Nonpresenting Dichorionic Twins and Placental Vascular Malperfusion
| Autor: | Jon Barrett, John Kingdom, Eran Weiner, Christopher Sherman, Michael Kahn, Kristine Giltvedt, Mia Kibel, Nir Melamed |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Birth weight Placenta Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy Chronic Villitis medicine Twins Dizygotic Birth Weight Humans 030212 general & internal medicine Retrospective Studies Ontario Fetus 030219 obstetrics & reproductive medicine Fetal Growth Retardation Obstetrics business.industry Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study Odds ratio medicine.disease Pregnancy Twin Gestation Female business Cohort study |
| Zdroj: | Obstetrics and gynecology. 129(6) |
| ISSN: | 1873-233X |
| Popis: | OBJECTIVE To explore the hypothesis that selective placental pathology affecting the nonpresenting twin is a significant contributory factor mediating the smaller size at birth of nonpresenting dichorionic twins. METHODS We conducted a retrospective cohort study of all dichorionic twin deliveries in a single tertiary center between 2002 and 2015 where by departmental policy, all placentas from multifetal gestations are routinely sent for pathologic examination. Maternal charts, neonatal charts, and pathology reports were reviewed. Placental abnormalities were classified into lesions associated with maternal vascular malperfusion, fetal vascular malperfusion, placental hemorrhage, and chronic villitis. Comparison of neonatal outcomes and placental abnormalities was made between all nonpresenting and all presenting twins as well as within twin pairs. RESULTS A total of 1,322 women with dichorionic twins were studied. Nonpresenting twins were smaller at birth compared with the presenting cotwin starting at 32 weeks of gestation (birth weight [±standard deviation] 2,224±666 g compared with 2,278±675 g, P=.036). Nonpresenting twins had smaller placentas (361±108 g compared with 492±129 g, P |
| Databáze: | OpenAIRE |
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