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1.
Clinics ; 72(5): 265-271, May 2017. tab, graf
Article Dans Anglais | LILACS | ID: biblio-840074

Résumé

OBJECTIVE: The aim of the present study was to compare the placental weight and birth weight/placental weight ratio for intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. METHODS: This was a retrospective analysis of placentas from twin pregnancies. Placental weight and the birth weight/placental weight ratio were compared in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. The association between cord insertion type and placental lesions in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins was also investigated. RESULTS: A total of 105 monochorionic (intrauterine growth restriction=40; non-intrauterine growth restriction=65) and 219 dichorionic (intrauterine growth restriction=57; non-intrauterine growth restriction=162) placentas were analyzed. A significantly lower placental weight was observed in intrauterine growth-restricted monochorionic (p=0.022) and dichorionic (p<0.001) twins compared to non-intrauterine growth-restricted twins. There was no difference in the birth weight/placental weight ratio between the intrauterine growth restriction and non-intrauterine growth restriction groups for either monochorionic (p=0.36) or dichorionic (p=0.68) twins. Placental weight and the birth weight/placental weight ratio were not associated with cord insertion type or with placental lesions. CONCLUSION: Low placental weight, and consequently reduced functional mass, appears to be involved in fetal growth restriction in monochorionic and dichorionic twins. The mechanism by which low placental weight influences the birth weight/placental weight ratio in intrauterine growth-restricted monochorionic and dichorionic twins needs to be determined in larger prospective studies.


Sujets)
Humains , Femelle , Grossesse , Adulte , Jeune adulte , Poids de naissance/physiologie , Chorion/physiologie , Développement foetal/physiologie , Retard de croissance intra-utérin/physiopathologie , Placenta/anatomie et histologie , Grossesse gémellaire/physiologie , Âge gestationnel , Taille d'organe , Placenta/anatomopathologie , Placenta/physiopathologie , Valeurs de référence , Études rétrospectives , Statistique non paramétrique , Facteurs temps , Jumeaux dizygotes , Jumeaux monozygotes
2.
Clinics ; 69(7): 447-451, 7/2014. tab, graf
Article Dans Anglais | LILACS | ID: lil-714603

Résumé

OBJECTIVE: We aimed to examine maternal postpartum complications of twin deliveries according to mode of delivery and investigate the associated risk factors. METHODS: This was a retrospective cohort review of twin pregnancies with delivery after 26 weeks at a tertiary teaching hospital (1993-2008). The rates of maternal postpartum complications were compared among vaginal, elective cesarean and emergency cesarean deliveries. Significant predictors of complications were investigated with stepwise regression analysis and relative risks were calculated. RESULTS: A total of 90 complications were observed in 56/817 (6.9%) deliveries: 7/131 (5.3%) vaginal, 10/251 (4.0%) elective cesarean and 39/435 (9.0%) emergency cesarean deliveries. Significant predictors included high-risk pregnancy, gestational age at birth and delivery mode. The occurrence of complications was significantly increased in emergency compared to elective cesarean deliveries (RR = 2.34). CONCLUSIONS: Maternal postpartum complications in twin pregnancies are higher in emergency compared to elective cesarean deliveries and are also related to preexisting complications and earlier gestational age at delivery. .


Sujets)
Adulte , Femelle , Humains , Grossesse , Jeune adulte , Accouchement (procédure)/statistiques et données numériques , Période du postpartum , Complications de la grossesse , Grossesse gémellaire , Césarienne , Âge gestationnel , Hôpitaux universitaires/statistiques et données numériques , Âge maternel , Issue de la grossesse , Études rétrospectives , Facteurs de risque , Centres de soins tertiaires/statistiques et données numériques
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