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Related Experiment Videos

Prenatal diagnosis in multiple pregnancy.

M J Taylor1, N M Fisk

  • 1Department of Maternal and Fetal Medicine, Imperial College School of Medicine, Division of Paediatrics, Obstetrics & Gynaecology, Queen Charlotte's & Chelsea Hospital, Goldhawk Road, London, W6 0XG, UK.

Bailliere'S Best Practice & Research. Clinical Obstetrics & Gynaecology
|September 14, 2000
PubMed
Summary

Prenatal diagnosis in multiple pregnancies presents unique challenges. Invasive procedures in twins have similar miscarriage risks to singletons, but contamination is a concern, necessitating specialized care.

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Area of Science:

  • Obstetrics and Gynecology
  • Prenatal Diagnosis
  • Maternal-Fetal Medicine

Background:

  • Multiple pregnancies have higher rates of fetal abnormality compared to singleton pregnancies.
  • Prenatal diagnosis in multiples requires careful consideration of risks for each fetus and selective termination procedures.
  • Determining chorionicity early is crucial for assessing genetic risks and selecting appropriate invasive procedures.

Purpose of the Study:

  • To highlight the challenges and complexities of prenatal diagnosis in multiple pregnancies.
  • To discuss the implications of chorionicity on genetic risks and invasive procedures.
  • To review management options for discordant fetal abnormalities in multiple gestations.

Main Methods:

  • Review of current practices in prenatal diagnosis for multiple pregnancies.

Related Experiment Videos

  • Assessment of nuchal translucency for identifying fetuses at risk of trisomy.
  • Discussion of invasive procedures like karyotyping and genotyping, including chorionic villus sampling.
  • Evaluation of techniques for managing discordant fetal abnormalities, including cord occlusion.

    • Main Results:

    • Invasive procedures in twins show similar miscarriage rates to singletons.
    • Contamination remains a significant concern during chorionic villus sampling.
    • Management of discordant abnormalities differs between dichorionic and monochorionic twins.
    • New techniques for cord occlusion in monochorionic pregnancies have been developed.

    Conclusions:

    • Early determination of chorionicity is essential for guiding prenatal diagnostic strategies.
    • Tertiary referral centers are recommended for all invasive procedures in multiple pregnancies due to complexity.
    • While miscarriage risks are comparable, contamination and co-twin sequelae require specialized management approaches.