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Best Practice & Research. Clinical... Feb 2014
Topics: Female; Humans; Incidence; Pregnancy; Pregnancy, Multiple; Premature Birth; Reproductive Techniques, Assisted; Risk Factors
PubMed: 24388730
DOI: 10.1016/j.bpobgyn.2013.12.009 -
Best Practice & Research. Clinical... Jan 2021The incidence of multiple births has risen in the last few decades. This rise is mainly due to the widespread use of assisted reproduction techniques mainly as a result... (Review)
Review
The incidence of multiple births has risen in the last few decades. This rise is mainly due to the widespread use of assisted reproduction techniques mainly as a result of increasing maternal age at conception. Twin and higher-order multiple pregnancies are associated with increased risk of perinatal, as well as maternal, mortality and morbidity compared to singleton pregnancies. There can also be psychosocial and socioeconomic implications for women and their families. In this chapter, we aim to discuss the risks associated with multiple pregnancies, the pros and cons of fetal reduction, the current techniques used in clinical practice, and how to approach counselling parents, enabling them to make informed decisions.
Topics: Counseling; Female; Humans; Maternal Age; Pregnancy; Pregnancy Outcome; Pregnancy Reduction, Multifetal; Pregnancy, Multiple; Pregnancy, Twin
PubMed: 32859535
DOI: 10.1016/j.bpobgyn.2020.06.013 -
Seminars in Neonatology : SN Jun 2002Iatrogenic - physician-made - multiple pregnancies (IMPs) significantly contribute to the epidemic of twins and high-order multiples in most developed and in many... (Review)
Review
Iatrogenic - physician-made - multiple pregnancies (IMPs) significantly contribute to the epidemic of twins and high-order multiples in most developed and in many developing countries. The primary etiology for IMPs is treatment of reduced fecundity, some but not all of which is associated with specific lifestyle changes of women in the second half of the 20th century. IMPs contribute to increased perinatal morbidity and mortality related to prematurity and low birth weights. In addition, the use of assisted conception techniques increases the frequency of monozygotic twinning and related pathology. Because assisted conceptions are costly interventions, current numbers of IMPs represent a balance between the need to maximize success rates and the desire to minimize the untoward outcome rates. We believe that eliminating procedures associated with unavoidable IMPs and controlling the number of transferred embryos can achieve a significant reduction in the adverse perinatal outcomes and costs associated with IMPs.
Topics: Adult; Female; Fetal Diseases; Humans; Middle Aged; Pregnancy; Pregnancy, Multiple; Prenatal Care; Reproductive Techniques; Risk; United States
PubMed: 12234741
DOI: 10.1053/siny.2002.0104 -
Romanian Journal of Morphology and... 2018The incidence of multiple pregnancy has significantly increased over the past decades, reaching different statistics to double, triple, or even overcome these numerical... (Review)
Review
The incidence of multiple pregnancy has significantly increased over the past decades, reaching different statistics to double, triple, or even overcome these numerical orders globally. Zygosity and chorionicity are the key elements in the multiple pregnancy but the placentation issue should be correlated primarily with zygosity, unlike chorionicity that should be correlated with the outcome and complications of multifetal gestation. Multiple pregnancy is by itself a special maternal-fetal condition, and the monochorionic one, moreover, due to specific complications. These aspects make early assessment of chorionicity and amnionicity a priority. Ultrasound is essential in pregnancy but pathological placental examination after delivery is complementary, in order to have a complete overview of potential mechanisms and pathogenesis affecting twin gestation. In this review, we highlight both ultrasound aspects specific to multifetal placentation, complemented by macro and microscopic morphological aspects, which underpin the obstetric imaging.
Topics: Female; Humans; Placentation; Pregnancy; Pregnancy, Multiple; Ultrasonography, Prenatal
PubMed: 30173248
DOI: No ID Found -
The Practitioner Feb 1964
Topics: Asian People; Black People; Delivery, Obstetric; Diagnosis; Female; Humans; Infant; Infant, Newborn; Labor, Obstetric; Pregnancy; Pregnancy, Multiple; Prenatal Care; Superfetation; Twins
PubMed: 14122915
DOI: No ID Found -
The Medical Journal of Malaya Sep 1958
Topics: Female; Humans; Pregnancy; Pregnancy, Multiple
PubMed: 13589370
DOI: No ID Found -
Indian Journal of Pediatrics Jun 2020
Topics: Drug Labeling; Female; Humans; Pregnancy; Pregnancy, Multiple
PubMed: 31863389
DOI: 10.1007/s12098-019-03141-w -
BMC Pregnancy and Childbirth Dec 2023Multiple pregnancies carry an increased risk of maternal and perinatal complications, notably prematurity. Few studies have evaluated the risk factors for preterm births... (Review)
Review
OBJECTIVE
Multiple pregnancies carry an increased risk of maternal and perinatal complications, notably prematurity. Few studies have evaluated the risk factors for preterm births in multiple pregnancies within the Thai population. This study aims to ascertain maternal and perinatal outcomes and identify factors linked to preterm births in multiple pregnancies.
METHODS
This study was carried out at Khon Kaen University, Faculty of Medicine, Department of Obstetrics and Gynecology in Thailand. We reviewed the medical records of women with multiple pregnancies who delivered at a gestational age of more than 20 weeks between January 1, 2012 and December 31, 2021. We excluded patients with incomplete data or those for whom data were missing.
RESULTS
Out of 21,400 pregnancies, 427 were multiple pregnancies, constituting approximately 1.99%. Over the ten-year period, 269 multiple pregnancies (65.1%) resulted in preterm births. Of these, 173 (64.3%) were monochorionic twins, and 96 (35.7%) were dichorionic twins. Monochorionic twins had a notably higher rate of preterm delivery (AOR, 2.06; 95%CI 1.29-3.30). Vaginal delivery was observed in 7.9% of the cases, while cesarean sections were performed for both twins in 91.5% of cases. In 0.5% of the cases, only the second twin was delivered by cesarean section. In terms of neonatal outcomes, 160 infants (19.4%) weighed less than 1,500 g at birth, and there were 78 perinatal deaths (9.4%). Birth asphyxia was noted in 97 cases (20.2%) among monochorionic twins and in 28 cases (8.1%) for dichorionic twins.
CONCLUSION
The prevalence of multiple pregnancies was 1.99%, with 65.1% resulting in preterm births. Neonatal complications were notably more frequent in monochorionic twins. Monochorionic placenta and antepartum complications emerged as significant risk factors for preterm birth.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Infant; Premature Birth; Pregnancy, Twin; Cesarean Section; Retrospective Studies; Thailand; Pregnancy, Multiple; Pregnancy Outcome
PubMed: 38110899
DOI: 10.1186/s12884-023-06186-0 -
Nursing Times Nov 1973
Topics: Female; Humans; Pregnancy; Pregnancy, Multiple; Twins
PubMed: 4774873
DOI: No ID Found -
Human Reproduction (Oxford, England) Dec 1996The incidence of multiple pregnancy and delivery has increased dramatically over the past 10-15 years in many developed countries of the world. Data for England and... (Review)
Review
The incidence of multiple pregnancy and delivery has increased dramatically over the past 10-15 years in many developed countries of the world. Data for England and Wales show that between 1980 and 1993 the twin maternity rate increased by approximately 25% and the triplet and higher order maternity rate more than doubled. Similar trends have been reported elsewhere. The majority of these increases have been linked to the use of ovarian stimulants and assisted reproduction techniques, and multiple pregnancy must be considered to be one of the most important adverse outcomes in current methods of infertility treatment. Obstetric complications associated with multiple pregnancy include prenatal screening problems and increased incidence of pregnancy-induced hypertension, antepartum haemorrhage, preterm labour and assisted or surgical delivery. Neonatal problems include low birthweight and increased prevalence of congenital malformations. Compared with singletons, neonatal mortality was seven times higher in twins and > 20 times higher in triplets and higher order births in England and Wales in 1991. Survivors also suffer higher rates of cerebral palsy and other neurological impairments. Most studies of pregnancies and babies resulting from assisted reproduction have demonstrated similar, if not higher, risks of adverse obstetric and neonatal outcomes for multiple births compared with national expectations. A poorer outcome in multiple pregnancy, especially in triplet and higher order pregnancy, supports the replacement of two good quality embryos in assisted reproduction treatment cycles.
Topics: Female; Humans; Incidence; Infant Mortality; Infant, Newborn; Morbidity; Pregnancy; Pregnancy Outcome; Pregnancy, Multiple; Reproductive Techniques
PubMed: 9147114
DOI: 10.1093/humrep/11.suppl_4.110