Abstract:
:Twin birth rates have increased dramatically over the past three decades, and twins currently account for 3% of all pregnancies. Twin pregnancies of any type are at risk for prematurity. In addition, monochorionic twin pregnancies (25-30% of all twin pregnancies) are predisposed to a specific set of complications, including twin-to-twin transfusion syndrome (TTTS), twin reversed arterial perfusion syndrome (TRAP), malformations, and intertwin growth discordance. This article reviews the basic mechanisms underlying the twinning process, the relationship between zygosity and chorionicity, and the various types of twinning. We describe the major complications of monochorionic twinning in association with their reported placental characteristics (or lack thereof). Finally, a rational, evidence-based approach to examination of the twin placenta is presented. It is essential for the pathologist to understand the value, strengths, and limitations of examination of the twin placenta in order to provide a meaningful clinicopathological correlation in complicated (monochorionic) twin pregnancies.
journal_name
Semin Perinatoljournal_title
Seminars in perinatologyauthors
Paepe MEdoi
10.1053/j.semperi.2014.10.005subject
Has Abstractpub_date
2015-02-01 00:00:00pages
27-35issue
1eissn
0146-0005issn
1558-075Xpii
S0146-0005(14)00120-7journal_volume
39pub_type
杂志文章,评审abstract:PURPOSE:The purpose of this analysis was to determine the impact on specific forms of neonatal morbidity and mortality by allowing women to opt for delivery by elective cesarean section at 39 weeks of gestation (EGA). According to the National Vital Statistics Reports, over 70% of deliveries in the U.S. annually are at...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2006.07.009
更新日期:2006-10-01 00:00:00
abstract::Hydrops fetalis, a condition characterized by abnormal accumulation of fluid and edema in the fetus, is the final common pathway in a number of pathological conditions. The diagnosis of hydrops is based on ultrasonographic findings of generalized edema along with a serous effusion (ascites, pleural effusion, or perica...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(05)80053-9
更新日期:1995-12-01 00:00:00
abstract::Increased hemolysis in the presence of severe neonatal hyperbilirubinemia appears to augment the risk of bilirubin neurotoxicity. The mechanism of this intensifying effect is uncertain. In direct antiglobulin titer (DAT) positive, isoimmune hemolytic disease, the bilirubin threshold at which neurotoxicity occurs appea...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2014.08.006
更新日期:2014-11-01 00:00:00
abstract::The safety of cesarean section has improved dramatically over the past 50 years. During the past 20 years a greater awareness of and discussion about the symptomatic morbidity that can result for women following vaginal delivery has occurred and women's expectations for the outcome of pregnancy for them and their babi...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2003.50002
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Pulmonary inflammation, increased production of the inflammatory cytokine interleukin-1beta (IL-1beta), and vitamin A deficiency are risk factors for the development of bronchopulmonary dysplasia (BPD) in premature infants. To determine the mechanisms by which IL-1beta influences lung development, we have ge...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2006.04.009
更新日期:2006-06-01 00:00:00
abstract::Prostaglandins PGE2, PGD2, PGI2, and PGF2 alpha, as well as thromboxanes and leukotrienes, are synthesized by the fetal and neonatal kidney. The major prostaglandin, PGE2, PGD2, and PGI2, increase RBF, free water clearance, urine flow, and natriuresis. Alterations in the synthetic and catabolic activity of renal prost...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1987-01-01 00:00:00
abstract::Preterm birth occurs in 7% to 12% of all deliveries, but accounts for over 85% of all perinatal morbidity and mortality. Although the ability of obstetric care providers to identify women at risk for preterm delivery has improved, the overall incidence of preterm birth has remained unchanged for the past 30 years. Pre...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.26417
更新日期:2001-08-01 00:00:00
abstract::For many years, all of the described cases of monoamine neurotransmitter deficiency were associated with hyperphenylalaninemia that was generally detected at neonatal screening. It is now clear that inherited deficiency of monoamines often occurs in the absence of hyperphenylalaninemia and that the normal battery of s...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(99)80051-2
更新日期:1999-04-01 00:00:00
abstract::This article reviews the central role of nutrition in advancing the maternal, newborn, and child health agenda with a focus on evidence for effective interventions generated using randomized controlled trials in low- and middle-income countries (LMIC). The 1000 days spanning from conception to 2 years of life are a cr...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.06.009
更新日期:2015-08-01 00:00:00
abstract::Sleep-disordered breathing occurs in 0.6-15% of reproductive age women. This condition is associated with an increased lifetime risk of cardiovascular disease, cardiovascular mortality, and all-cause mortality. A substantial body of evidence demonstrated increased perinatal morbidity among pregnancies affected by SDB ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.05.010
更新日期:2015-06-01 00:00:00
abstract::Up to half of all aortic dissections and ruptures in women younger than 40 years are associated with pregnancy. In pregnancy, women with aortic disease such as arteritis and aortitis are at significant risk of aneurysmal formation and dissection with potential for catastrophic outcomes. Pregnancy places predisposed wo...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2014.04.019
更新日期:2014-08-01 00:00:00
abstract::The importance of omega-3 long chain polyunsaturated fatty acids in the perinatal period has been the focus of research for several decades. Infants born preterm miss out on the last trimester in utero transfer of omega-3 fatty acids and consequently have lower blood levels than infants born at term. Preterm infant fo...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.06.004
更新日期:2019-11-01 00:00:00
abstract::Late preterm infants (34-37 weeks gestation) pose unique challenges to physicians and nurses involved in their care after birth. They may be cared for in different units within hospitals after birth, including Neonatal Intensive Care Units, Newborn Nurseries, or rooming in with the mother. As a result of their gestati...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2006.01.014
更新日期:2006-02-01 00:00:00
abstract::A single course of antenatal corticosteroids is a rare example of a treatment that yields both a health benefit and a cost savings. This article reviews the history and background of antenatal corticosteroids, its use in clinical practice and the controversy today regarding the use of multiple courses of antenatal cor...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.26418
更新日期:2001-10-01 00:00:00
abstract::The intended and unintended effects of epidural labor analgesia are reviewed. Mothers randomized to epidural rather than parenteral opioid analgesia have better pain relief. Fetal oxygenation is not affected by analgesic method; however, neonates whose mothers received intravenous or intramuscular opioids rather than ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2002.32201
更新日期:2002-04-01 00:00:00
abstract::While the cesarean delivery (CD) rates have increased worldwide, operative vaginal delivery (OVD) rates continue to decline, with the United States having some of the lower rates amongst developed countries. It is clear that the use of forceps or vacuum can safely assist in accomplishing a vaginal delivery and prevent...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2012.04.021
更新日期:2012-10-01 00:00:00
abstract::Oligohydramnios is a severe and common complication of pregnancy. The finding of oligohydramnios can be associated with fetal anomalies, PROM, uteroplacental insufficiency (eg, growth retardation, postdatism, abruptio placenta, significant maternal illness), abnormalities of twinning, and idiopathic oligohydramnios. U...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract::Extracorporeal membrane oxygenation (ECMO) is a highly technical and complex method of life support. Patient and circuit emergencies on ECMO are rare, but in these cases, prompt and correct actions to address the crisis are needed to prevent morbidity and mortality. ECMO simulation programs have gained popularity in r...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2016.08.002
更新日期:2016-11-01 00:00:00
abstract::Inhaled nitric oxide (iNO), a selective pulmonary vasodilator, is available for treatment of persistent pulmonary hypertension of the newborn in term and near-term neonates. iNO decreases pulmonary vascular resistance leading to diminished extrapulmonary shunt and also has a microselective effect which improves ventil...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2000.20085
更新日期:2000-12-01 00:00:00
abstract::Accurate assessment of fetal growth status requires the definition of an optimal standard, which represents the growth potential of the baby. Against this standard, individually 'customized' percentiles can be calculated. They improve the distinction between normal and abnormal, and help in our understanding and diagn...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2003.12.002
更新日期:2004-02-01 00:00:00
abstract::Universal prenatal Rhesus (Rh) screening and prophylaxis with Rh immunoglobulin have been highly effective practices for preventing neonatal morbidities and mortality. However, there has been an enormous failure to prevent Rh sensitization and its adverse consequences worldwide, especially in low- and middle-income co...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1016/j.semperi.2020.151357
更新日期:2021-02-01 00:00:00
abstract::Given the historically high rates of cesarean delivery in the United States, obstetrical providers must often consider an induction of labor for women with a history of prior cesarean delivery versus repeat cesarean delivery. Clinical evaluation of this scenario involves weighing the benefits of a successful trial of ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.07.011
更新日期:2015-10-01 00:00:00
abstract::Gene therapy carries the potential to treat more than 10,000 human monogenic diseases and benefit an even greater number of complex polygenic conditions. The repurposing of CRISPR/Cas9, an ancient bacterial immune defense system, into a gene-editing technology has armed researchers with a revolutionary tool for gene t...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2018.09.003
更新日期:2018-12-01 00:00:00
abstract::The unexpectedness of genital ambiguity in an infant creates an urgent and stressful situation. A logical approach, using a team of specialists together with nursery staff and physicians, allows each member to contribute expertise and unnecessary overlap of investigations. The psychological needs of the parents should...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1992-12-01 00:00:00
abstract::Supplemental oxygen is often used as a life-saving therapy in the treatment of preterm infants. However, its protracted use can lead to the development of bronchopulmonary dysplasia (BPD), and more recently, has been associated with adversely affecting the general health of children and adolescents who were born prete...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2013.01.002
更新日期:2013-04-01 00:00:00
abstract::Before sounds originating outside the abdomen of pregnant women can reach the inner ear of the fetus, they must first pass through the tissues and fluids surrounding the fetal head. Low-frequency sound energy easily penetrates to the fetal head, less than 5 dB attenuation for frequencies below 500 Hz, whereas higher f...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(96)80053-x
更新日期:1996-02-01 00:00:00
abstract::Infants meeting retinopathy of prematurity (ROP) screening guidelines based on birth weight and gestational age undergo serial examinations by ophthalmologists for detection and treatment. However, less than 10% require treatment, and less than half develop ROP. Slow postnatal weight gain is highly predictive of ROP, ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.05.008
更新日期:2019-10-01 00:00:00
abstract::Newborn screening (NBS) reaches approximately all of the 4 million newborns in the United States each year and has been effective in significantly reducing the morbidity and mortality that results from certain congenital conditions. The comprehensive NBS system can be divided into preanalytic (education and screening)...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2009.12.002
更新日期:2010-04-01 00:00:00
abstract::The complex nature of amniotic fluid reflects contributions from many fetal systems, many functional roles, and multiple interactions with fetal maturation, obstetric, and maternal factors. Simple ultrasound measurement, probably done best with the maximum vertical pocket method, has a clinical role in fetal surveilla...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2008.04.012
更新日期:2008-08-01 00:00:00
abstract::This review documents and assesses recent trends in sudden infant death syndrome. We review medical literature, Internet resources, and national governmental data. A striking reduction in SIDS incidence of more than 50% has been observed in various countries after interventions, particularly during the early 1990s, to...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2002.34774
更新日期:2002-08-01 00:00:00