1/8. Vanished twin and fetal alcohol syndrome in the surviving twin. A case report.BACKGROUND: The diagnosis of twin pregnancy can be made early in pregnancy by ultrasonography (US). Follow-up examination occasionally demonstrates the disappearance of one of the twins. CASE: A twin disappeared on US examination; the surviving twin exhibited signs of fetal alcohol syndrome and other congenital anomalies, accompanied by a placental form of fetus papyraceus. CONCLUSION: Early US examination is useful for diagnosing multiple gestation. However, a follow-up examination is required to alert the clinician to the disappearance of one twin. Careful examination of the placenta may document fetal remnants. In this case a small, atretic nodule on the placental surface was evidence of the vanished twin.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
2/8. The vanishing twin: morphologic and cytogenetic evaluation of an ultrasonographic phenomenon.Twin pregnancy was observed by ultrasonographic examination in the 6th week of gestation. After singleton term delivery a thickening of the membranes opposite to the main placenta showed degenerated chorionic villi embedded between one layer of amnion and chorion; no fetal parts were observed. Villus cells from both placentas were mainly diploid; 2 of 30 were tetraploid. However, 19 of 30 cells from membranes overlying the satellite placenta were tetraploid. Marker analysis was consistent with duplication of a normal conception diploid chromosome complement as the mechanism for tetraploidy. Postconceptional nondisjunction leading to tetraploidy in one twin conceptus may explain demise in early pregnancy. tetraploidy observed by chorionic villus biopsy must be confirmed by amniocentesis before interruption of the pregnancy is considered.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
3/8. absorption of a first trimester fetus.A case of an 8-week fetus with ultrasound demonstrated heart beat, which was absorbed completely prior to abortion at 11 weeks' gestation, is reported.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
4/8. Outcome of the surviving cotwin of a fetus papyraceus or of a dead fetus.Serial ultrasound examinations have demonstrated that one of two gestational sacs in a twin pregnancy may often disappear. When it disappears at an early stage of gestation, the pregnancy may advance without any disturbance and the cotwin can be delivered well developed and lively. When the intrauterine death occurs in the second trimester, the dead fetus usually results in a fetus papyraceus and the cotwin continues to be alive near term. However, when death occurs in the last trimester, the viable twin may be spontaneously delivered soon and be premature. In some cases of late fetal death, the dead fetus may induce intravascular thromboses in many organs of the surviving cotwin, so that the living infant may develop cerebral palsy later after birth.- - - - - - - - - - ranking = 2keywords = gestation (Clic here for more details about this article) |
5/8. Successful treatment of an advanced interstitial pregnancy by sequential systemic and local administration of methotrexate.A patient is presented with an advanced interstitial pregnancy, diagnosed by transvaginal ultrasound and confirmed by laparoscopy. Amenorrhoea at the time of diagnosis was 57 days. methotrexate was given systemically (4 x 50 mg i.m.). Because of persisting viability of the fetus, systemic methotrexate treatment was followed by local instillation of methotrexate into the gestational sac (50 mg). Follow-up revealed rapid human chorionic gonadotrophin regression but slow regression of fetal remnants.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
6/8. Non-surgical treatment of ectopic pregnancy in the sole remaining tube.We reported on three successive cases of intrauterine term pregnancy obtained in patients with an ectopic gestation in their solitary remaining tube who were treated by three different non-surgical conservative methods: parenteral methotrexate, local injection of methotrexate combined with systemic administration, and expectant management respectively. The opposite tube had been removed because of previous tubal ectopic pregnancy. The cases, which were at a high risk of repeated ectopic implantation, are unequivocal proof of intact function of a tube after conservative non-surgical procedures for ectopic pregnancy. Thus, our report adds further evidence favouring the feasibility, the safety and fertility potential of these procedures for selected unruptured tubal gestations.- - - - - - - - - - ranking = 2keywords = gestation (Clic here for more details about this article) |
7/8. A false-positive diagnosis of turner syndrome by amniocentesis.A 45,X karyotype was observed in all cells examined from an amniotic fluid sample taken at 16 weeks' gestation from a 37-year-old patient referred because of her age. Following termination of the pregnancy, all cells examined from fetal tissues (cardiac blood, skin, and muscle) showed a 46,XX karyotype. The most likely explanation for the discordant results is thought to be a dizygotic twin pregnancy with a normal fetus and an empty sac, the latter being sampled at amniocentesis resulting in a 45,X karyotype.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
8/8. A hypothesis for the aetiology of spastic cerebral palsy--the vanishing twin.The aetiology of spastic cerebral palsy (CP), in the majority of cases, is not known but the general consensus is that cerebral impairment occurs prepartum. In monochorionic twin pregnancies, death of one twin late in gestation is recognised as being an important risk factor for the surviving cotwin to have CP. It has been suggested that a significant proportion of singletons with spastic CP may be the result of death of a cotwin in the second half of gestation. In this paper it is hypothesised that spastic CP of unknown aetiology is the result of the death of a monochorionic cotwin and that the death of the cotwin may impair the neurological development of the survivor throughout gestation. If so, vanishing-twin syndrome, which is now a recognised phenomenon revealed by ultrasound examination in early pregnancy, is important in the aetiology of spastic CP.- - - - - - - - - - ranking = 3keywords = gestation (Clic here for more details about this article) |