Frequency Of Multiple Pregnancies Research Articles

Early Pregnancy Ultrasound Assessment of Multiple Pregnancies

As the frequency of multiple pregnancies is increasing, every obstetrician has to know that the correct, accurate, and timely determination of gestational age, chorionicity and amnionicity has significant importance in the management of a multiple pregnancy. Surveillance, complications, outcome, morbidity, and mortality are totally different in a mono-chorionic and a di-chorionic pregnancy. In this study, we will present the sonographic figures that are visualized in the first trimester in a multiple pregnancy and help us define the gestational age, chorionicity and amnionicity. We will classify them into two periods: the early first trimester, including the 10 first weeks of gestation and the late first trimester including the period between the 10th and 14th week of gestation. Finally, we will review some interesting, although infrequent, cases from the literature, showing that pitfalls in the determination of both chorionicity and amnionicity exist and highlighting the importance of being aware of their subsistence.

In Twin Pregnancies, Zinc and Iron Decreased, while Copper Increased Minimally

Objective: Along with the increase in the frequency of multiple pregnancies, an increase is observed in the frequency of feto-maternal negativities. In our study, we aimed to determine the iron, ferritin, hemoglobin, zinc, and copper levels in second-trimester multiparous twin pregnancies and compare them with the values in singleton pregnancies and healthy women with the same demographic characteristics.Methods: Three groups were created in the study; control group, single pregnancy group, and twin pregnancy group. Fasting venous blood samples were taken from individuals. Iron, zinc, copper, and ferritin levels were measured.Results: Compared with the control group, the ferritin (Fe), and zinc (Zn) values of the individuals in the single and twin pregnancy groups were statistically low while copper (Cu) levels were significantly high (p<0.05). Also, when compared with individuals in a single pregnancy group, a statistically significant decrease was found in Fe, and Zn levels in the twin pregnancy group (p<0.05). Although there was a minimal increase in Cu levels, this increase was not statistically significant in the twin pregnancy group.Conclusion: Since changes in trace element levels can lead to feto-maternal adverse effects, we think that dietary habits should be monitored, and zinc, copper, ferritin, and iron levels should be followed in pregnant women.

Dispensing of clomiphene citrate to treat infertility: medication supplied and population prevalence of assisted pregnancies and multiple births

To determine the proportion of pregnancies resulting in birth that were conceived with the use of clomiphene citrate (CC) and the frequency of multiple pregnancy. Whole-of-population cohort study, constructed through data linkage. Comprehensive Australian Government records of dispensed medications were linked to state Perinatal Registry records for all births of at least 20 weeks' gestation. The state of South Australia. Women who maintained pregnancy for at least 20 weeks and gave birth between July 2003 and December 2015, a total of 150,713 women with 241,561 pregnancies. Not applicable. Ongoing pregnancy occurring in proximity to CC, defined as dispensing from 90 days before to the end of a conception window derived from newborn date of birth and gestational age. Linkage to dispensed prescription records was achieved for 97.9% of women. Women who conceived with CC tended to be older and socioeconomically advantaged and more likely than other women to have a history of miscarriage. Ongoing pregnancies associated with CC comprised 1.6% of the total; 5.7% were multiple births (mostly twins, 94.6%) compared with 1.5% in the remainder (98.5% twins). In South Australia, 1.6% of pregnancies (1 in 60) of at least 20 weeks' gestation were conceived proximal to CC dispensing. Of these, 5.7% were multiple pregnancies. This takes the proportion of women who achieved an ongoing pregnancy with medical assistance from 4.4%, based on reports from assisted reproductive technology clinics, to 6% in total.

Hearing function in twins from spontaneous and induced pregnancy

In recent years, an increase in the frequency of multiple pregnancies has been observed worldwide, which is primarily associated with the widespread use of assisted reproductive technology for the treatment of infertility. Pregnancy resulting from in vitro fertilization is a high-risk group. In the world scientific literature there are practically no works on the study of auditory function in children from multiple pregnancy. As for the studies of the auditory function of children from multiple pregnancies, such works are practically absent in the literature. The article presents the results of an audiological examination of 204 children from twins, 94 of which were born as a result of using assisted reproductive technologies, and 110 from a spontaneous multiple pregnancy. According to an audiological survey using the method of otoacoustic emission at the frequency of product distortion in the expected period of labor, we have proven that the conception method (spontaneous or induced) does not affect the maturation of the auditory function in children from twins: registration of the distortion product otoacoustic emissions (DPOAE) test is 56,1 and 54,4% of cases, respectively. The auditory function of each child from one twin must be considered individually.

MULTIPLE PREGNANCY, ANTENATAL CARE PROBLEMS AND THEIR SOLUTIONS RESULTS

Aim of the work. The aim of our study is to summarize the course of pregnancy and delivery in multiple pregnancies in modern conditions. Materials and methods. The analysis of the pregnancy course, labor and perinatal outcomes was carried out in 182 women with diochorionic and 86 patients with monochorionic twins and 40 women with a singleton pregnancy. Multiple pregnancies were proved to be a monochorionic (MH) and diochorionic (DH) that is a high risk factor for perinatal complications. The research included clinical and laboratory examination metods, study of hormonal function of fetoplacental complex (FPC), transvaginal ultrasound examination. Statistical processing of data was carried out using the package of applied programs Microsoft Office Excel 2010 and StatSoft Statistica 6.1. Results and discussion. In the analysis of pregnancy the abortion threat was detected in 51 (59.3%) women with monochorionic and 34 (62%) women with diochorionic twins. Preeclampsia during pregnancy complicated in 26 (30.2%) and 43 (23.6%) patients, with monochorionic and diochorionic placentation type, respectively. A frequent complication of both the MH and DH twins was anemia, which was found in more than half of the surveyed (56.9 and 51%, respectively). Delivery in the case of multiple pregnancies is also much more complicated and is terminated surgically three times more often than in singleton births. The most frequent indications for operative delivery were first breech fetus, fetal distress during pregnancy and childbirth, FGR, severe preeclampsia, premature detachment of normally situated placenta, anomalies of labor activity. These perinatal losses were equally observed both after cesarean section and after spontaneous labor and amounted to 4% at monochorionic and 1.7% at diochorionic twins. The frequency dependence of identified lesions at pregnancy with twins was established by chorionic. Careful observation of the patients with multiple pregnancies in the antenatal period, the prevention of the most frequent complications, ultrasound monitoring of early pregnancy allows a differentiated approach to the management of pregnancy and childbirth, helping to reduce perinatal morbidity and mortality. Conclusions. Multiple pregnancies occur with a large number of complications compared with singletons. Thus, the increase of frequency of multiple pregnancy influences the obstetric and perinatal indicators, pushing this issue in a number of the most pressing issues of modern obstetrics and perinatology.

Роль прозапальних цитокінів у патогенезі передчасної пологової діяльності при багатоплідній вагітності, яка настала внаслідок застосування допоміжних репродуктивних технологій

In recent years there has been an increase in the frequency of multiple pregnancies and the associated perinatal losses. It is a result of multiple pregnancy in ART refers to a high-risk gestation, at which premature births occur in 2 times more often than in singleton pregnancies. The objective: to determine the role of pro-inflammatory cytokines in the pathogenesis of premature labor in multiple pregnancy, as a result of assisted reproductive technology. Patients and methods. to determine the pro-inflammatory cytokines that all pregnant with bagtopliddyam held immunosorbent assay, defined concentrations of interleukin (IL) in serum and cervical mucus. Results. The analysis of the levels of pro-inflammatory cytokines (IL-1, IL-8) in the test environment, found high concentrations in the surveyed women with multiple pregnancy, due to the use of ART, compared with spontaneous multiple and singleton pregnancy. Increased concentration of proinflammatory cytokines in patients with multiple pregnancy by ART is associated with their synthesis at the system level, it stimulated foci of inflammation in the female genitals and extragenital localization. This correlates with the clinical data and statistical analysis, patients with multiple pregnancy as a result of ART had weighed infectious-inflammatory history. Conclusion. The study showed that elevated levels of proinflammatory cytokines in the systemic and local level in patients with multiple pregnancy due to ART, typical for women with miscarriage, because of the physiological course of pregnancy characterized by the predominance of anti-inflammatory cytokines that prevent rejection of the fetus as a foreign factor. Based on the data obtained proved the role of systemic inflammatory factors in the genesis of preterm labor in women with a multiple pregnancy, as a result of assisted reproductive technology. Key words: multiple pregnancy, assisted reproductive technology, premature birth, interleukine-1, interleukine-8.

High occurrence of HIV-positive siblings due to repeated mother-to-child transmission in Brazil

Pregnancies in women without knowledge of their HIV-positive status increase the risk of mother-to-child transmission, and of disease progression. This study aimed to characterize the frequency of multiple pregnancies and of HIV-positive children in the family, during HAART era. We analyzed data of a national multicenter cohort study among Brazilian children with AIDS diagnosed between 1999 and 2002. In total, 945 children and their 928 mothers were included. Five hundred and ninety (64.6%) women had a history of multiple pregnancies, and 49.5% attended prenatal care (mean: 3.5 consultations; SD 3.6). In 483 child cases, HIV status of the sibling was known; 130 (26.9%) of these were infected with HIV. In 38.5% of cases, the child with AIDS included in the cohort study was the first case in the family. Despite the overall positive results of the Brazilian control policy of HIV/AIDS, our study shows that HIV infection in pregnant women was often undetected and that consequently there was a high frequency of repeated HIV-infected children. There is a need to improve comprehensive prenatal and postnatal care of Brazilian women. HIV-affected families are most vulnerable and should be targeted by specific control programs, preventing additional HIV infections in other children.

The effective prevention of multiple pregnancies by elective single embryo transfer

ObjectiveMaintaining high pregnancy rates without multiple pregnancies is important for assisted reproductive technology (ART) treatment. This study evaluated the consequences of using a new embryo quality assessment for pregnancy, implantation and multiple pregnancy rates achieved with single embryo transfer (compulsory (cSET) and elective (eSET)) or 2 embryos transfer (DET).DesignRetrospective study.Materials and methodsSubjects were 188 patients (188 cycles) who utilized c-IVF and ICSI during from January 2005 to August 2006. Embryo transfer was performed on day 3. Embryo quality was primarily estimated by the time needed to reach 2 cells division at 25–27 hours after insemination. In addition, we scored morphological assessment of blastomere and first polar body, hollow formation of cytoplasm and nucleolus aspect.ResultsPregnancy rate (44.4% and 55.6%, respectively) and implantation rate (44.4% and 36.1%, respectively) of eSET and DET were significantly higher than cSET group (P<0.05). No significant differences in pregnancy and implantation rates were between eSET and DET, however, the frequency of multiple pregnancies was significantly reduced in eSET (0%, 0/24) compared with in DET (30.0%, 15/50) (P<0.05).ConclusionsThis study confirmed that eSET resulted in pregnancy rates as high as those achieved with double embryos transfer. Furthermore it is note that multiple pregnancy rate can clearly be reduced after eSET. Therefore, our novel embryo quality assessment is an excellent methods for selecting embryos to transfer. In future, when good quality embryos are present on day 3, only 1 elective embryo should be transferred to reduce the risk of multiple pregnancies. ObjectiveMaintaining high pregnancy rates without multiple pregnancies is important for assisted reproductive technology (ART) treatment. This study evaluated the consequences of using a new embryo quality assessment for pregnancy, implantation and multiple pregnancy rates achieved with single embryo transfer (compulsory (cSET) and elective (eSET)) or 2 embryos transfer (DET). Maintaining high pregnancy rates without multiple pregnancies is important for assisted reproductive technology (ART) treatment. This study evaluated the consequences of using a new embryo quality assessment for pregnancy, implantation and multiple pregnancy rates achieved with single embryo transfer (compulsory (cSET) and elective (eSET)) or 2 embryos transfer (DET). DesignRetrospective study. Retrospective study. Materials and methodsSubjects were 188 patients (188 cycles) who utilized c-IVF and ICSI during from January 2005 to August 2006. Embryo transfer was performed on day 3. Embryo quality was primarily estimated by the time needed to reach 2 cells division at 25–27 hours after insemination. In addition, we scored morphological assessment of blastomere and first polar body, hollow formation of cytoplasm and nucleolus aspect. Subjects were 188 patients (188 cycles) who utilized c-IVF and ICSI during from January 2005 to August 2006. Embryo transfer was performed on day 3. Embryo quality was primarily estimated by the time needed to reach 2 cells division at 25–27 hours after insemination. In addition, we scored morphological assessment of blastomere and first polar body, hollow formation of cytoplasm and nucleolus aspect. ResultsPregnancy rate (44.4% and 55.6%, respectively) and implantation rate (44.4% and 36.1%, respectively) of eSET and DET were significantly higher than cSET group (P<0.05). No significant differences in pregnancy and implantation rates were between eSET and DET, however, the frequency of multiple pregnancies was significantly reduced in eSET (0%, 0/24) compared with in DET (30.0%, 15/50) (P<0.05). Pregnancy rate (44.4% and 55.6%, respectively) and implantation rate (44.4% and 36.1%, respectively) of eSET and DET were significantly higher than cSET group (P<0.05). No significant differences in pregnancy and implantation rates were between eSET and DET, however, the frequency of multiple pregnancies was significantly reduced in eSET (0%, 0/24) compared with in DET (30.0%, 15/50) (P<0.05). ConclusionsThis study confirmed that eSET resulted in pregnancy rates as high as those achieved with double embryos transfer. Furthermore it is note that multiple pregnancy rate can clearly be reduced after eSET. Therefore, our novel embryo quality assessment is an excellent methods for selecting embryos to transfer. In future, when good quality embryos are present on day 3, only 1 elective embryo should be transferred to reduce the risk of multiple pregnancies. This study confirmed that eSET resulted in pregnancy rates as high as those achieved with double embryos transfer. Furthermore it is note that multiple pregnancy rate can clearly be reduced after eSET. Therefore, our novel embryo quality assessment is an excellent methods for selecting embryos to transfer. In future, when good quality embryos are present on day 3, only 1 elective embryo should be transferred to reduce the risk of multiple pregnancies.

The particular problems of ambulatory-controlled ovarian stimulation

The impact of infertility treatments on the frequency of multiple pregnancies in France was investigated using data on total multiple deliveries and multiple deliveries from assisted reproduction and intrauterine insemination (IUI) between 1994 and 2004, and by making assumptions about the expected rate of natural multiple deliveries. During this period, 72.0% of multiple deliveries were the result of infertility treatments. The rate of triplet delivery after assisted reproduction decreased by 50% between 2000 and 2004, despite a large increase in deliveries resulting from assisted reproduction. In 2004, assisted reproduction techniques accounted for 23.6% of all triplets delivered and for 34.9% of those delivered after infertility treatments. The corresponding figures for IUI were 12.2% and 18.0% respectively, with a doubling since 1996; for ovulation induction without IUI the corresponding figures were 27.7% and 37.9% respectively. The figures for ovulation induction are slightly higher than for assisted reproduction treatment, probably due to the high number of quadruplets and higher order deliveries in this group. However, no conclusion can be drawn on the relative contribution of increased risk for a given ovarian stimulation cycle on one hand and of a simple increase in the number of treated cycles on the other, since no surveillance data to distinguish between them exists in France. There is a real need for more investigation on ovulation induction in France.

Number of Embryos Transferred and Implantation

Multiple pregnancies are considered the most frequent and serious complication of assisted reproduction technology. To reduce the frequency of multiple pregnancies, several centers have adopted a policy of reducing the number of embryos transferred in the uterus, suggesting single embryo transfer. Even though a significant number of papers have been published on this issue, no general consensus exists on how many embryos to replace in the uterus and at which cleavage stage. We conducted a retrospective study on cycles performed throughout 2003, analyzing the relation between the number of embryos transferred and the pregnancy and implantation rates, evaluating also the role of the woman's age. No differences were found among the groups except in one-embryo transferred women, which were mostly natural cycles, for estradiol levels, number of mature oocytes retrieved, number of top quality embryos, and pregnancy rate. The implantation rate was significantly higher in the two-embryo transfers versus three-embryo transfers. We found higher pregnancy and implantation rates with similar multiple pregnancy rates in patients where only two embryos were transferred versus three embryos transfer when women were less than 35 years old. In women aged less than 35 years, which in turn have the higher expectancy of successful pregnancy and also the higher risk of multiple pregnancy, the single embryo transfer is a suitable choice for these patients.

Genetic and environmental effects on twin pregnancy and length of reproduction in Thoroughbred mares

Abstract. Reproductive data of 1910 Thoroughbred mares from seven Polish studs were analyzed using linear animal model. The mares were born between 1929 and 1994. The frequency of multiple pregnancies was 3.5% in this population. Fecundity (defined as ratio of number of progeny to number of pregnancies) and length of reproduction were recorded. Heritability estimates of fecundity and the number of pregnancies were 0.03 and 0.07, respectively. Genetic correlation between these traits was −0.42 whereas phenotypic and environmental correlations were close to zero (−0.05 and −0.04, respectively). In general, genetic, phenotypic and environmental trends for fecundity and the number of pregnancies were non-negative. However, these annual effects are highly fluctuated. It may be attributed to the influence of some sires incorporated into population. Hence, a segregation of single locus can be hypothesised.

Combined bilateral tubal and multiple intrauterine pregnancy after ovulation induction

Over the last 20 years, the frequency of multiple pregnancy has increased mainly because of the introduction of exogenous pituitary gonadotropins in the treatment of sterility. The incidence of ectopic pregnancies also increased during the same period of time. This paper describes the first reported case of a simultaneous bilateral tubal and multiple intra-uterine pregnancy after ovulation induction with human gonadotropins.

Quadruplet pregnancy in IVF

The frequency of multiple pregnancy following IVF with the presently accepted methods is ten times higher than in natural cycles, and is identical to that following induction of ovulation with HMG. In spite of the fact that multifetal pregnancy exposes both fetus and mother to certain dangers, most couples joining IVF programs expose themselves to, and generally accept the risk of, multiple pregnancy, since this is their last resort for having a baby of their own. We report such a case of quadruplet pregnancy after the IVF procedure and review the literature.

An evaluation of serum uric acid estimations in toxaemia of pregnancy.

Summary1. There was an increase in the proportion of patients with raised serum uric acid (SUA) levels with increasing severity of pre‐eclamptic toxaemia.2. Raised SUA levels were also found in one‐third of patients with unclassified toxaemia. The criteria of diagnosis of unclassified toxaemia requires revision.3. In the hypertensive patients in this study, the frequency of multiple pregnancy was twice that expected in normal pregnancy.4. The ratio SUA/BUN x 100 was similar in pre‐eclampsia of all three grades of severity and in unclassified toxaemia, but the ratio in essential hypertension in this study was lower than in the other groups. Therefore this ratio may be of value in separating the patients with essential hypertension from the unclassified toxaemia patients.5. While an elevated SUA from 6.0‐10.0 mg./100 ml. was suggestive of preeclampsia, and an increasing level was highly significant, half the patients with pre‐eclampsia had normal SUA levels.6. There is a place for SUA estimations in the management of hypertension in pregnancy, but the results require to be interpreted in the light of clinical findings. patients under their care. Special thanks are due to Professor L. W. Cox for his interest in this study, and to Dr. J. R. Lawrence, for helpful criticism.

Saggio di indagine sulla gemelliparità in un archivio parrocchiale

SUMMARYThe author made use ot parochial archives for a genetic research. All parochial archives keep the registers of the newborn, the dead, the marriages, the confirmands, the amounting of the population in a parish. According to the canon 1813 (§ 1), these registers are public and ecclesiastical documents, and they form a mine of biological and genetic information too.In this work the author, by making use of parochial archives in Busnago (Milan), — starting in 1634 — has controlled the proceeding of multiple pregnancies. These appear to have a percentage of 1,53% — superior to that of the Italian population (1, 13%) and to that of the human population officially numbered (1, 25% according to Caullery).During the three centuries considered by the author, the proceeding of these multiple pregnancies shows a certain periodicity, but, from 1764 to 1804, there is an abrupt fall occuring at the same time of an endemic pellagrous disease. A further inquiry on 23 twin-pairs selected during the last forty years, and a research during the three centuries considered did not show any relationship between consanguinity and multiple pregnancies. On the contrary, this research showed a periodical proceeding of the frequency of multiple pregnancies on the total of the newborn with cusps, every quarter of a century, which seems to support the hypothesis of the existence of a dominant hereditary factor. At last, the greatest number of percentage of multiple pregnancies on the mother's side, as compared with the father's one, makes us think of a hereditary factor on the mother's side.