Antenatal fetal death in multiple pregnancy: is early prediction possible?
Introduction. Perinatal mortality in multiple pregnancies increases by 8–10 times compared to singletons. Stillbirth is a significant part of all complications of multiple pregnancies. Although the incidence of perinatal mortality in multiple pregnancies has decreased consistently compared to extrem...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
IRBIS LLC
2021-01-01
|
| Series: | Акушерство, гинекология и репродукция |
| Subjects: | |
| Online Access: | https://www.gynecology.su/jour/article/view/886 |
| _version_ | 1797884098148040704 |
|---|---|
| author | V. I. Tsibizova D. V. Blinov V. O. Bitsadze T. M. Pervunina E. V. Komlichenko I. E. Govorov E. K. Kudryashova I. I. Averkin |
| author_facet | V. I. Tsibizova D. V. Blinov V. O. Bitsadze T. M. Pervunina E. V. Komlichenko I. E. Govorov E. K. Kudryashova I. I. Averkin |
| author_sort | V. I. Tsibizova |
| collection | DOAJ |
| description | Introduction. Perinatal mortality in multiple pregnancies increases by 8–10 times compared to singletons. Stillbirth is a significant part of all complications of multiple pregnancies. Although the incidence of perinatal mortality in multiple pregnancies has decreased consistently compared to extremely high rates in the past, it remains relatively high, despite significant positive changes in the management of such pregnancies. Aim: to assess the diagnostic potential of the first trimester's biochemical screening in multiple pregnancies for predicting antenatal fetal death. Materials and Methods. As part of a retrospective study, a cohort of twin pregnancies after in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or spontaneous conception underwent screening of the first trimester at 11+0–13+6 weeks of gestation as recommended by the Fetal Medicine Foundation. Determination of pregnancy-associated plasma protein-A (PAPP-A) in blood serum with subsequent calculation of the relative PAPP-A MoM (multiples of median) – a multiple of the median (an indicator of how much the individual test result deviates from the reference values) was performed. Results. Prenatal screening and outcomes of 302 multiple pregnancies showed that with PAPP-A MoM < 0.5, antenatal fetal death occurred with a frequency of 42.86 % (6/14), with PAPP-A MoM within the reference values – In 12.67 % (28/221), with PAPP-A MoM > 2.0 – in 6.7 % (2/30). Differences between patients with PAPP-A MoM < 0.5 and PAPP-A MoM within the reference values, as well as PAPP-A MoM < 0.5 and PAPP-A MoM > 2.0 were statistically significant (p = 0.002 and p = 0.004, respectively). No differences were detected between spontaneous and assisted reproductive technology (ART) pregnancies. Conclusion. In women with multiple pregnancies resulting from ART or spontaneous, PAPP-A MoM values below the reference interval (< 0.5) in the first trimester are associated with an increased risk of antenatal fetal death. |
| first_indexed | 2024-04-10T04:01:07Z |
| format | Article |
| id | doaj.art-f6704cfd2c0c4e5091c44eb4c3ff32f3 |
| institution | Directory Open Access Journal |
| issn | 2313-7347 2500-3194 |
| language | Russian |
| last_indexed | 2024-04-10T04:01:07Z |
| publishDate | 2021-01-01 |
| publisher | IRBIS LLC |
| record_format | Article |
| series | Акушерство, гинекология и репродукция |
| spelling | doaj.art-f6704cfd2c0c4e5091c44eb4c3ff32f32023-03-13T07:09:51ZrusIRBIS LLCАкушерство, гинекология и репродукция2313-73472500-31942021-01-0114660261110.17749/2313-7347/ob.gyn.rep.2020.199621Antenatal fetal death in multiple pregnancy: is early prediction possible?V. I. Tsibizova0D. V. Blinov1V. O. Bitsadze2T. M. Pervunina3E. V. Komlichenko4I. E. Govorov5E. K. Kudryashova6I. I. Averkin7Almazov National Medical Research Centre, Health Ministry of Russian FederationInstitute for Preventive and Social Medicine; Lapino Clinical Hospital, MD Medical Group "Mother and Child"Sechenov UniversityAlmazov National Medical Research Centre, Health Ministry of Russian FederationAlmazov National Medical Research Centre, Health Ministry of Russian FederationAlmazov National Medical Research Centre, Health Ministry of Russian FederationLeningrad Regional Clinical HospitalAlmazov National Medical Research Centre, Health Ministry of Russian FederationIntroduction. Perinatal mortality in multiple pregnancies increases by 8–10 times compared to singletons. Stillbirth is a significant part of all complications of multiple pregnancies. Although the incidence of perinatal mortality in multiple pregnancies has decreased consistently compared to extremely high rates in the past, it remains relatively high, despite significant positive changes in the management of such pregnancies. Aim: to assess the diagnostic potential of the first trimester's biochemical screening in multiple pregnancies for predicting antenatal fetal death. Materials and Methods. As part of a retrospective study, a cohort of twin pregnancies after in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or spontaneous conception underwent screening of the first trimester at 11+0–13+6 weeks of gestation as recommended by the Fetal Medicine Foundation. Determination of pregnancy-associated plasma protein-A (PAPP-A) in blood serum with subsequent calculation of the relative PAPP-A MoM (multiples of median) – a multiple of the median (an indicator of how much the individual test result deviates from the reference values) was performed. Results. Prenatal screening and outcomes of 302 multiple pregnancies showed that with PAPP-A MoM < 0.5, antenatal fetal death occurred with a frequency of 42.86 % (6/14), with PAPP-A MoM within the reference values – In 12.67 % (28/221), with PAPP-A MoM > 2.0 – in 6.7 % (2/30). Differences between patients with PAPP-A MoM < 0.5 and PAPP-A MoM within the reference values, as well as PAPP-A MoM < 0.5 and PAPP-A MoM > 2.0 were statistically significant (p = 0.002 and p = 0.004, respectively). No differences were detected between spontaneous and assisted reproductive technology (ART) pregnancies. Conclusion. In women with multiple pregnancies resulting from ART or spontaneous, PAPP-A MoM values below the reference interval (< 0.5) in the first trimester are associated with an increased risk of antenatal fetal death.https://www.gynecology.su/jour/article/view/886antenatal fetal deathmultiple pregnancypregnancy-associated plasma protein-apapp-abiochemical screening |
| spellingShingle | V. I. Tsibizova D. V. Blinov V. O. Bitsadze T. M. Pervunina E. V. Komlichenko I. E. Govorov E. K. Kudryashova I. I. Averkin Antenatal fetal death in multiple pregnancy: is early prediction possible? Акушерство, гинекология и репродукция antenatal fetal death multiple pregnancy pregnancy-associated plasma protein-a papp-a biochemical screening |
| title | Antenatal fetal death in multiple pregnancy: is early prediction possible? |
| title_full | Antenatal fetal death in multiple pregnancy: is early prediction possible? |
| title_fullStr | Antenatal fetal death in multiple pregnancy: is early prediction possible? |
| title_full_unstemmed | Antenatal fetal death in multiple pregnancy: is early prediction possible? |
| title_short | Antenatal fetal death in multiple pregnancy: is early prediction possible? |
| title_sort | antenatal fetal death in multiple pregnancy is early prediction possible |
| topic | antenatal fetal death multiple pregnancy pregnancy-associated plasma protein-a papp-a biochemical screening |
| url | https://www.gynecology.su/jour/article/view/886 |
| work_keys_str_mv | AT vitsibizova antenatalfetaldeathinmultiplepregnancyisearlypredictionpossible AT dvblinov antenatalfetaldeathinmultiplepregnancyisearlypredictionpossible AT vobitsadze antenatalfetaldeathinmultiplepregnancyisearlypredictionpossible AT tmpervunina antenatalfetaldeathinmultiplepregnancyisearlypredictionpossible AT evkomlichenko antenatalfetaldeathinmultiplepregnancyisearlypredictionpossible AT iegovorov antenatalfetaldeathinmultiplepregnancyisearlypredictionpossible AT ekkudryashova antenatalfetaldeathinmultiplepregnancyisearlypredictionpossible AT iiaverkin antenatalfetaldeathinmultiplepregnancyisearlypredictionpossible |