Reestimating Date of Delivery in Multifetal Pregnancies

Minakami, Hisanori; Sato, Ikuo

doi:10.1001/jama.1996.03530420060037

Cited by 129 publications

(81 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our result is consistent with previous studies indicating similar higher incidences of such births compared to total live births including singletons (Minakami and Sato 1996;Choi et al 2010). We also found that the location of multiple birth deliveries was associated with GA and birth weight (BW): mature delivery (≥ 38 weeks of GA or ≥ 2,500 g of BW) in clinics and very premature delivery (≤ 34 weeks of GA or ≤ 1,500 g of BW) in hospitals.…”

Section: Discussionsupporting

confidence: 94%

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

Koshida

Ono

Tsuji

et al. 2016

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 94%

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

Koshida

Ono

Tsuji

et al. 2016

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…The length of gestation is much shorter, and the perinatal mortality rate is much higher for twin pregnancies than for singleton pregnancies [2] In general, the degree of physiological change in the mother is also greater in women with twin pregnancies than in women with singleton pregnancies. For example, the normal expansion in maternal blood volume is greater in women with twin pregnancies [3]; the average increase in late pregnancy is about 40% to 50% with a single fetus, whereas it is about 50% to 60% with twins [3].…”

Section: Coagulation-fibrinolysis In Twin Pregnanciesmentioning

confidence: 99%

Coagulation-fibrinolysis is more enhanced in twin than in singleton pregnancies

Morikawa

Yamada

Turuga

et al. 2006

Journal of Perinatal Medicine

Self Cite

View full text Add to dashboard Cite

Aims: To examine whether coagulation-fibrinolysis in late pregnancy in women with twin pregnancies is more pronounced than in women with singleton pregnancies. Patients and methods: The plasma levels of D-dimer, fibrinogen/fibrin degradation products (FDP), and fibrinogen, the platelet count, and the antithrombin activity were assessed from 3 weeks before delivery until postpartum day 7 in 48 women (24 singleton and 24 twin pregnancies) without preeclampsia who underwent cesarean sections. Results: Women with singleton or twin pregnancies gave birth at 37.3±1.2 weeks or 35.2±1.4 weeks, respectively. Compared with singleton mothers, prenatal D-dimer and FDP levels were consistently and significantly higher among women with twin pregnancies. A significantly larger proportion of twin mothers exhibited prenatal levels of D-dimer >5.0 μg/mL, FDP >10.0 μg/mL, fibrinogen <420 mg/mL and antithrombin activity <70%. In addition, prenatal antithrombin activity in plasma was significantly lower. Conclusions: Coagulation-fibrinolysis is more enhanced in women with twin gestation than in women with singleton gestation

show abstract

“…Although several ultrasound studies have compared Doppler indices among human singletons and multiple foetuses (20,21), such studies have not resulted in routine applications in veterinary medicine. A multiple pregnancy is known to differ from a singleton pregnancy with respect to the mean duration of pregnancy and the mean birth weight of the infants (22). Thus, the possibility in differences in foetal Doppler data in multiple pregnancies should be considered.…”

Section: Introductionmentioning

confidence: 99%