Twin Dichorionic Diamniotic Placenta, Twin Monochorionic Monoamniotic Placenta, Twin Pregnancy With Antenatal Problem, Twin-To-Twin Transfusion Syndrome
Conditions
Brief summary
About one third of twin pregnancies are resulting from a single fertilized oocyte. Two third of these monozygotic twins share a common placenta and are therefore called monochorionic. Due to placental sharing and the ever-present inter-fetal vascular connections, specific complications may arise and lead to an increased risk of intrauterine death and long-term neurodevelopmental impairment. Specific complications include twin-to-twin transfusion syndrome (TTTS), twin-anemia-polycythemia sequence (TAPS), selective intrauterine growth restriction (sIUGR) and discordant major anomalies, occurring in about 10%, 5%, 20% and 6% of monochorionic diamniotic twins. Prenatal interventions may improve perinatal and long-term outcome of affected fetuses. However, general knowledge about early diagnosis of monochorionic twins and their specific complications is still limited in a significant number of practitioners in Austria and systematic analysis of pregnancy outcomes are not conducted. In this prospective multicenter registry study, the investigators aim to include all monochorionic pregnancies in Austria. Main outcome parameter is the occurrence of complications. Secondary outcomes are gestational age at occurrence of complications, gestational age delivery and neonatal outcome. The investigators also strive for long-term outcome, especially of infants following complicated pregnancies or preterm birth.
Interventions
None listed
Sponsors
Medical University of Vienna
Medical University Innsbruck
Johannes Kepler University of Linz
Paracelsus Medical University
Klinikum Klagenfurt am Wörthersee
Brothers of Saint John of God Eisenstadt
SMZ-Ost Donauspital
Hospital Hochsteiermark
Landesklinikum Sankt Polten
Klinikum Wels-Grieskirchen
Landeskrankenhaus Feldkirch
Landesklinkum Wiener Neustadt
Mödling Hospital
Medical University of Graz
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* All monochorionic pregnancies diagnosed from 11+0 weeks of gestation
Exclusion criteria
* Dichorionic twin pregnancies or higher-grade multiples without a monochorionic pair
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| occurrence of specific complications | from 12 weeks of gestation to delivery | TTTS, sIUGR, TAPS, TRAP, IUFD, malformations, miscarriage |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| birth weight | at first day of life | birth weight in grams |
| body length at birth | at first day of life | body length in cm |
| umbilical artery pH-value | immediately after birth | pH-Value derived from umbilical cord blood after birth |
| gestational age at delivery | at delivery | gestational age (weeks+days) at delivery |
| APGAR score | within 10 min after birth | APGAR score 1, 5 and 10 min following delivery |
| neonatal complications | within 1 month after birth | occurrence of neonatal complications including neonatal death, cerebral hemorrhage, periventricular leucomalacia, bronchopulmonary dysplasia, sepsis, retinopathy of the newborn, necrotizing enterocolitis, seizures |
| long-term outcome | 2 years of age | Neurodevelopmental outcome should be performed at the corrected age of 2 years. If available, neurodevelopment will be assessed by using the Bayley Scales of Infant Development. In other cases the Bayleys or the Ages & Stages Questionnaires may be used. |
| cord blood hemoglobin levels | immediately after birth | hemoglobin levels derived from umbilical cord blood after birth |
Countries
Austria
Contacts
Primary ContactPhilipp Klaritsch, MD
Backup ContactIsabella Pfniss, MD
Outcome results
None listed