Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy
Introduction: The incidence of multiple gestations is increasing worldwide and many studies have shown higher perinatal morbidity and mortality rates in monochorionic twins compared to dichorionic. The aim of this study was to assess the twin population born at a tertiary center and to evaluate the...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Ordem dos Médicos
2017-01-01
|
| Series: | Acta Médica Portuguesa |
| Subjects: | |
| Online Access: | http://actamedicaportuguesa.com/revista/index.php/amp/article/view/7133 |
| _version_ | 1819147090516770816 |
|---|---|
| author | Marta Machado Elsa Lima Teixeira Lígia Maria Ferreira Filipa Rodrigues Raquel Henriques Eulália Afonso |
| author_facet | Marta Machado Elsa Lima Teixeira Lígia Maria Ferreira Filipa Rodrigues Raquel Henriques Eulália Afonso |
| author_sort | Marta Machado |
| collection | DOAJ |
| description | Introduction: The incidence of multiple gestations is increasing worldwide and many studies have shown higher perinatal morbidity and mortality rates in monochorionic twins compared to dichorionic. The aim of this study was to assess the twin population born at a tertiary center and to evaluate the impact of chorionicity on perinatal outcomes of twin pregnancies.
Material and Methods: Retrospective study of all twins born in a tertiary center from January 2004 to December 2013.
Results: In this period, 1051 twins were born, related to 540 gestations (26.7% monochorionic; 73.3% dichorionic). There was no statistical significant difference between the groups concerning obstetric complications. The monochorionic group had a higher incidence of intrauterine growth restriction (20.5 vs 11.3%, p < 0.001), lower mean maternal age (29.9 vs 31.9 years, p < 0.001), lower mean gestational age (33.4 vs 34.3 weeks, p < 0.05) and lower mean birth weight (1943 vs 2147 g, p < 0.001). Monochorionic twins had a higher incidence of hyaline membrane disease (7 vs 4%, p < 0.05), sepsis (10.3 vs 5.8%, p < 0.05) and anemia (9.5 vs 5.4%, p < 0.05). There were no statistical significant differences concerning necrotizing enterocolitis, intraperiventricular hemorrhage or retinopathy of prematurity. Perinatal mortality was higher in the monochorionic group (5.2 vs 2.9%, p < 0.05).
Discussion: Monochorionic twins represent considerable challenges to both obstetricians and neonatologists and should be monitored and delivered at tertiary centers.
Conclusion: Currently gemelarity has a major impact on total births. It would be interesting to develop protocols to standardize clinical approach to twins. |
| first_indexed | 2024-12-22T13:24:17Z |
| format | Article |
| id | doaj.art-7217aa6c0ab64425a6ab45dfc41f9c5c |
| institution | Directory Open Access Journal |
| issn | 0870-399X 1646-0758 |
| language | English |
| last_indexed | 2024-12-22T13:24:17Z |
| publishDate | 2017-01-01 |
| publisher | Ordem dos Médicos |
| record_format | Article |
| series | Acta Médica Portuguesa |
| spelling | doaj.art-7217aa6c0ab64425a6ab45dfc41f9c5c2022-12-21T18:24:22ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582017-01-01301121610.20344/amp.71334400Perinatal Outcome in Relation to Chorionicity in Twin PregnancyMarta Machado0Elsa Lima Teixeira1Lígia Maria Ferreira2Filipa Rodrigues3Raquel Henriques4Eulália Afonso5Serviço de Pediatria. Centro Hospitalar do Baixo Vouga. Aveiro. Portugal.Serviço de Pediatria. Centro Hospitalar Tondela-Viseu. Viseu. Portugal.Serviço de Pediatria. Centro Hospitalar Tondela-Viseu. Viseu. Portugal.Serviço de Pediatria. Centro Hospitalar do Baixo Vouga. Aveiro. Portugal.Serviço de Neonatologia. Maternidade Daniel de Matos. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.Serviço de Neonatologia. Maternidade Daniel de Matos. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.Introduction: The incidence of multiple gestations is increasing worldwide and many studies have shown higher perinatal morbidity and mortality rates in monochorionic twins compared to dichorionic. The aim of this study was to assess the twin population born at a tertiary center and to evaluate the impact of chorionicity on perinatal outcomes of twin pregnancies. Material and Methods: Retrospective study of all twins born in a tertiary center from January 2004 to December 2013. Results: In this period, 1051 twins were born, related to 540 gestations (26.7% monochorionic; 73.3% dichorionic). There was no statistical significant difference between the groups concerning obstetric complications. The monochorionic group had a higher incidence of intrauterine growth restriction (20.5 vs 11.3%, p < 0.001), lower mean maternal age (29.9 vs 31.9 years, p < 0.001), lower mean gestational age (33.4 vs 34.3 weeks, p < 0.05) and lower mean birth weight (1943 vs 2147 g, p < 0.001). Monochorionic twins had a higher incidence of hyaline membrane disease (7 vs 4%, p < 0.05), sepsis (10.3 vs 5.8%, p < 0.05) and anemia (9.5 vs 5.4%, p < 0.05). There were no statistical significant differences concerning necrotizing enterocolitis, intraperiventricular hemorrhage or retinopathy of prematurity. Perinatal mortality was higher in the monochorionic group (5.2 vs 2.9%, p < 0.05). Discussion: Monochorionic twins represent considerable challenges to both obstetricians and neonatologists and should be monitored and delivered at tertiary centers. Conclusion: Currently gemelarity has a major impact on total births. It would be interesting to develop protocols to standardize clinical approach to twins.http://actamedicaportuguesa.com/revista/index.php/amp/article/view/7133Complicações na GravidezCórionGravidez de GémeosResultado da Gravidez |
| spellingShingle | Marta Machado Elsa Lima Teixeira Lígia Maria Ferreira Filipa Rodrigues Raquel Henriques Eulália Afonso Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy Acta Médica Portuguesa Complicações na Gravidez Córion Gravidez de Gémeos Resultado da Gravidez |
| title | Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy |
| title_full | Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy |
| title_fullStr | Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy |
| title_full_unstemmed | Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy |
| title_short | Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy |
| title_sort | perinatal outcome in relation to chorionicity in twin pregnancy |
| topic | Complicações na Gravidez Córion Gravidez de Gémeos Resultado da Gravidez |
| url | http://actamedicaportuguesa.com/revista/index.php/amp/article/view/7133 |
| work_keys_str_mv | AT martamachado perinataloutcomeinrelationtochorionicityintwinpregnancy AT elsalimateixeira perinataloutcomeinrelationtochorionicityintwinpregnancy AT ligiamariaferreira perinataloutcomeinrelationtochorionicityintwinpregnancy AT filiparodrigues perinataloutcomeinrelationtochorionicityintwinpregnancy AT raquelhenriques perinataloutcomeinrelationtochorionicityintwinpregnancy AT eulaliaafonso perinataloutcomeinrelationtochorionicityintwinpregnancy |