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At least 73 records · Page 4Linked to original sources
PubMed1983

Fetal movements in multiple pregnancy.

Fetal activity in multiple pregnancies, as expressed by maternal daily fetal movement recordings, was compared with that in singleton pregnancies. It was found that the mean fetal activity in 33 cases of twins, six cases of triplets, one case of quadruplets, and one case of quintuplets was generally higher than that obtained during singleton pregnancies. In most cases, fetal movements of triplets, quadruplets, and quintuplets were even higher than the movement of twins.

Female↗
PubMedDate not supplied

Prenatal care and multiple pregnancy.

Prenatal care of multiple pregnancy presents a variety of nursing challenges. Specialized care, beginning in early pregnancy, can have a significant impact on the outcome for mothers and neonates. Dramatically increasing roles for advanced technology in the care of multifetal pregnancies must be balanced with families' needs for education and support.

Female↗
PubMed1993

[Multiple pregnancy risk factors in medically assisted reproduction].

FIVNAT registry collected 4,323 clinical pregnancies from 1987 to 1991, and allowed us to analyse the risk factors for multiple pregnancies. The multiple pregnancy rate is around 28%, 23% for twin pregnancies and 5% for triplet pregnancies. The number of transferred embryos is not the only factor to be significantly related with the risk of multiple pregnancy: male infertilities, cleavage rate over 50%, and women's age (at young ages multiple pregnancy rate are higher) are also significant. A multivariate logistic model was applied to analyse the relative part of these different factors. We also estimated the success rate and the multiple pregnancy rate which should have been obtained if the number of transferred embryos has been limited, in order to reduce the multiple pregnancy rate to 3%.

Adult↗
PubMed2004

Clomiphene citrate intrauterine insemination (IUI) before gonadotropin IUI affects the pregnancy rate and the rate of high-order multiple pregnancies.

OBJECTIVE: To determine if previous treatment with clomiphene citrate intrauterine insemination (CC-IUI) affects pregnancy and high-order multiple pregnancy (HOMP) rates in subsequent hMG-IUI or FSH-IUI cycles. DESIGN: Retrospective cohort study. SETTING: Private infertility clinic. PATIENT(S): Five hundred fifty-one patients (age <38 years) without tubal factor infertility, treated with 918 cycles of hMG/FSH-IUI after one or more unsuccessful cycles of CC-IUI; 908 patients treated with 1459 cycles of hMG/FSH-IUI without prior CC-IUI. INTERVENTION(S): CC-IUI, hMG-IUI, FSH-IUI. MAIN OUTCOME MEASURE(S): Pregnancy rate per cycle, HOMP (three or more gestational sacs). RESULT(S): Pregnancy rates during the first three hMG-IUI or FSH-IUI cycles averaged 21.8 +/- 1.1% without previous CC-IUI, 19.6 +/- 1.3% after one to four cycles of CC-IUI, and 3.6 +/- 2.6% after >or= five previous CC-IUI cycles. The HOMP rates were 8.8% without previous CC-IUI, 7.5% after one, 5.7% after two and <2.6% (0 out of 38) after >or= three previous CC-IUI cycles. CONCLUSION(S): Pregnancy rates in hMG/FSH-IUI cycles are significantly reduced after four unsuccessful CC-IUI cycles. High-order multiple pregnancies due to hMG/HMG-IUI are reduced following previous unsuccessful CC-IUI cycles.

Adult↗
PubMed1977

[Management and monitoring of multiple pregnancies (author's transl)].

The fetal prognosis in multiple pregnancies can be improved by a multifaceted antenatal program which includes early diagnosis prior to 28 weeks gestation, follow-up of multiple pregnancies in the high risk antenatal clinic, early discontinuation of work, treatment of pre-eclampsia, bed rest in hospital between 28 and 33 weeks and sometimes cerclage, prophylactic and therapeutic administration of labour inhibiting drugs, speedy delivery of the second twin and immediate pediatric care. Bed rest and administration of labour inhibiting drugs are the most important points of this program. With this combination, the utero-placental perfusion can be improved. The gestation can be prolonged and the incidence of small weight neonates and the incidence of the perinatal mortality can be reduced. Since even a large antenatal clinic only cares for a small number of multiple pregnancies, a multicentre study to determine the optimal management of multiple pregnancies is urgently required. Multiple pregnancies had too little attention in modern perinatal medicine and deserve all our attention for an improvement of their outcome.

Adrenergic beta-Agonists↗
PubMed1994

Triggering of ovulation by a gonadotropin releasing hormone agonist in gonadotropin-stimulated cycles for prevention of ovarian hyperstimulation syndrome and multiple pregnancy.

Ovarian hyperstimulation syndrome (OHSS) and multiple pregnancies are the two main complications of ovulation induction using gonadotropins. Withholding an ovulatory dose of human chorionic gonadotropin (hCG) remains the safest option for prevention of both complications. However, this policy frustrates both patient and physician, wastes time and money due to cancelled treatment, and results in cancellation of a high proportion of cycles that would not have progressed to clinical OHSS. As gonadotropin releasing hormone analogs (GnRH-a) may elicit surges of endogenous luteinizing hormone and follicle stimulating hormone, we investigated the usefullness of a single s.c. injection of leuprolide acetate (0.5 mg) to trigger ovulation, without inducing OHSS or multiple pregnancy, in 23 consecutive gonadotropin-stimulated cycles which would otherwise have been cancelled. All patients had at least 4 mature follicles (> or = 14 mm in diameter) and plasma estradiol levels > 1000 pg/ml on the day of GnRH-a injection. No luteal support was given. Seventeen of the 23 (74%) cycles were ovulatory and four singleton pregnancies resulted, giving a pregnancy rate of 17.4% per cycle. The remaining six patients (26%) clearly had defective or short luteal phases. No patient developed OHSS. It is concluded that GnRH-a may be an acceptable substitute for hCG to salvage treatment cycles in patients thought to be at risk for OHSS or multiple pregnancy. However, further studies are necessary for optimization of this approach in order to improve ovulatory and conceptional results.

Adult↗
PubMed1997

Population based study of rates of multiple pregnancies in Denmark, 1980-94.

OBJECTIVE: To study trends in multiple pregnancies not explained by changes in maternal age and parity patterns. DESIGN: Trends in population based figures for multiple pregnancies in Denmark studied from complete national records on parity history and vital status. POPULATION: 497,979 Danish women and 803,019 pregnancies, 1980-94. MAIN OUTCOME MEASURES: National rates of multiple pregnancies, infant mortality, and stillbirths controlled for maternal age and parity. Special emphasis on primiparous women > or = 30 years of age, who are most likely to undergo fertility treatment. RESULTS: The national incidence of multiple pregnancies increased 1.7-fold during 1980-94, the increase primarily in 1989-94 and almost exclusively in primiparous women aged > or = 30 years, for whom the adjusted population based twinning rate increased 2.7-fold and the triplet rate 9.1-fold. During 1989-94, the adjusted yearly increase in multiple pregnancies for these women was 19% (95% confidence interval 16% to 21%) and in dizygotic twin pregnancies 25% (21% to 28%). The proportion of multiple births among infant deaths in primiparous women > or = 30 years increased from 11.5% to 26.9% during the study period. The total infant mortality, however, did not increase for these women because of a simultaneous significant decrease in infant mortality among singletons. CONCLUSIONS: A relatively small group of women has drastically changed the overall national rates of multiple pregnancies. The introduction of new treatments to enhance fertility has probably caused these changes and has also affected the otherwise decreasing trend in infant mortality. Consequently, the resources, both economical and otherwise, associated with these treatments go well beyond those invested in specific fertility enhancing treatments.

Adult↗
PubMed2006

Clinical strategies to avoid multiple pregnancies in assisted reproduction.

Multiple pregnancies following assisted reproductive techniques (ART) became an epidemic in the early nineties. Since then, most European countries have tried to apply restrictive policies to avoid multiples and high order multiples as far as possible. Those pregnancies may cause severe consequences to both the fetuses and mother. Economic, social and ethical dilemmas are also avoidable if caution is exercised when using ART to achieve those pregnancies. When restrictive policies are used in ovulation induction and in vitro fertilization, the results show a clear reduction in the number of MP maintaining satisfactory rates.

Female↗
PubMed2000

[Peculiarities of multiple pregnancy: epidemiology].

The epidemiology of multiple pregnancy is complex and depends on various factors including age, race, genetic and environmental factors, season of conception and, more recently, iatrogenic factors. In recent years, twinning rate increased dramatically especially in countries where ovulation induction and assisted reproductive technologies are widely used. Multiple pregnancies are most frequent in Nigeria where majority of them are dizygotic. The lowest frequency of twinning is observed in Japan where almost 70% of multiples are monozygotic. This paper discusses genetic, environmental and sociocultural factors which are related to the "epidemic" of multiples.

Age Distribution↗
PubMed2003

Impaired adrenocortical function in very low birth weight infants after multiple pregnancies.

OBJECTIVE: To evaluate the differences in adrenal function between very low birth weight (VLBW) infants from singleton and multiple pregnancies. DESIGN AND METHODS: Forty infants of birth weights less than 1500 g underwent an ACTH test. Thirty infants born from singleton pregnancies (singleton group) and ten born from multiple pregnancies (multiple group) were enrolled. A baseline blood sample was drawn for cortisol measurement and thereafter serum cortisol was measured 1 and 2 h after an i.v. injection of ACTH. RESULTS: In multiple pregnancies, the median basal cortisol level of the infants was significantly lower than that in the singletons. The median cortisol level at 1 and 2 h after administration of ACTH was significantly lower in infants from multiple gestations than in singletons. Of infants from the multiple gestation group six, and of the singleton infants 12, had baseline cortisol levels lower than the reference values (P=0.48). One hour after ACTH stimulation all multiple and 53% of the singleton group infants showed a subnormal (<500 nmol/l, P=0.007) cortisol response. Two hours after ACTH, nine multiple group patients and 43% of the singletons had subnormal (<500 nmol/l, P=0.01) stimulated cortisol levels. CONCLUSIONS: We have concluded that VLBW infants from multiple gestations seem to be at an increased risk of insufficient postnatal adrenocortical function. In the future, specific attention should be paid to evaluate further newborn infants from multiple pregnancies with regard to a possible benefit of hydrocortisone substitution in stressful clinical situations.

Adrenal Cortex↗