• Non ci sono risultati.

Multiple Pregnancy: Diagnosis and Management

N/A
N/A
Info
Scarica
Protected

Academic year: 2021

Condividi "Multiple Pregnancy: Diagnosis and Management"

Copied!
12
0
0

Caricamento.... (Visualizza il testo completo ora)

Scarica adesso ( 12 pagine )

Testo completo

(1)

Multiple Pregnancy: Diagnosis and Management

Erich Cosmi MD

Department of Gynecological Science and Human Reproduction Section of Maternal Fetal Medicine

University of Padua School of Medicine

(2)

Twin Gestation

Expected

Twins: 43,329

Actual

Twins: 96,726

1997-2000

Total births USA 15,856,807

ART

Twins Triplets

USA USA, 1995, source CDC; Reynolds et al, Pediatrics, 2003

(3)

OUTLINE

• Chorionicity

• Complications of the twin gestations

• Anomalies in twins

• Growth in twins

(4)
(5)

Dizygotic twins Monozygotic twins

80 %

20 %

Mahony et al, , Radiology, 1985; Benirschle et al, NEJM, 1973;Spellacy et al, Obstet Gynecol, 1990;

(6)

Diagnosis of Coryonicity

• Sex/Placentation

• Yolk sac and membranes

• T-sign

• Twin peak or Lambda sign

(7)
(8)
(9)

Twin to twin transfusion syndrome

Incidence = from 5 to 15% of MC twin pregnancy

No treatment = 80-90% of fetal death

Possible therapy

•Septotomy

•Amnioreduction

•Selective laser coaugulation

Hawerkamp F et al. Eur J Paediat Neurol, 2001; Mari G. et al. Am J Obstet Gynecol, 2001; Ville Y et al, NEJM, 2001.

(10)

Placental Anastomosis AV; AA; VV=unbalanced

TTTS

(11)

Recipient

Donor

TTTS stage Quintero Classification

• I Abnormal amniotic fluid level

• II Collapsed bladder in donor

• III Abnormal Doppler flow in either twins

• IV Hydrops in either twin

• V Death of one twin

Quintero et al. Am J Obstet Gynecol, 2003; Ville Y et al, BJOG, 1998

Amnioreduction SLPC

(12)

Riferimenti

Scarica adesso ( PDF - 12 pagine - 710.63 KB )

Documenti correlati

Lithuanian University of Health Science Faculty of Medicine Department of Health Psychology Yasmine Jafari

Medical education is considered to be one of most demanding and stressful courses undertaken at tertiary level due to its six year duration and the intense study required

Lithuanian University of Health Sciences Faculty of Medicine Department of Gynecology and Obstetrics

Group 4: Multiparous women without a previous uterine scar, with single cephalic pregnancy, ≥37 weeks gestation who either had labour induced or were delivered by

UNIVERSITY OF PADUA

The purpose of this work is make an objective analysis of the already existing and recognized sacred natural sites in the various areas of the world, as well as identify in

UNIVERSITY OF PADUA FACULTY OF AGRICULTURE Department of Land and Agro-forestry Systems

Recent researches and initiatives (see for details paragraph 2.6) suggest the chance to link FSC certification with FT principles to differentiate community produced

UNIVERSITY OF PADUA Department of Territory and Agro-Forestry Systems

In the sector of forests and environment, the projects based on the Reduction of the Emissions due to Deforestation and forest Degradation (REDD), implemented in the

UNIVERSITY OF PADUA FACULTY OF AGRICULTURE Department of Land and Agro-forestry Systems

Table 2.1: Prices of walnut logs belonging to different grades in 2003 Table 3.1: List of the 21 plots sampled in 2009 with the respective species composition and municipality in

UNIVERSITY OF PADUA ICEA DEPARTMENT

(2013) predicts the trajectories of floating particles subjected to a uniform water flow in proximity of emerging stems, the computation assumes Re values lower than 48. The

University of Padua

The ActivaS was used during the road acquisition tests and during the test bench dynamic and static calibration, in order to found the correct bench parameters and