Placental Cord Insertion and Birth Weight Discordancy in Twin Gestations

Hanley, Maryellen L.; Ananth, Cande V.; Shen‐Schwarz, Susan; Smulian, John C.; Lai, Yu‐Ling; Vintzileos, Anthony M.

doi:10.1097/00006250-200203000-00018

Cited by 28 publications

(46 citation statements)

References 17 publications

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“…Fetal thrombosis was associated with SGA, confirming the work of others. 6,7 Redline et al 8 reported that avascular villi with occlusion of fetal vessels in the placenta was associated with intrauterine growth retardation and discordant growth in monochorionic-twin placentas. Fetal vessel thrombosis is common in the placentas of SGA infants.…”

Section: Discussionmentioning

confidence: 99%

“…21 In our study, it was much more common in monochorionic than dichorionic placentas (12% vs 7.3%). Hanley et al 7 reported that the presence of a velamentous cord insertion increases the risk of birth weight discordancy in monochorionic twins. Redline et al 8 also demonstrated an association between peripheral cord insertion and avascular villi, indicating occlusion of fetal vessels in the placenta.…”

Section: Table 3 Relationship Of Fetal Vessel Thrombosis and Neonatalmentioning

confidence: 99%

“…Victoria et al 6 and Hanley et al 7 reported that severe discordance occurred significantly more often in monochorionic than in dichorionic twins and was significantly associated with velamentous cord insertions. Redline et al 8 demonstrated that peripheral insertion of the umbilical cord and avascular villi were associated with abnormal growth in twins.…”

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confidence: 99%

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Increased Prevalence of Fetal Thrombi in Monochorionic-Twin Placentas

Sato

Benirschke

2006

Pediatrics

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OBJECTIVE. Fetal vessel thrombosis has been related to pregnancy complications and adverse neonatal outcomes in singleton pregnancies, but the clinical and pathologic characteristics of fetal thrombosis in twin pregnancy are still ill defined. METHODS. To clarify the characteristics of fetal thrombosis in twins, we reviewed the histology slides and medical records of live-born infants of twin pregnancies involving the live birth of at least 1 fetus (monochorionic: 389 cases; dichorionic: 780 cases) and singleton pregnancies (1162 cases). RESULTS. The incidence of fetal thrombosis in monochorionic-twin pregnancies was significantly higher than that of dichorionic-twin and singleton pregnancies (5.1% vs 3.0% and 2.8%, respectively). The incidence of velamentous umbilical cord insertion in monochorionic- and dichorionic-twin placentas was also higher than in singleton placentas (12% and 7% vs 2%, respectively). Fetal thrombosis in twin placentas was associated with intrauterine growth restriction. In monochorionic twins, fetal thrombosis was associated with co-twin fetal death, but in dichorionic twins no correlation was identified. Microscopically, fetal vessel thrombosis in twin placentas was associated with vascular cushions (fibrous hyperplasia of fetal vessel), as is the case occasionally in singletons. CONCLUSIONS. The incidence of fetal vessel thrombosis in monochorionic placentas was higher than that seen in dichorionic-twin placentas and singleton gestations. Fetal vessel thrombosis in twin pregnancies showed a correlation with intrauterine growth restriction, peripheral cord insertions, and major vascular cushions.

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Section: Discussionmentioning

confidence: 99%

Section: Table 3 Relationship Of Fetal Vessel Thrombosis and Neonatalmentioning

confidence: 99%

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Increased Prevalence of Fetal Thrombi in Monochorionic-Twin Placentas

Sato

Benirschke

2006

Pediatrics

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“…Uyumsuz (diskordan) gelişim bulunan ikizlerde perinatal mortalite ve morbidite oranları 2,5 ile 6,5 kat daha fazladır [28].…”

Section: İkiz Gebeliklerde Perinatal Morbidite Ve Mortaliteunclassified

Cogul Gebeliklerde Ultrasonografi

Güven¹,

Kantarcı²

2017

Trd Sem

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Çoğul Gebeliklerde İnsidansSon yıllarda, ilerleyen anne yaşı ve üreme tekniklerinin kullanımının artması nedeniyle çoğul gebelik insidansında belirgin artış gözlenmekte-dir. İkiz gebeliklerin yaklaşık %50'si; üçüz ya da daha fazla sayıda olanların ise çoğu erken ya da düşük doğum ağırlıklı dünyaya gelmektedir. İkiz gebeliklerde, embriyo sayısı üç ve üzeri olanlardan daha düşük olmakla birlikte, perinatal ölümlerin yaklaşık %12'si çoğul gebeliklerde görülmektedir. İkizlerde perinatal ölüm oranı tekil gebeliklerden 5-10 kat daha fazladır. Çoğul gebelikler aynı zamanda artmış düşük insidansının yanısıra çeşitli fetal ve maternal komplikasyonlar açısından da artmış risk taşırlar. Ço-ğul gebelikler antepartum dönemde daha fazla gözetim gerektiren yüksek riskli gebelikler olup ileri merkezlerde doğum planlanmalıdır [1][2][3][4]. Koryonisite ve Zigositeİkiz gebelikler iki ayrı ovumun döllenme-siyle (dizigotik) veya tek bir ovumun bölün-

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“…Generally the cord inserts at or near the centre of the placental disc, but it can insert at the periphery of the disc and in extreme cases can be velamentous (run in the amniotic membrane for some distance from the placenta). There is debate as to whether umbilical cord insertion influences birthweight in all twins or only in monochorionic twins (Hanley et al, 2002), among whom location of each cord insertion determines the proportion of placental parenchyma allocated to each twin (Machin, 2001). No association has been seen between cord insertion and birthweight in singleton infants (Woods & Malan, 1978;Liu et al, 2002).…”

Section: Zygosity Chorionicity and Umbilical Cord Insertionmentioning

confidence: 99%