Perinatal outcome of monochorionic triamniotic triplet pregnancy
| Autor(a) principal: | |
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| Data de Publicação: | 2023 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10362/160094 |
Resumo: | Publisher Copyright: © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. |
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Perinatal outcome of monochorionic triamniotic triplet pregnancymulticenter cohort studygrowth restrictionmiscarriagemultipleoutcomepregnancyTAPStriamniotictripletTTTSRadiological and Ultrasound TechnologyReproductive MedicineRadiology Nuclear Medicine and imagingObstetrics and GynaecologyPublisher Copyright: © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.Objective: Monochorionic (MC) triplet pregnancies are extremely rare and information on these pregnancies and their complications is limited. We aimed to investigate the risk of early and late pregnancy complications, perinatal outcome and the timing and methods of fetal intervention in these pregnancies. Methods: This was a multicenter retrospective cohort study of MC triamniotic (TA) triplet pregnancies managed in 21 participating centers around the world from 2007 onwards. Data on maternal age, mode of conception, diagnosis of major fetal structural anomalies or aneuploidy, gestational age (GA) at diagnosis of anomalies, twin-to-twin transfusion syndrome (TTTS), twin anemia–polycythemia sequence (TAPS), twin reversed arterial perfusion (TRAP) sequence and or selective fetal growth restriction (sFGR) were retrieved from patient records. Data on antenatal interventions were collected, including data on selective fetal reduction (three to two or three to one), laser surgery and any other active fetal intervention (including amniodrainage). Data on perinatal outcome were collected, including numbers of live birth, intrauterine demise, neonatal death, perinatal death and termination of fetus or pregnancy (TOP). Neonatal data such as GA at birth, birth weight, admission to neonatal intensive care unit and neonatal morbidity were also collected. Perinatal outcomes were assessed according to whether the pregnancy was managed expectantly or underwent fetal intervention. Results: Of an initial cohort of 174 MCTA triplet pregnancies, 11 underwent early TOP, three had an early miscarriage, six were lost to follow-up and one was ongoing at the time of writing. Thus, the study cohort included 153 pregnancies, of which the majority (92.8%) were managed expectantly. The incidence of pregnancy affected by one or more fetal structural abnormality was 13.7% (21/153) and that of TRAP sequence was 5.2% (8/153). The most common antenatal complication related to chorionicity was TTTS, which affected just over one quarter (27.6%; 42/152, after removing a pregnancy with TOP < 24 weeks for fetal anomalies) of the pregnancies, followed by sFGR (16.4%; 25/152), while TAPS (spontaneous or post TTTS with or without laser treatment) occurred in only 4.6% (7/152) of pregnancies. No monochorionicity-related antenatal complication was recorded in 49.3% (75/152) of pregnancies. Survival was apparently associated largely with the development of these complications: there was at least one survivor beyond the neonatal period in 85.1% (57/67) of pregnancies without antenatal complications, in 100% (25/25) of those complicated by sFGR and in 47.6% (20/42) of those complicated by TTTS. The overall rate of preterm birth prior to 28 weeks was 14.5% (18/124) and that prior to 32 weeks' gestation was 49.2% (61/124). Conclusion: Monochorionicity-related complications, which can impact adversely perinatal outcome, occur in almost half of MCTA triplet pregnancies, creating a challenge with regard to counseling, surveillance and management.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNSileo, F. G.Accurti, V.Baschat, A.Binder, J.Carreras, E.Chianchiano, N.Cruz-Martinez, R.D'Antonio, F.Gielchinsky, Y.Hecher, K.Johnson, A.Lopriore, E.Massoud, M.Nørgaard, L. N.Papaioannou, G.Prefumo, F.Salsi, G.Simões, T.Umstad, M.Vavilala, S.Yinon, Y.Khalil, A.Boito, SimonaFichera, AnnaFort-Jacquier, JulieLiu, BeckyLópez-Briones, HugoMiller, JenaPateisky, PetraPineda-Aleman, HugoPrasad, SmritiQueirós, AlexandraRodo, CarlotaRosner, MaraSalsi, GinevraSlaghekke, FemkeSundberg, KarinTenebaum-Gavish, KinneretYoussef, AlyZussman, Noa Mevorach2023-11-17T22:11:24Z2023-102023-10-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article12application/pdfhttp://hdl.handle.net/10362/160094eng0960-7692PURE: 74203415https://doi.org/10.1002/uog.26256info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:42:40Zoai:run.unl.pt:10362/160094Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:57:52.063952Repositório 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 of monochorionic triamniotic triplet pregnancy multicenter cohort study |
| title |
Perinatal outcome of monochorionic triamniotic triplet pregnancy |
| spellingShingle |
Perinatal outcome of monochorionic triamniotic triplet pregnancy Sileo, F. G. growth restriction miscarriage multiple outcome pregnancy TAPS triamniotic triplet TTTS Radiological and Ultrasound Technology Reproductive Medicine Radiology Nuclear Medicine and imaging Obstetrics and Gynaecology |
| title_short |
Perinatal outcome of monochorionic triamniotic triplet pregnancy |
| title_full |
Perinatal outcome of monochorionic triamniotic triplet pregnancy |
| title_fullStr |
Perinatal outcome of monochorionic triamniotic triplet pregnancy |
| title_full_unstemmed |
Perinatal outcome of monochorionic triamniotic triplet pregnancy |
| title_sort |
Perinatal outcome of monochorionic triamniotic triplet pregnancy |
| author |
Sileo, F. G. |
| author_facet |
Sileo, F. G. Accurti, V. Baschat, A. Binder, J. Carreras, E. Chianchiano, N. Cruz-Martinez, R. D'Antonio, F. Gielchinsky, Y. Hecher, K. Johnson, A. Lopriore, E. Massoud, M. Nørgaard, L. N. Papaioannou, G. Prefumo, F. Salsi, G. Simões, T. Umstad, M. Vavilala, S. Yinon, Y. Khalil, A. Boito, Simona Fichera, Anna Fort-Jacquier, Julie Liu, Becky López-Briones, Hugo Miller, Jena Pateisky, Petra Pineda-Aleman, Hugo Prasad, Smriti Queirós, Alexandra Rodo, Carlota Rosner, Mara Salsi, Ginevra Slaghekke, Femke Sundberg, Karin Tenebaum-Gavish, Kinneret Youssef, Aly Zussman, Noa Mevorach |
| author_role |
author |
| author2 |
Accurti, V. Baschat, A. Binder, J. Carreras, E. Chianchiano, N. Cruz-Martinez, R. D'Antonio, F. Gielchinsky, Y. Hecher, K. Johnson, A. Lopriore, E. Massoud, M. Nørgaard, L. N. Papaioannou, G. Prefumo, F. Salsi, G. Simões, T. Umstad, M. Vavilala, S. Yinon, Y. Khalil, A. Boito, Simona Fichera, Anna Fort-Jacquier, Julie Liu, Becky López-Briones, Hugo Miller, Jena Pateisky, Petra Pineda-Aleman, Hugo Prasad, Smriti Queirós, Alexandra Rodo, Carlota Rosner, Mara Salsi, Ginevra Slaghekke, Femke Sundberg, Karin Tenebaum-Gavish, Kinneret Youssef, Aly Zussman, Noa Mevorach |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
| dc.contributor.author.fl_str_mv |
Sileo, F. G. Accurti, V. Baschat, A. Binder, J. Carreras, E. Chianchiano, N. Cruz-Martinez, R. D'Antonio, F. Gielchinsky, Y. Hecher, K. Johnson, A. Lopriore, E. Massoud, M. Nørgaard, L. N. Papaioannou, G. Prefumo, F. Salsi, G. Simões, T. Umstad, M. Vavilala, S. Yinon, Y. Khalil, A. Boito, Simona Fichera, Anna Fort-Jacquier, Julie Liu, Becky López-Briones, Hugo Miller, Jena Pateisky, Petra Pineda-Aleman, Hugo Prasad, Smriti Queirós, Alexandra Rodo, Carlota Rosner, Mara Salsi, Ginevra Slaghekke, Femke Sundberg, Karin Tenebaum-Gavish, Kinneret Youssef, Aly Zussman, Noa Mevorach |
| dc.subject.por.fl_str_mv |
growth restriction miscarriage multiple outcome pregnancy TAPS triamniotic triplet TTTS Radiological and Ultrasound Technology Reproductive Medicine Radiology Nuclear Medicine and imaging Obstetrics and Gynaecology |
| topic |
growth restriction miscarriage multiple outcome pregnancy TAPS triamniotic triplet TTTS Radiological and Ultrasound Technology Reproductive Medicine Radiology Nuclear Medicine and imaging Obstetrics and Gynaecology |
| description |
Publisher Copyright: © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023-11-17T22:11:24Z 2023-10 2023-10-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10362/160094 |
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http://hdl.handle.net/10362/160094 |
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eng |
| language |
eng |
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0960-7692 PURE: 74203415 https://doi.org/10.1002/uog.26256 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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12 application/pdf |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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