Multiple Gestations, An Issue of Obstetrics and Gynecology Clinics (The Clinics: Internal Medicine)

Cover......Page 1
Preface......Page 2
Fetal and Neonatal Mortality Risks of Multiple Births......Page 4
Trends in fetal and neonatal mortality......Page 6
Maternal demographics......Page 8
Adjusted odds ratios for maternal characteristics......Page 9
Maternal demographics......Page 10
Adjusted odds ratios for maternal characteristics......Page 11
Birth weight and gestational age-specific proportion and rates......Page 12
Summary......Page 16
References......Page 17
Embryonic Loss in Iatrogenic Multiples......Page 20
The Fertility Institute of New Orleans' experience......Page 21
Type of infertility treatment......Page 22
Maternal age......Page 23
Effect of number of initial gestational sacs on length of pregnancy......Page 24
Effect of number of initial gestational sacs on weight at birth......Page 27
Comment......Page 28
References......Page 29
Neonatal Morbidity of Very Low Birth Weight Infants from Multiple Pregnancies......Page 31
The epidemic of very low birth weight infants from multiple pregnancies......Page 32
Delivery room care......Page 33
Very low birth weight multiples: risks compared with singletons......Page 34
Comparisons of outcome after adjustment for confounding variables......Page 35
Effect of birth order......Page 37
References......Page 38
Growth Aberration in Multiple Pregnancy......Page 41
Function of the utero-placental unit......Page 42
Intrauterine growth restriction and small-for-gestational-age status in multiples......Page 45
Growth discordance......Page 46
Management of growth aberrations in multiple pregnancies......Page 49
Patient counseling......Page 52
Summary......Page 53
References......Page 54
Risk of Cerebral Palsy in Multiple Pregnancies......Page 57
Multiple versus singleton birth differences in crude cerebral palsy prevalence......Page 58
Risk factors for cerebral palsy in multiple and singleton gestations......Page 59
Twinning, zygosity, chorionicity, and cerebral palsy......Page 60
Pathogenic mechanisms in cerebral palsy......Page 64
Summary......Page 65
References......Page 66
The Paradox of Old Maternal Age in Multiple Pregnancies......Page 70
Sizing the problem......Page 71
Traditional evidence from singleton pregnancies......Page 72
The outcomes paradox......Page 73
Paradox or not: older gravida concept revisited......Page 77
Behavioral factors......Page 78
Physiologic factors......Page 79
Summary......Page 80
References......Page 81
Screening versus diagnosis......Page 82
What is screening all about?......Page 83
Twinning process: does it matter?......Page 85
Screening in twin pregnancies......Page 87
Biochemical screening......Page 88
Nuchal translucency......Page 89
Combination of nuchal translucency and biochemical markers for screening of trisomy 21 at 11 to 14 weeks' gestation: the gold standard?......Page 93
Summary......Page 95
References......Page 96
Determining chorionicity......Page 98
Invasive diagnostic procedures......Page 99
Loss rates after amniocentesis in multiple gestations......Page 100
Loss rates after chorionic villus sampling in multiple gestations......Page 101
References......Page 103
Invasive Antenatal Interventions in Complicated Multiple Pregnancies......Page 105
Fetoscopic laser treatment for twin-to-twin transfusion syndrome......Page 106
Hardware......Page 110
Procedure......Page 111
Risks and outcome of the procedure......Page 114
Selective feticide in multiple pregnancies......Page 115
Technique and outcome of selective feticide in monochorionic twins......Page 118
Summary......Page 122
References......Page 123
En Route to an Instant Family: Psychosocial Considerations......Page 127
Parenting motives......Page 129
Stresses associated with infertility......Page 130
Effects on self-esteem......Page 131
Effects on internal control......Page 132
The desire for multiples......Page 133
Pregnancy after in vitro fertilization......Page 134
Perinatal death......Page 135
Summary......Page 136
References......Page 137