Can early ultrasonography explain the lower miscarriage rates in twin as compared to singleton pregnancies following assisted reproduction?
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Ana Póvoa
Abstract
Objective:
To compare first trimester 2D conventional and 3D power Doppler angiography measures in twins and singletons following assisted reproduction.
Methods:
We prospectively evaluated 50 singleton and 47 twin pregnancies that eventually ended in live births. Patients were recruited from a single assisted reproductive technology (ART) center with standard treatment protocols. Obstetric ultrasound was performed at 8–9 weeks +6 days. Intervillous flow, uteroplacental circulation and uterine artery pulsatility (PI) and resistance index (RI) using two-dimensional (2D) ultrasound examination were evaluated. Using three-dimensional (3D) power Doppler angiography, placental volume and the 3D power Doppler indices from the intervillous and uteroplacental circulation were calculated.
Results:
Demographic and cycle characteristics were similar in mothers of singletons and twins. Placental volume was significantly (1.6-fold) larger in twins. Vascular density and blood perfusion in the intervillous space were lower in twins. The comparison of the other parameters did not show significant differences between singletons and twins.
Conclusion:
The data confirm the larger placental volume in twins, denoting a probable higher production of placental hormones that would support an early twin pregnancy. The lower vascular density and blood perfusion in the intervillous space in twins may also confer a reproductive advantage to them.
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
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- Review article
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- Commentary
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- Letters to the Editor
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Articles in the same Issue
- Frontmatter
- Editorial
- Antenatal and prepregnancy care – prevention of perinatal morbidity and mortality
- Review article
- Fetal interventional procedures and surgeries: a practical approach
- Opinion paper
- Inverted pyramid of prenatal care – is it enough? Should it be – extended inverted pyramid of prenatal care?
- Research articles
- Expectant management in di-chorionic pregnancies complicated by discordant anomalous twin
- Pregnancy outcomes among patients with recurrent pregnancy loss and uterine anatomic abnormalities
- Early postnatal echocardiographic assessment of pulmonary blood flow in newborns with congenital diaphragmatic hernia
- Sonographic prediction of small and large for gestational age in breech-presenting fetuses
- Comparison of fetal weight distribution improved by paternal height by Spanish standard versus Intergrowth 21st standard
- Can early ultrasonography explain the lower miscarriage rates in twin as compared to singleton pregnancies following assisted reproduction?
- Pregnancy outcomes among patients with recurrent pregnancy loss and chromosomal aberration (CA) without PGD
- Regular research articles
- Induction of labor in twin gestation: can we predict success?
- Low dose aspirin for preventing fetal growth restriction: a randomised trial
- Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies
- Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial
- Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy
- Fetal brain development in diabetic pregnancies and normal controls
- Body composition in preterm infants with intrauterine growth restriction: a cohort study
- Commentary
- Professionally responsible management of gynecologic cancer in pregnancy when clinical resources are unavoidably limited
- Letters to the Editor
- Erroneous conclusion due to mis-calculation of data: reply to Rai SE, Sidhu AK, Krishnan RJ. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis. J Perinat Med 2017
- Reply to: Letter to the Editor by Stritzke A and Shah PS. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis
- Congenital Zika syndrome in non-endemic regions
- Reply to: Congenital Zika syndrome in non-endemic regions: A neuroimaging pattern-based approach
