Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy
Main Author: | |
---|---|
Publication Date: | 2017 |
Other Authors: | , , , , |
Format: | Article |
Language: | por eng |
Source: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Download full: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133 |
Summary: | 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. |
id |
RCAP_3dc2d0b5eae7df5a45ce223f394d68a5 |
---|---|
oai_identifier_str |
oai:ojs.www.actamedicaportuguesa.com:article/7133 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Perinatal Outcome in Relation to Chorionicity in Twin PregnancyImpacto da Corionicidade nas Complicações Perinatais da Gestação GemelarChorionPregnancy ComplicationsPregnancy OutcomePregnancyTwinComplicações na GravidezCórionGravidez de GémeosResultado da GravidezIntroduction: 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.Introdução: A incidência da gestação múltipla tem vindo a aumentar em todo o mundo e vários estudos têm demonstrado taxas de morbilidade e mortalidade mais elevadas nos gémeos monocoriónicos comparativamente com os bicoriónicos. Os objetivos deste trabalho foram: caracterizar a população de gémeos fruto de gravidez bifetal nascidos num hospital nível três e avaliar o impacto da corionicidade na morbimortalidade perinatal.Material e Métodos: Estudo retrospetivo de todos os gémeos fruto de gravidez bifetal nascidos num hospital nível três entre janeiro de 2004 e dezembro de 2013.Resultados: Neste período nasceram 1051 gémeos, fruto de 540 gestações (26,7% monocoriónicos; 73,3% bicoriónicos). Não houve diferença estatisticamente significativa entre os dois grupos no respeitante às complicações obstétricas. No grupo monocoriónico verificou-se uma incidência mais elevada de restrição do crescimento intra-uterino (20,5 vs 11,3%, p < 0,001), idade materna mais baixa (29,9 vs 31,9 anos, p < 0,001), idade gestacional mais baixa (33,4 vs 34,3 semanas, p < 0,05) e peso de nascimento mais baixo (1943 vs 2147 g, p < 0,001). Os gémeos monocoriónicos tiveram uma incidência mais elevada de doença de membrana hialina (7 vs 4%, p < 0,05), sépsis (10,3 vs 5,8%, p < 0,05) e anemia (9,5 vs 5,4%, p < 0,05). Não se encontrou diferença estatisticamente significativa relativamente à ocorrência de enterocolite necrotizante, hemorragia intraperiventricular ou retinopatia da prematuridade. A mortalidade perinatal foi mais elevada no grupo monocoriónico (5,2 vs 2,9%, p < 0,05).Discussão: Os gémeos monocoriónicos representam um desafio para obstetras e neonatologistas, devendo a vigilância pré-natal e o parto ser realizados em centros de referência.Conclusão: A gemelaridade tem atualmente um importante impacto nos nascimentos, pelo que seria interessante desenvolver protocolos que uniformizassem a prática clínica na abordagem a estes recém-nascidos.Ordem dos Médicos2017-01-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfimage/x-ms-bmpimage/jpegimage/x-ms-bmpapplication/mswordimage/jpegimage/x-ms-bmphttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133oai:ojs.www.actamedicaportuguesa.com:article/7133Acta Médica Portuguesa; Vol. 30 No. 1 (2017): January; 12-16Acta Médica Portuguesa; Vol. 30 N.º 1 (2017): Janeiro; 12-161646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/4888https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/5123https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8038https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8039https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8183https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8184https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8372https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8377Direitos de Autor (c) 2017 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessMachado, MartaLima Teixeira, ElsaFerreira, Lígia MariaRodrigues, FilipaHenriques, RaquelAfonso, Eulália2022-12-20T11:05:06Zoai:ojs.www.actamedicaportuguesa.com:article/7133Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:25.007728Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy Impacto da Corionicidade nas Complicações Perinatais da Gestação Gemelar |
title |
Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy |
spellingShingle |
Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy Machado, Marta Chorion Pregnancy Complications Pregnancy Outcome Pregnancy Twin Complicações na Gravidez Córion Gravidez de Gémeos Resultado da Gravidez |
title_short |
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_sort |
Perinatal Outcome in Relation to Chorionicity in Twin Pregnancy |
author |
Machado, Marta |
author_facet |
Machado, Marta Lima Teixeira, Elsa Ferreira, Lígia Maria Rodrigues, Filipa Henriques, Raquel Afonso, Eulália |
author_role |
author |
author2 |
Lima Teixeira, Elsa Ferreira, Lígia Maria Rodrigues, Filipa Henriques, Raquel Afonso, Eulália |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Machado, Marta Lima Teixeira, Elsa Ferreira, Lígia Maria Rodrigues, Filipa Henriques, Raquel Afonso, Eulália |
dc.subject.por.fl_str_mv |
Chorion Pregnancy Complications Pregnancy Outcome Pregnancy Twin Complicações na Gravidez Córion Gravidez de Gémeos Resultado da Gravidez |
topic |
Chorion Pregnancy Complications Pregnancy Outcome Pregnancy Twin Complicações na Gravidez Córion Gravidez de Gémeos Resultado da Gravidez |
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. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-01-31 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133 oai:ojs.www.actamedicaportuguesa.com:article/7133 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/7133 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/4888 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/5123 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8038 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8039 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8183 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8184 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8372 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7133/8377 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2017 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2017 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf image/x-ms-bmp image/jpeg image/x-ms-bmp application/msword image/jpeg image/x-ms-bmp |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 30 No. 1 (2017): January; 12-16 Acta Médica Portuguesa; Vol. 30 N.º 1 (2017): Janeiro; 12-16 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799130644963393536 |