonstrate a higher perinatal morbidity and mortality compared to singletons. Prematurity is the main reason for most neonatal diseases in twins, but other variables may play a role and their prenatal evaluation may improve the overall outcome. Main findings: Prematurity is six times more frequent in twins and therefore birth weight is significantly lower compared to singletons. Thus, twins are more exposed to prematurity related diseases (respiratory, cardiovascular, infectious, etc.) and to long-term complications (especially neurological disabilities). Results: It is very difficult to estimate the increased risk of neonatal morbidity related to twinning independently to the increased risk of prematurity and therefore to interpret data on morbidity rates, in particular regarding the neurodevelopmental outcome. Conclusion: Prevention of preterm birth is a primary goal in managing multiple pregnancies, together with prophylaxis with corticosteroids in order to improve foetal lung maturity. Accurate risk assessment strategies and adequate obstetrical-neonatological management of multiple pregnancies may reduce the increasing need for neonatal intensive care and for health resources in the long-term follow-up that has been observed over the last decades.

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Section: Twin Discordance and Ethical Issuesmentioning

confidence: 99%

Prematurity and twinning

Giuffrè

Piro

Corsello

2012

The Journal of Maternal-Fetal & Neonatal Medicine

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“…Heterokaryotypia for Turner syndrome, Down syndrome, and Klinefelter syndrome are all rare but have been reported (Rustico et al, 2005). These probably arise as a consequence of post-zygotic non-dysjunction.…”

Section: Discussionmentioning

confidence: 99%

The Outcome of Twin Pregnancies Discordant for Trisomy 21

et al. 2013

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The management of twin pregnancies discordant for trisomy 21 is dependent on the gestation at diagnosis, chorionicity, and parental preference. Our experience with the management of 15 cases in 1,839 twin pregnancies over a 12-year period is described. Selective termination is not always associated with a successful outcome for the normal co-twin. Two of the three monochorionic twin pregnancies affected by trisomy 21 were discordant. Amniocentesis should be strongly considered rather than chorionic villus sampling in monochorionic twin pregnancies. Pregnancies that continue with a trisomy 21 affected fetus are at risk of polyhydramnios and premature labor.

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“…Affected twin pregnancies are mainly discordant. Overall, it has been estimated that both twins are affected for the same anomaly in approximately 15% of cases (Rustico et al, 2005). Phenotypical discordances in DZ twins may eventually originate from genetic disorders.…”

Section: Discussionmentioning

confidence: 99%

“…This situation impacts on obstetrical management and is conditioned by three elements (Gul et al, 2005;Rustico et al, 2005): chorionicity, zygosity, and the progression of the malformation with its associated complications such as polyhydramnios.…”

Section: Discussionmentioning

confidence: 99%

Twins discordant for fetal skeletal abnormalities: a natural confrontation between the two siblings

et al. 2007

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BackgroundSkeletal abnormalities encompass a heterogeneous group of disorders characterized by anomalies of cartilage as well as bone growth and development. Some are lethal and express early during fetal life, making them amenable to prenatal diagnosis. The increasing use of routine ultrasonography (US) during pregnancy permits a reliable primary evaluation of the fetal skeleton. However, when a skeletal dysplasia is suspected, it is more difficult to establish a specific diagnosis. Moreover, detailed ultrasonographic evaluation of the whole fetal skeleton may be limited in some circumstances, especially during the third trimester due to the fetal position and in the case of multiple pregnancies.MethodsRetrospective study of twin pregnancies complicated with skeletal abnormalities.Results6 twin pregnancies were reviewed. The prenatal diagnosis was correctly made in 66.66% (4/6) with the primary use of combined 2D and 3D‐US. 3D‐HCT permits to improve the simultaneous assessment of both fetuses, and is of greater value than US in 16.66% (1/6).ConclusionThe combined use of 2D or 3D‐US with 3D‐HCT permits the best imaging evaluation. Copyright © 2007 John Wiley & Sons, Ltd.

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Managing twins discordant for fetal anomaly

Cited by 84 publications

References 46 publications

Prematurity and twinning

Prematurity and twinning

The Outcome of Twin Pregnancies Discordant for Trisomy 21

Twins discordant for fetal skeletal abnormalities: a natural confrontation between the two siblings

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