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Witold Malinowski

Publications and source records attributed to Witold Malinowski.

15 recordsLinked to original sources
PubMed2006

[Monoamnotic twin pregnancy. Multicenter study].

OBJECTIVE: The purpose of this study was to evaluate of perinatal mortality and morbidity of monoamniotic twins. STUDY DESIGN: This was a multicenter retrospective analysis of 26 monoamniotic twin gestations identified between 1985 and 2004 in a 3 perinatal departments. Of these 26 pregnancies, 11 women were admitted electively for inpatient fetal monitoring. Overall mortality rates, the risk of intrauterine fetal death and neonatal mortality and morbidity, pregnancy complications and fetal anomalies were calculated. RESULTS: Monoamniotic twin pregnancies were diagnosed reliably prenatally by ultrasound in 22 women and at delivery in 4 cases. Of the 26 gestations, spontaneous fetal losses before 22 weeks of gestation were 4 cases. The overall loss rate and the perinatal mortality rate were 52% and 19.4%, respectively. Twenty-two women had both twins alive at 24 weeks of gestation; 11 women were admitted electively for inpatient fetal monitoring at 26-27 week of gestation. In this group there were 2 neonatal deaths. No intrauterine fetal death occurred in any hospitalized patient. In our series there were 100% incidence of prematurity, 38,5% of umbilical cord entaglement, 23% of TTTS, 3.6% of TRAP and 9.6% fetal congenital anomalies. CONCLUSION: Monoamniotic twins are at extremly risk of pregnancy complications and fetal loss. These pregnancies can be diagnosed reliably by ultrasound in most cases. Electively admitted women for inpatient fetal monitoring could be improved neonatal survival and decreased perinatal morbidity.

Congenital Abnormalities↗
PubMed2006

[Superfecundation in etiology of twin pregnancy].

Superfecundation is the fertilisation of two or more ova from the same cycle by sperm from separate acts of sexual intercourse. The term is also sometimes used to refer to the instances of two different males fathering fraternal twins, though this is more accurately known as heteropaternal superfecundation. This therefore leads to the possibility of twins also being half-siblings. This way of formation of multiply pregnancy aroused and it arouses still among doctors on whole world. This problem aroused large interest also among Polish doctors. For example, we found mention of superfecundation in first Polish medical journal, in Primitiae physico-medicae..., given in Leszno in years 1750-1753. Authors introduced relate opinion of superfecundation in aetiology of multiple pregnancies in historical aspect, as early as from Old Testament to present times as well as current state of medical knowledge of such a situation.

Female↗
PubMed2005

The case of monochorionic twin gestation complicated by intrauterine demise of one fetus in the first trimester.

The study investigated the clinical and pathomorphological characteristics of monochorionic diamniotic twin gestations complicated by the spontaneous loss of one fetus during the first trimester. Nine monochorionic diamniotic twin gestations were analyzed in which the demise of one fetus occurred during the first trimester. During the course of the study, 178 twin gestations were sonographically identified during the first trimester. Forty-three (24.2%) were complicated by the intrauterine demise of one fetus before the end of the 12th week of pregnancy. Nine cases were monochorionic diamniotic. The gestational age of the demised fetuses ranged between 5 and 11 weeks (mean 7.4 weeks). The prognoses for the surviving fetuses were rather poor with the surviving co-twin dying 1 to 3 weeks after the first twin, with abortion of both fetuses. In only one case was gestation concluded on the 40th week with delivery of a live neonate. No blood coagulation changes were observed in the affected pregnant women, and the one live newborn did not reveal any haematological or neurological abnormalities. A postnatal study provided evidence for the history of monochorionic diamniotic placentation in all of the cases. In two cases, probable causes of fetal death were established (congenital malformation, the presence of anastomoses between blood vessels). The obtained results suggest an extremely high risk of mortality for the surviving twin fetus following the co-twin's death in cases of monochorial placentation. The morphological evaluation of placentas and fetal membranes enables the establishment of the type of placenta and, in certain cases, the probable cause of the intrauterine demise of one twin fetus during the first trimester of monochorionic diamniotic twin gestation.

Amnion↗
PubMed2005

[Intrauterine death of one fetus during the first trimester of monochorionic diamniotic twin gestation].

OBJECTIVES: The goal of our study was the clinical and pathological characteristics of the monochorionic diamniotic twin gestations complicated by the intrauterine death of one fetus during the first trimester. MATERIAL AND METHODS: This study is a prospective review of 9 monochorionic diamniotic twin gestations involving the intrauterine death of one fetus during the first trimester. RESULTS: During the study period 178 twin gestations were identified sonographically during the first trimester. Forty three of them (24,2%) were complicated by the intrauterine death of one fetus before the end of 12th gestation week. Nine cases were monochorionic diamniotic. Gestational age of one fetus demise ranged from 5 to 11 (mean 7,4) weeks. Prognoses for surviving fetus were adverse. In 8 cases there was a death of a second fetus after the period of 1 to 3 weeks, with abortion of both fetuses. Only in one case, the gestation has finished in 40th week by delivery of liveborn infant. Maternal coagulation changes did not occur in those cases. One liveborn infant was without evidence of hematological and neurological abnormalities. The postdelivery examination allowed to establish a presence of monochorionic diamniotic placentation in all cases. In two of them, the probable causes of death were established (developmental defect, presence of anastomoses between blood vessels). CONCLUSION: These results suggest that the risk of mortality for the living twin is very high, after the death of its sibling, in case of monochorionic placentation. Morphological examination of placenta and fetal membranes lets to establish a type of placenta, and in some cases a probable cause of intrauterine death of one twin during the first trimester of monochorionic diamniotic twin gestation.

Adult↗
PubMed2005

[Endoparasite twin (fetus in fetu)].

Fetus in fetu is a very rare abnormality (estimated incidences: 1 in 500,000 deliveries), and is secondary to a pathological diamniotic monochorionic pregnancy. It consists of a malformed parasitic twin that is found within the body of its sibling. Hardly 70 cases have been reported in the literature since its first description about 1800. Its discovery is usually postnatal. We present two boys: two and half years and eleven days old newborn presented a mass in the retroperitoneum in the left upper abdominal quadrant. There were removed by surgery and contained two independent fetuses. Dissection and radiological study of the fetuses showed an axial skeleton and long bones. It corresponds to the generally recognized diagnostic criteria of fetus in fetu. The embryology, operative procedure, hypothesis and pathology of this condition are discussed and the literature briefly reviewed. The difference between teratomas and fetus in fetu is point.

Child, Preschool↗
PubMed2004

[Prognostic value of ultrasonography of the yolk sac in singleton pregnancy].

OBJECTIVES: The aim of the research was evaluation of the clinical usefulness of chosen ultrasonographic morphological parameters of the yolk sac in the first trimester of unifetal pregnancies. MATERIAL AND METHOD: Analysis has been done on 391 cases of unifetal pregnancies in the first trimester. Parameters of ultrasonographic evaluation: diameter, appearance and size of yolk sac, biometrics and fetal anatomy, confirmation of heart beating. CONCLUSIONS: The yolk sac should be observed in the fifth week or when its biggest size equals to 10 mm in a normal pregnancy. Abnormal morphological appearance of the yolk sac and/or the size over 9 mm suggest serious growth disorders of the fetus or its necrobiosis. The yolk sac, apart from cases of hydatid mole, should be possible to be observed between 5-12 weeks of pregnancy.

Female↗
PubMed2004

[Monochorionic, diamniotic triplet pregnancy complicated by twin reversed arterial perfusion sequence. Postpartum autopsy of placenta and acardiac fetus].

The twin reversed-arterial-perfusion sequence (TRAP) is a severe complication of monochorionic twin pregnancies characterized by the hemodynamic dependence of a "recipient" twin from a "pump" twin. The recipient twin exhibits lethal abnormalities including acardia and acephaly. The pump twin has a mortality rate of 50% as a result of high-output heart failure. We present a case of a 24-year-old female, gravida 2, para 2, with monochorionic diamniotic triplet pregnancy. The sonographic examination at 18 weeks' gestation revealed acardiac-acephalus fetus. Reversed arterial perfusion sequence was confirmed with Doppler sonography. Postpartum autopsy examination of placenta and acardiac fetus (acardius anceps) was detailed described.

Abnormalities, Multiple↗
PubMed2004

[Triplets, quadruplets and more...].

Theoretically, a woman could bear unlimited number of fetuses. Practically, the human being on the top of his phylogenetic spread, has chosen the singleton birth as its dominant. The anatomical constitution of the woman let her feed no more than two children at the same time. This were probably the reasons for considering the multiple birth as a nature phenomenon. With the time passing, there was a growing body of legends and misunderstandings, based on exagerated histories on their births. Based on world literature, the super multiple births are analyzed.

Adult↗
PubMed2003

[Intrauterine death of one twin in the third trimester].

OBJECTIVES: The goal of our study was the clinical characteristics of the twin gestations complicated by the intrauterine death of one fetus in the third trimester. MATERIAL AND METHODS: This study was a multicenter retrospective review of 12 twin gestations complicated by the intrauterine death of one fetus in the third trimester. RESULTS: During the study period there were 295 twin gestations. 12 of them (4.1%) were complicated by the intrauterine death of one fetus in the third trimester. Three cases were monochorionic diamniotic and nine dichorionic. Ones gestational age of one fetus demise ranged from 25 to 37 (mean 30.0) weeks. Delivery was performed between 25 and 38 (mean 32.1) weeks. In monochorionic twin gestation the intrauterine death of one twin occurred earlier in gestation, had a shorter duration between the death and delivery, and delivered earlier in gestation. One liveborn infant with monochorionic and two with dichorionic placentation died in the postnatal period. Maternal coagulation changes did not occur in those cases. All live-born infants were without evidence of hematological abnormalities. CONCLUSION: These results suggest that the risk of morbidity and mortality for the living twin is increased, after the death of its sibling, in case of monochorial placentation.

Adult↗
PubMed2003

[Umbilical cord complications in twin pregnancies].

OBJECTIVES: The postpartum umbilical cord examination can provide a lot of significant information concerning discordant twin growth or reasons of intrauterine death of one or all the fetuses. The aim of this study was the postpartum assessment of umbilical cords in twin pregnancies. MATERIAL AND METHODS: The examination material consisted placentas coming from 110 twin pregnancies. The analysis concerned the assessment of placenta types, the umbilical cords attachment place and also the twins birth weight. RESULTS: Basing on the studies of placentas coming from 110 twin pregnancies 76 (69.0%) dichorionic and 34 (31.0%) monochorionic placentas were found. Among dichorionic, 40 (53%) separated and 36 (47%) fused placentas were observed. Among monochorionic 31 (91%) diamniotic and 3 (9.0%) monoamniotic placentas were present. Abnormal umbilical insertion to placenta was most frequently observed in monochorionic pregnancies: in diamniotic--marginal insertion in 21.2%, velamentous insertion in 15.9%, and in monoamniotic--equally 33.3%. In dichorionic pregnancies, for fused placentas--marginal in 8.7%, velamentous in 9.1%, and for separated--5.6% and 3.1%. CONCLUSIONS: The abnormal umbilical cord insertions to the placenta was most frequently found in monochorionic pregnancies. Among pairs of twin born with body weight discordance, the abnormal umbilical cord insertion was more frequently found in the case of the smaller newborn.

Female↗
PubMed2002

[Clinical significance of echogenic amniotic fluid at term pregnancy].

PURPOSE: This study is aimed to determine the clinical significance of echogenic amniotic fluid. MATERIAL AND METHODS: I surveyed 9 at term pregnancies in which the amniotic fluid was echogenic. Morphologic characteristics of amniotic fluid were assessed from samples taken at amniocentesis or upon delivery within one day after last sonographic examination. RESULTS: In pregnancies with echogenic amniotic fluid, assessment revealed clear fluid in 4 cases (44.5%), vernix caseosa in 4 (44.5%), and meconium in 1 (11.0%). CONCLUSIONS: Echogenic amniotic fluid on prenatal sonography is not predictive of fetal distress.

Adult↗
PubMed2002

[Reliability of sonographic diagnosis of chorionicity and amnionicity in twin pregnancy ].

OBJECTIVES: The aim of the study was to compare the reliability of chorionicity determination in twin pregnancy using different ultrasonographic methods as compared with post-partum placental assessment. STUDY DESIGN: The study included 262 spontaneous twin pregnancies delivered at Kutno Hospital between 1989 and 1996. All twin gestations were diagnosed by sonography by the 28-th week's gestation. The ultrasonographic and pathologic correlation between the chorionic and amniotic type was assessed in this group. RESULTS: The ultrasonographic evaluation of the 262 spontaneous twin gestations demonstrated 181 (69.1%) dichorionic and 81 (30.9%) monochorionic twin pregnancies. Three of monochorionic twins were monoamniotic. In all 262 transvaginal and abdominal ultrasonography correctly predicted the chorionic and amniotic type as determined by the pathologic findings. CONCLUSIONS: Ultrasonography before the 28-th week can accurately determine the chorionic and amniotic type in twin pregnancies. The determination of chorionicity during the first half of pregnancy should be based on the various signs. In the second half of pregnancy, the obstetrician should rely on fetal sex in combination with the number of placentas, and characteristics of the dividing membrane.

Amnion↗
PubMedDate not supplied

[Preterm birth in multiple pregnancy].

The incidence of twin and higher-order multiple gestations has increased significantly over the past 15 years primarily because of the availability and increased use of ovulation-inducing drugs and newly developed assisted reproductive technologies. Physicians now must deal with a previously unknown type of multiple gestation, that is, the iatrogenic multiple pregnancy. The most significant and common complication of multiple pregnancy is preterm labor resulting in preterm delivery. Perinatal morbidity and mortality are affected by gestational age and weight at delivery as well as by the number of fetuses. Patient education, risk assessment, serial cervical evaluation by manual or transvaginal ultrasound examinations, specialized antepartum clinics will be use to prevent preterm birth in multiple gestations.

Birth Weight↗
PubMedDate not supplied

[Twin birth weight discordance and risk of preterm birth].

Our purpose was to determine whether birth weight discordance is a risk factor for preterm birth of twins. Maternally linked 1970-2000 Kutno Hospital birth certificates were used to analyze gestations resulting in live twins. The degree of discordance correlated strongly with risk for live preterm birth but only for discordances > 20%. Twin birth weight discordance has demonstrated to be a risk factor for preterm birth. The effect was found particularly with discordance > 30%.

Birth Weight↗