Survival rates of monoamniotic twins do not decrease after 30 weeks' gestation

Article Abstract:

Monoamniotic twinning (twins that share a common amniotic sac, the membrane that surrounds the fetus) occurs rarely, and when it does, the event is associated with an increased risk of fetal complications and death. One approach to reducing this risk is to induce delivery early in the last trimester of pregnancy, however, few studies have systematically investigated the effectiveness of this method of treatment. To determine whether early delivery improves the survival of monoamniotic twins, a review of medical records was carried out for all women who gave birth at one hospital during a 13-year period (138,232 live births). Twenty-four sets of monoamniotic twins had both fetuses alive at some time prior to 18 weeks' gestation. At 30 weeks' gestation, 15 sets had both fetuses alive, two sets had one dead twin, one set was delivered and both survived, and in the remaining six sets both fetuses died. Among the 17 sets with at least one twin alive at week 30, no death occurred during the remaining gestational period. Both twins survived in 46 percent of the cases, with survival of at least one fetus in 63 percent. Twins had been diagnosed prenatally in only 29 percent of the cases, and monoamniotic twins, in 21 percent. Thus, it appears that the highest mortality occurs between 18 and 30 weeks' gestational age. Any advantage to early delivery must be weighed against the better survival of fetuses delivered later in gestation. There appears to be no support for the practice of early delivery of monoamniotic twins. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Patient outcomes, Mortality, Physiological aspects, Twins, Amniotic sac, Amnion

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Precision of office-based blood glucose meters in screening for gestational diabetes

Article Abstract:

Two new glucose measuring tests may be accurate enough to detect gestational diabetes and may be used in a doctor's office as opposed to a laboratory. Researchers tested the accuracy of three glucose measuring tests: HemoCue, OneTouch II, and ExacTech, on 62 pregnant women and compared the results to those obtained by laboratory tests. The HemoCue was found to be the most accurate, compared to laboratory tests, at detecting gestational diabetes blood sugar levels in vein and capillary whole blood and plasma. The OneTouch II could detect gestational diabetes in capillary whole blood but not in vein or capillary whole blood or capillary plasma. Both the HemoCue and OneTouch II could be used in a doctor's office and prevent the need for laboratory testing.

Equipment and supplies, Diagnosis, Measurement, Blood sugar, Blood glucose, Diabetes in pregnancy, Gestational diabetes, Blood sugar monitoring, Blood glucose test

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Preoperative planning with magnetic resonance imaging and computerized volume rendering in twin-to-twin transfusion syndrome

Article Abstract:

Doctors were able to preoperatively plan surgery for twin-twin transfusion syndrome by downloading MRI scans of the mother's abdomen into a computer and plan the entire operation using SNN 3.0 Planning and Navigation Software from Surgical Navigation Network of Ontario, Canada. Twin-twin transfusion syndrome occurs when one twin takes blood from the other twin.

Planning, Surgery, Information management, Magnetic resonance imaging, Fetofetal transfusion

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