Congenital malformations in multiple births.

Objective: The present study was done to know and compare the incidence of congenital malformations in singleton and multiple births in our hospital & compare with other studies. Methods: A retrospective study done by collecting the data from parturition register from Jan 2008 to Dec 2011 (4yrs) from Cheluvamba Hospital attached to Mysore Medical College and Research Institute. Total number of the live births, still births, and abortions> 20 wks were collected. Details of multiple births such as maternal age, gestational age, sex & birth weight of the babies, U/S reports and congenital anomalies (CA) were noted. Results: The total number of singleton births were 48700 and number of babies who had congenital malformations were 235 (48.25/10,000 births).Total number of multiple births were 579 including 10 triplets and number of babies who had CA were 11 (189.98/10,000 births, P<0.0001). In the present study sex of the babies were noted in all multiple births and zygosity could not be recorded. Among 579 multiple births 404 were of the Same Sex (SS) and 165 were of Opposite Sex (OS) in twins and 6 were of the same sex and 4 were of opposite sex in triplets. According to Weinberg formula 50% of same sex (SS) twins are monozygotic and 50% are dizygotic twins. Among the 11 babies with CA, 4 monozygotic twins had anomalies related to twinning such as Acardia with TRAP sequence (3 twins), and Thoracophagus (1 twin).5 babies had CNS anomalies, 1 with cystic hygroma, 1 baby with multiple system affected. Conclusion: The incidence of birth defects is more in multiple births and especially in monozygotic twins. In the present days increase in twinning rate due to advanced maternal age, hereditary factors and use of ovulation inducing drugs, which results in premature and low birth wt babies associated with poor lung maturity.

Congenital Malformations in Twins: Effect of Chorionicity and Zygosity.

Twins suffer a high risk of congenital malformations but the data from our region is scanty. In this study, 133 twin pairs (266 twin babies) were studied and a 3.4% incidence of malformations was seen without gender preference. There was no association of chorionicity and zygosity with the risk for having congenital malformations

Esophageal Atresia with Distal Tracheoesophageal Fistula in Both Members of Monozygotic Twins

Although the incidence of esophageal atresia (EA) is higher in twins than in singletons by two to three times, EA usually affects only one member of twins. We report one pair of twins concordant for EA. A 31-year-old healthy woman bore monozygotic female twins at 36 weeks of gestation. They weighed 2,216 and 2,480g, respectively. They had EA with distal tracheoesophageal fistula and underwent primary esophageal anastomosis on the birth day and the 2nd day of life, respectively. Twin A also had suspicious antral obstruction and pyloroplasty was done simultaneously with esophageal repair. She needed antral web excision for continued gastric stasis one month after 1st operation and three balloon dilatations of the esophagus. Twin B recovered uneventfully.

Motor Development of Japanese Twins in Childhood as Reported by Mothers

Objective: Twins tend to lag behind singletons in their motor development, though the causes of this appear to be complicated and are not yet fully understood. The present study was performed to clarify the factors associated with the motor development of twins. Methods: The twins in the first group consisted of school applicants, including 1131 twin pairs, and the second group consisted of children of members of several maternal associations, and included 951 pairs. All data were gathered by questionnaire survey, and six gross-motor development milestones were analyzed in individuals or pairs. Results: Relative to general population norms in Japan, twins tended to be delayed in reaching several motor development milestones. Stepwise regression analysis showed that of all the variables measured, gestational age was the most influential on all six milestones. Birthweight was also influential on most milestones. Other factors affecting motor development milestones were parity for ‘sitting without support,’ ‘pulling up to a standing position,’ and ‘walking without support,’ and zygosity for ‘walking without support.’ In these cases, longer gestational age, heavier birthweight, primiparity, and dizygosity showed a tendency toward earlier attainment of development. Motor development within pairs was more similar in monozygotic pairs compared with dizygotic pairs regarding each item, suggesting genetic contributions. Conclusion: The results of the present study showed specific and nonspecific factors that affect motor development of twins. These findings should prove useful in understanding the motor development of twin children and help clinicians to refine maternal and child health care for multiple-birth children.

Motor development of Japanese twins in childhood as reported by mothers

<p><b>OBJECTIVE</b>Twins tend to lag behind singletons in their motor development, though the causes of this appear to be complicated and are not yet fully understood. The present study was performed to clarify the factors associated with the motor development of twins.</p><p><b>METHODS</b>The twins in the first group consisted of school applicants, including 1131 twin pairs, and the second group consisted of children of members of several maternal associations, and included 951 pairs. All data were gathered by questionnaire survey, and six gross-motor development milestones were analyzed in individuals or pairs.</p><p><b>RESULTS</b>Relative to general population norms in Japan, twins tended to be delayed in reaching several motor development milestones. Stepwise regression analysis showed that of all the variables measured, gestational age was the most influential on all six milestones. Birthweight was also influential on most milestones. Other factors affecting motor development milestones were parity for 'sitting without support,' 'pulling up to a standing position,' and 'walking without support,' and zygosity for 'walking without support.' In these cases, longer gestational age, heavier birthweighf, primiparity, and dizygosity showed a tendency toward earlier attainment of development. Motor development within pairs was more similar in monozygotic pairs compared with dizygotic pairs regarding each item, suggesting genetic contributions.</p><p><b>CONCLUSION</b>The results of the present study showed specific and nonspecific factors that affect motor development of twins. These findings should prove useful in understanding the motor development of twin children and help clinicians to refine maternal and child health care for multiple-birth children.</p>

Study of CREG zygosity principles applied in kidney transplantation / 中国免疫学杂志

Objective:To study the applied value of CREG Zygosity Principles in kidney transplantation.Methods:Relationship between HLA CREG zygosity and acute rejection incidence was analyzed in 173 kidney transplantation and the concerned principles were discussed.Results:HLA-A,B,DR antigens of 0 mismatch (MM) were 7.51%,4.04%,3.46%;and those of 2 MM were 39.88%,65.31%,58.38% respectively.Compared in CREGs,A,B,and DR,the 0 MMs were 49.71%,30.63% and 24.27%;whereas 2MMs were only 5.20%,12.14% and 8.67%.In HLA-A,B and DR antigens 0 MM,the incidence of acute rejection was 21.96%,21.38% and 7.51% respectively;and in 2MMs,those were 22.54%,20.23%,and 66.67% respectively.Compared by CREGs A,B and DR 0 MM,acute rejection reached 21.83%,20.21% and 6.14%;and in 2MMs the incidence of acute rejection were 22.22%,20.00% and 69.82%.Conclusion:CREGs model is a novel method of choosing kidney transplantation donor-recipients’s matching.

Clinical Significance of Zygosity as a Prognostic Factor in Complete Hydatidiform Mole / 대한산부인과학회잡지

To evaluate the possible correlation between the origin of complete hydatidiform mole(CHM) and subsequent persistent gestational trophoblastic tumor(GTT) after molar evacua-tion, we have studied genetic origin patterns against conventional clinical parameters -pati-ent's age, gestational age, uterine size for gestational age, serum beta-hCG levels before mol-ar evacuation- in 69 patients with CHM. In our study, each of large uterine size for gesta-tional age, serum beta-hCG levels before molar evacuation, and genetic origin of CHM had a prognostic significance of subsequent persistent GTT. However, each of gestational age and patient's age is not a good prognostic indicator for subsequent persistent GTT. Among the patients with persistent GTT, there are no differences in clinical parameters- patient's age, gestational age, tumor age(the interval between evacuation of CHM and initiation of chem-otherapy), serum beta-hCG levels before molar evacuation and before initiation of chemother-apy- according to the origin of CHM. There are no differences in the analysis of sex-chr-omosome and variable number tandem repeat sequence YNZ22 and APOB gene in the extr-acted DNA from frozen tissues and paraffin blocks and from EDTA treated peripheral blood and dried blood specimen on Wartman paper. It is suggested that analysis of sex-chromo-some and polymorphism of YNZ22 and APOB gene from the extracted DNA of paraffin bl-ock and dried blood specimen on Wartman paper is the valauble experiment to evaluate the origin and the classification of hydatidiform mole and seems to be the sensitive molecular genetic method in predicting subsequent persistent GTT.