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OBJECTIVE: To provide an overview of the etiology and early dia-gnosis of triple pregnancy, with emphasis on the possibilities of ultrasound and magnetic resonance (MR) imaging. METHODOLOGY: Processing of data from the available literature on the issue of triple pregnancy. CONCLUSION: Spontaneous triple pregnancy conception is rare. In most cases, it is a concept associated with assisted reproduction methods. Multiple pregnancy is associated with a higher incidence of complications during pregnancy and childbirth, but it also has its own specific complications. Chorionicity and amnionicity of multiple pregnancies are two important parameters in determining the strategy of dispensary care in pregnancy and management of childbirth. The use of ultrasound and MR imaging is crucial for their accurate determination in early pregnancy.
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Corion , Ultrasonografía Prenatal , Embarazo , Femenino , Humanos , Ultrasonografía Prenatal/métodos , Corion/diagnóstico por imagen , Embarazo Múltiple , Amnios/diagnóstico por imagen , Diagnóstico PrecozRESUMEN
Although the accuracy of chorioamnionicity determination in multiple pregnancy is nearly 100%, some pitfalls do exist. These pitfalls may arise from some confusing sonographic appearance or because of certain rare variations of twinning going against the general principles. Pitfalls in chorionicity determination include (1) the disappearance of the twin peak sign with the regression of chorion frondosum and thinning of the intertwin membrane with advancing gestation; (2) fake twin peak sign because of other structures creeping into the intertwin membrane-placental junction; (3) intrauterine septum or synechia being mistaken as a thick intertwin membrane; (4) bipartite placenta in monochorionic twin being misinterpreted as two separate placentas of dichorionic twin; (5) erroneous fetal sex determination in sex chromosome mosaicism, monogenic disorders, and malformed genitalia in one fetus; and (6) rare twinning types such as dizygotic monochorionic twin and sesquizygotic twin. Pitfalls in amnionicity determination are (1) the lack of correlation between the number of yolk sacs and amnionicity and (2) failure to visualize the intertwin membrane because of technical issues.
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Placenta , Embarazo Gemelar , Femenino , Embarazo , Humanos , Placenta/diagnóstico por imagen , Ultrasonografía Prenatal , Corion/diagnóstico por imagen , Amnios/diagnóstico por imagenRESUMEN
OBJECTIVE: The study aimed to evaluate healing in apicomarginal defects with amniotic membrane (AM) using 2D periapical radiography and 3D cone beam computed tomography imaging. METHOD AND MATERIALS: Thirty-four patients with symptomatic apical periodontitis and apicomarginal communication were allocated to either the AM or control group. Clinical and radiographic assessment was performed at baseline and at 12 months using Molven criteria, modified Penn 3D criteria, and RAC and B indices at resected plane, apical area, cortical plate, and combined apicocortical area, respectively. RESULTS: There was no significant difference in the healing outcome in 2D imaging (93.3% control and 86.7% AM) and 3D imaging (80.0% control and 53.3% AM) between the groups. With RAC scoring, a greater percentage of unhealed cases was observed in cortical plate. Radiographic buccal bone formation in the 3D imaging was evident only in six cases. However, both the groups depicted significantly greater percentage reduction in the size of the lesion in 2D than the 3D analysis (AM group 91.69 ± 15.99 2D, 76.06 ± 47.62 3D, P = .020) and (control group 92.06 ± 14.36 2D, 85.12 ± 18.55 3D, P = .005). CONCLUSION: No significant difference in healing was observed between the AM and the control groups with the use of both periapical radiography and CBCT imaging. Despite good clinical healing and radiographic apical bone fill, buccal bone formation was not evident in 3D imaging in most of the cases.
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Imagenología Tridimensional , Periodontitis Periapical , Amnios/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Humanos , Cicatrización de HeridasRESUMEN
In twin pregnancies, amnionicity and chorionicity are crucial as they strongly determine prenatal and perinatal management. First trimester ultrasound allows a highly reliable diagnosis of amnionicity and chorionicity, making it an internationally accepted standard in antenatal care. However, in rare cases, amnionicity can change from diamniotic to monoamniotic throughout pregnancy, substantially impacting perinatal management. We report the case of a confirmed monochorionic diamniotic twin pregnancy with a diagnosis of spontaneous septostomy of the dividing membrane (SSDM) at 28 weeks of gestation, resulting in a pseudomonoamniotic pregnancy. Even though SSDM is a rare condition and its sonographic diagnosis might be challenging, it should be considered if, in a known diamniotic pregnancy, there is a sudden failure to visualise the intertwin membrane truly separating both twins.
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Corion , Ultrasonografía Prenatal , Amnios/diagnóstico por imagen , Amnios/cirugía , Corion/diagnóstico por imagen , Femenino , Humanos , Embarazo , Primer Trimestre del Embarazo , Embarazo Gemelar , Gemelos , Gemelos MonocigóticosRESUMEN
OBJECTIVE: To evaluate the accuracy and diagnostic value of genome-wide noninvasive prenatal testing (NIPT) for the detection of fetal aneuploidies in multiple gestations, with a focus on dichorionic-diamniotic twin pregnancies. METHODS: We performed a retrospective cohort study including data from pregnant women with a twin or higher-order gestation who underwent genome-wide NIPT at one of the eight Belgian genetic centers between November 1, 2013, and March 1, 2020. Chorionicity and amnionicity were determined by ultrasonography. Follow-up invasive testing was carried out in the event of positive NIPT results. Sensitivity and specificity were calculated for the detection of trisomy 21, 18, and 13 in the dichorionic-diamniotic twin cohort. RESULTS: Unique NIPT analyses were performed for 4,150 pregnant women with a multiple gestation and an additional 767 with vanishing gestations. The failure rate in multiple gestations excluding vanishing gestations ranged from 0% to 11.7% among the different genetic centers. Overall, the failure rate was 4.8%, which could be reduced to 1.2% after single resampling. There were no common fetal trisomies detected among the 86 monochorionic-monoamniotic and 25 triplet cases. Two monochorionic-diamniotic twins had an NIPT result indicative of a trisomy 21, which was confirmed in both fetuses. Among 2,716 dichorionic-diamniotic twin gestations, a sensitivity of 100% (95% CI 74.12-100%) and a specificity of 100% (95% CI 99.86-100%) was reached for trisomy 21 (n=12). For trisomy 18 (n=3), the respective values were 75% (95% CI 30.06-95.44%) sensitivity and 100% (95% CI 99.86-100%) specificity, and for trisomy 13 (n=2), 100% (95% CI 20.65-100%) sensitivity and 99.96% (95% CI 99.79-99.99%) specificity. In the vanishing gestation group, 28 NIPT results were positive for trisomy 21, 18, or 13, with only five confirmed trisomies. CONCLUSION: Genome-wide NIPT performed accurately for detection of aneuploidy in dichorionic-diamniotic twin gestations.
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Síndrome de Down/diagnóstico , Reabsorción del Feto , Pruebas Prenatales no Invasivas , Embarazo Múltiple , Síndrome de la Trisomía 13/diagnóstico , Síndrome de la Trisomía 18/diagnóstico , Amniocentesis , Amnios/diagnóstico por imagen , Ácidos Nucleicos Libres de Células/análisis , Corion/diagnóstico por imagen , Errores Diagnósticos , Reacciones Falso Negativas , Femenino , Reabsorción del Feto/diagnóstico , Reabsorción del Feto/genética , Genoma Humano , Humanos , Embarazo , Embarazo Cuádruple , Embarazo Triple , Embarazo Gemelar , Estudios Retrospectivos , Sensibilidad y Especificidad , TrisomíaRESUMEN
In this study, we aimed to analyse the clinical features of the third-trimester pregnant women, with echogenic amniotic fluid and to compare their obstetric and neonatal outcomes with pregnant women with normal amniotic fluid echogenicity. This case-control study was conducted in a tertiary antenatal care centre. A total of 560 term (37-42 weeks of gestation) singleton women; 280 with echogenic particles in amniotic fluid and 280 with clear amniotic fluid, who delivered within 24 h after the ultrasound scan were evaluated. The women in the two groups were similar in terms of age, parity, body mass index, foetal birth weight, and gestational age. More patients in the particulate amnion group had lower Apgar scores (<7) in 1st and 5th minutes than controls (p = .006, p = .031 respectively) however the rate of admission to neonatal intensive care was similar. Vernix stained amniotic fluid was more common in the study group (48.8%, p = .031), the rate of meconium-stained amniotic fluid was similar in the study and control groups (9.6-9.2%, p = .881). The primary caesarean section rate was higher in women with particulate amnion (18.4%, p = .037). Echogenic particles in the amniotic fluid in the third trimester could not be attributed to meconium, however, higher rates of primary caesarean section may require further attention.IMPACT STATEMENTWhat is already known on this subject? Previous studies showed that high-density intra-amniotic particles were possibly related to vernix caseosa, intra-amniotic bleeding, and meconium. The number of study groups in these studies was also limited.What do the results of this study add? Additional to other previous studies, we found an increased rate of intra-amniotic echogenic particles in male foetuses.What are the implications of these findings for clinical practice and/or further research? The presence of echogenic particles on ultrasound was not related to increased risk for the presence of meconium. Significantly more neonates born to mothers with intra-amniotic echogenic particles tended to have lower Apgar scores (<7), however, this significant difference did not affect the need for NICU admission. The presence of echogenic particles in the amniotic fluid of the third-trimester pregnant women could not be attributed to meconium and adverse perinatal outcomes, however, the higher rates of primary caesarean section may require further attention.
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Líquido Amniótico/química , Líquido Amniótico/diagnóstico por imagen , Material Particulado/análisis , Ultrasonografía Prenatal , Adulto , Amnios/diagnóstico por imagen , Puntaje de Apgar , Estudios de Casos y Controles , Cesárea/estadística & datos numéricos , Femenino , Humanos , Recién Nacido , Meconio/química , Meconio/diagnóstico por imagen , Embarazo , Resultado del Embarazo , Tercer Trimestre del Embarazo/metabolismo , Vernix Caseosa/química , Vernix Caseosa/diagnóstico por imagenRESUMEN
INTRODUCTION: In previous studies on the mechanical parameters of amnions (AM), there is a limitation due to the lack of an accurate thickness measurement, which is an important parameter for determining AM-specific mechanical properties. As a bottleneck, the characterization of the basic mechanical properties of AM are greatly restricted, even with the proposal of fracture criteria. METHOD: First, the initial thickness of the AM is estimated by the interpolated-volume-area method. Second, through combinations of our self-developed mini-biaxial tensile device with speckle pattern interferometry, this is the first time that researchers can accurately obtain the AM thickness at each transient moment in the process of loading. RESULTS: Based on the experimental results, an accurate stress-strain curve could be obtained. Two important mechanical parameters-the fracture energy density and amnion rupture modulus-could be extracted as 0.184±0.036MPa and 108.57±17.32MPa, respectively. The fracture energy density and amnion rupture modulus provide objective criteria and a scientific basis for the evaluation of AM rupture. DISCUSSION: The tensile stress-strain curve of a normal human amnion shows a distinct J-shape. This proves that the experimental results are basically reliable. Both important parameters --the fracture energy density and amnion rupture modulus, can be calculated from the stress-strain curve. Extracting these two parameters is critical for the evaluation and prediction of ROM, PROM and PPROM.
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Amnios/diagnóstico por imagen , Rotura Prematura de Membranas Fetales/diagnóstico por imagen , Interferometría/métodos , Femenino , Humanos , Embarazo , Estrés Mecánico , Resistencia a la TracciónAsunto(s)
Membranas Extraembrionarias/patología , Complicaciones del Embarazo/patología , Ultrasonografía Prenatal , Cordón Umbilical/patología , Vasa Previa/patología , Adulto , Amnios/diagnóstico por imagen , Amnios/patología , Corion/diagnóstico por imagen , Corion/patología , Membranas Extraembrionarias/diagnóstico por imagen , Femenino , Humanos , Ilustración Médica , Embarazo , Complicaciones del Embarazo/diagnóstico por imagen , Cordón Umbilical/diagnóstico por imagen , Vasa Previa/diagnóstico por imagenAsunto(s)
Amnios/diagnóstico por imagen , Puntos Anatómicos de Referencia/diagnóstico por imagen , Corion/diagnóstico por imagen , Embarazo Triple/estadística & datos numéricos , Ultrasonografía Prenatal , Adulto , Amnios/embriología , Puntos Anatómicos de Referencia/embriología , Corion/embriología , Femenino , Edad Gestacional , Humanos , Embarazo , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
Objective: To investigate the clinical characteristics and outcomes of monochorionic monoamniotic (MCMA) twin pregnancy. Methods: The clinical data of 60 MCMA twin pregnant women who were terminated in Peking University Third Hospital from January 2011 to December 2019 were collected, and the general clinical data, prenatal examination and pregnancy outcomes were analyzed retrospectively. Results: The age of 60 MCMA twin pregnant women was (31.0±4.1) years old, among which 44 cases were primiparas (73%, 44/60) and 16 cases were multiparas (27%, 16/60). Fifty-eight cases were diagnosed as MCMA twin pregnancy prenatally and were confirmed after delivery. Median ultrasonic diagnosis of gestational age was 12 weeks (range: 8-30 weeks). In the 60 MCMA twin pregnancies, 6 cases were conjoined twins, 5 cases were complicated with twin reversed arterial perfusion sequence (TRAPS), and 10 cases were diagnosed as other fetal malformation by prenatal ultrasound examination. Among the 60 MCMA twin pregnant women, 19 cases had spontaneous abortion or induced abortion due to fetal malformation, fetal death or other reasons within 28 weeks of pregnancy, 41 cases entered the perinatal period, a total of 70 newborns survived. The main cause of perinatal fetal or neonatal death was fetal dysplasia. Conclusions: There is a high incidence of fetal abnormality and perinatal mortality in MCMA twin pregnancy. Accurate early diagnosis, enhanced management and monitoring during pregnancy, and individualized treatment are the keys to improve MCMA twin pregnancy outcomes.
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Amnios/diagnóstico por imagen , Placenta/diagnóstico por imagen , Embarazo Gemelar , Gemelos Monocigóticos , Ultrasonografía Prenatal/métodos , Adulto , Amnios/fisiopatología , Femenino , Edad Gestacional , Humanos , Recién Nacido , Mortalidad Perinatal , Placenta/fisiopatología , Embarazo , Resultado del Embarazo , Estudios RetrospectivosAsunto(s)
Amnios/diagnóstico por imagen , Retardo del Crecimiento Fetal/diagnóstico por imagen , Placenta/diagnóstico por imagen , Complicaciones del Embarazo/diagnóstico por imagen , Embarazo Gemelar , Cordón Umbilical/diagnóstico por imagen , Adulto , Cesárea Repetida , Corion , Femenino , Humanos , Embarazo , Ultrasonografía PrenatalRESUMEN
Human amniotic membrane (HAM) has recently been used as an interpositional material to prevent ankylosis or primary re-ankylosis after temporomandibular joint (TMJ) arthroplasty. Here, the authors describe an unusual case of a 32-year-old woman who presented with a noninflammatory degenerative osteoarthritis of the TMJ in which a HAM was placed following a high condylar arthroplasty and discectomy and show the clinicoradiological results. The procedure resulted in total pain relief and significant improvement in jaw movements. On the long-term follow-up computed tomography, complete remodeling of the glenoid fossa with formation of new ectopic bone was observed. While the application of a HAM can be an alternative procedure to prevent ankylosis when performing a discectomy and arthroplasty, this clinical report highlights the possibility that it can induce ectopic bone formation at this location.
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Amnios/cirugía , Osteoartritis/cirugía , Trastornos de la Articulación Temporomandibular/cirugía , Adulto , Amnios/diagnóstico por imagen , Artroplastia/métodos , Femenino , Humanos , Imagen por Resonancia Magnética , Osteoartritis/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To evaluate the clinical and in vivo confocal microscopy outcome of lamellar keratoplasty combined with amniotic membrane transplantation for the treatment of corneal perforations. METHODS: In this retrospective, noncomparative, and interventional case series, 13 eyes of 13 patients with corneal perforation were included. All eyes were treated with lamellar keratoplasty combined with amniotic membrane transplantation for corneal reconstruction. Age, underlying etiology, location, size of corneal ulcer, size of corneal perforation, hospitalization days and follow-up time, and corneal confocal microscopy were investigated. Aqueous leakage, anterior chamber formation, epithelial healing time, and visual acuity (VA) were monitored after operation. RESULTS: The cause of corneal perforation (n = 13) was classified as infectious (n = 13) was classified as infectious (n = 13) was classified as infectious (. CONCLUSION: Lamellar keratoplasty combined with amniotic membrane transplantation may be an alternative, safe, and effective surgical therapy in the treatment of corneal perforations in the absence of a fresh donor cornea. We recommend this surgery to treat with the size of corneal perforation of <4 mm in diameter no matter peripheral or central corneal perforation, especially who had immune-related diseases.
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Amnios/trasplante , Perforación Corneal/cirugía , Trasplante de Córnea/métodos , Microscopía Confocal/métodos , Adolescente , Adulto , Anciano , Amnios/diagnóstico por imagen , Amnios/patología , Cámara Anterior , Córnea/diagnóstico por imagen , Córnea/cirugía , Perforación Corneal/diagnóstico por imagen , Perforación Corneal/patología , Úlcera de la Córnea/patología , Úlcera de la Córnea/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Agudeza Visual , Cicatrización de Heridas , Adulto JovenRESUMEN
Dichorionic diamniotic (DCDA) twin pregnancies after single blastocyst embryo transfer have been reported recently, although a blastocyst ovum is generally believed to divide into monochorionic twin pregnancy. We investigated the incidence of DCDA twin pregnancy after single blastocyst embryo transfer and their zygosity. This prospective cohort study included 655 consecutive twin pregnancies that were managed from 2006 to 2014 at our institution. Chorionicity and amnionicity were determined using first-trimester ultrasonography and/or placental pathology. Zygosity was analyzed if the cases were DCDA twins after single blastocyst embryo transfer. Among 655 twin pregnancies, there were 348 DCDA cases, 295 monochorionic diamniotic (MCDA) cases and 12 monochorionic monoamniotic cases. Single blastocyst embryo transfer was performed in 43 cases. Six out of the 43 (14%) cases involved DCDA twin pregnancies and the other 37 cases involved MCDA twin pregnancies. Three DCDA twins born after single blastocyst embryo transfer, wherein frozen embryo transfer (FET) was performed in the natural cycle, were dizygotic, and the other three cases, wherein FET with hormone replacement therapy was performed, were monozygotic. DCDA twin pregnancy occurred in 14% (7% for monozygotic and 7% for dizygotic) of twin pregnancies after single blastocyst embryo transfer cases.
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Amnios/diagnóstico por imagen , Corion/diagnóstico por imagen , Gemelos Monocigóticos/estadística & datos numéricos , Adulto , Amnios/crecimiento & desarrollo , Blastocisto , Corion/crecimiento & desarrollo , Estudios de Cohortes , Transferencia de Embrión , Femenino , Humanos , Embarazo , Primer Trimestre del Embarazo , Estudios Prospectivos , Gemelos Dicigóticos/genética , Gemelos Dicigóticos/estadística & datos numéricos , Gemelos Monocigóticos/genética , Ultrasonografía PrenatalRESUMEN
Monochorionic pregnancies are associated with a higher risk of perinatal morbidity and mortality than dichorionic pregnancies. Early determination of chorionicity by an ultrasound exam between 11+0 and 14+0 weeks' gestation (WG) is essential for the subsequent management of twin pregnancies. The presence of the T-sign is the most specific sign for determination of monochorionicity. During the second trimester, the presence of two distinct placental masses has a lower specificity in determining the chorionicity. We report here two cases of a monochorionic pregnancy with a bipartite placenta, suggesting that a placenta with two separate masses, each with a distinct cord insertion is not always indicative of a dichorionic pregnancy.'
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Corion/diagnóstico por imagen , Placenta/diagnóstico por imagen , Embarazo Gemelar/fisiología , Ultrasonografía Prenatal , Adulto , Amnios/diagnóstico por imagen , Fístula Arteriovenosa/patología , Reacciones Falso Negativas , Femenino , Transfusión Feto-Fetal/cirugía , Fetoscopía , Edad Gestacional , Humanos , Coagulación con Láser , Masculino , Placenta/irrigación sanguínea , Placenta/patología , Embarazo , Cordón Umbilical/patologíaRESUMEN
AIM: The presence of amniotic fluid sludge has been identified as a risk factor for preterm birth. We sought to validate the clinical characteristics of amniotic fluid sludge in Japanese pregnant women with preterm labor and intact membranes. METHODS: This was a retrospective study of 54 patients. The presence of amniotic fluid sludge was confirmed using transvaginal ultrasonography data during pregnancy. The following data were collected: gestational age, the presence of histologic chorioamnionitis, time from the diagnosis of threatened premature labor to delivery, oncofetal fibronectin (onfFN) levels, C-reactive protein peak value levels, cervical length at the time of onset of threatened premature labor and types of neonatal complications. RESULTS: Significant differences (P = 0.03) were observed in the age at delivery in relation to the presence of amniotic sludge: delivery occurred at 28.3 ± 4.5 weeks and 31.7 ± 4.3 weeks in sludge positive patients and sludge-negative patients, respectively. Presence of sludge in patients diagnosed with histological chorioamnionitis at <37 weeks of gestation differed significantly (P = 0.01): sludge-positive, 81.8%; sludge-negative, 20.9%. Among the sludge-positive patients, 100% were positive for serum onfFN (≥50 ng/mL), whereas only 54% of sludge-negative patients were positive for serum onfFN (P = 0.03). Presence of amniotic fluid sludge did not significantly affect neonatal complications. CONCLUSION: Our results confirmed previous findings that amniotic fluid sludge is a self-determining risk factor for preterm birth and chorioamnionitis in pregnant Japanese women.
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Líquido Amniótico/diagnóstico por imagen , Corioamnionitis/diagnóstico por imagen , Trabajo de Parto Prematuro/diagnóstico por imagen , Complicaciones Infecciosas del Embarazo/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Adulto , Amnios/diagnóstico por imagen , Amnios/patología , Medición de Longitud Cervical , Cuello del Útero/diagnóstico por imagen , Corioamnionitis/etiología , Corioamnionitis/patología , Femenino , Fibronectinas/sangre , Edad Gestacional , Humanos , Recién Nacido , Enfermedades del Recién Nacido/etiología , Japón , Trabajo de Parto Prematuro/etiología , Trabajo de Parto Prematuro/patología , Embarazo , Complicaciones Infecciosas del Embarazo/etiología , Complicaciones Infecciosas del Embarazo/patología , Resultado del Embarazo , Estudios Retrospectivos , Factores de RiesgoRESUMEN
The twin birth rate is increasing in the United States. Twin pregnancies can be dichorionic or monochorionic (MC). MC twins account for 20% of twin pregnancies but 30% of all-cause pregnancy-related complications. This article describes the imaging findings that establish chorionicity and amnionicity. Ideally, these are established in the first trimester when accuracy is high, but they can also be determined later in pregnancy. Complications unique to MC twin pregnancy include twin-twin transfusion syndrome, twin anemia polycythemia sequence, twin reversed arterial perfusion sequence, and selective fetal growth restriction. The US features, staging systems, and management of these complications are reviewed, and the consequences of MC twin demise are illustrated. Ongoing surveillance for these conditions starts at 16 weeks gestation. Monoamniotic (MA) twins are a small subset of MC twins. In addition to all of the MC complications, specific MA complications include cord entanglement and conjoined twinning. Radiologists must be able to determine chorionicity and amnionicity and should be aware of potential complications so that patients may be referred to appropriate regional specialized centers. A proposed algorithm for referral to specialized fetal treatment centers is outlined. Online supplemental material is available for this article. ©RSNA, 2019.
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Amnios/diagnóstico por imagen , Corion/diagnóstico por imagen , Embarazo Gemelar , Ultrasonografía Prenatal/métodos , Amnios/cirugía , Corion/cirugía , Enfermedades en Gemelos/diagnóstico por imagen , Enfermedades en Gemelos/terapia , Femenino , Muerte Fetal , Enfermedades Fetales/diagnóstico por imagen , Terapias Fetales , Transfusión Feto-Fetal/diagnóstico por imagen , Transfusión Feto-Fetal/cirugía , Fetoscopía , Humanos , Terapia por Láser , Embarazo , Trimestres del Embarazo , Gemelos Siameses , Gemelos Dicigóticos , Gemelos Monocigóticos , Ultrasonografía Doppler en Color/métodosRESUMEN
Human derived composite amnion-chorion membrane (ACM) has been used to facilitate wound healing due to reported anti-inflammatory properties and promotion of cell proliferation. This study aimed to assess the antimicrobial properties of the ACM using novel methods to visualize the antimicrobial efficacy of membranes in situ at different time points. Porcine Pericardium Collagen Membranes (PPCM) served as membrane controls. Circular pieces of the membranes were used in three different assays: insert, agar contact and glass-bottom well assays. Streptococcus gordonii were spotted onto the membranes and the plates were subsequently centrifuged to ensure direct bacterial contact with the membranes in the insert and agar contact assays, thus better mimicking bacterial adherence in the oral cavity. After incubation at 37 °C for 8, 24, and 48 hours, the membranes were dyed with the Live/Dead BacLight Bacterial Viability fluorescence stain and analyzed via confocal microscopy. The results demonstrated that the ACM completely inhibited bacterial growth at all time points, whereas the PPCM did not demonstrate any antimicrobial properties. Within the limits of this study, the ACM showed extremely high antimicrobial efficacy against oral streptococci. In addition, our methods may be useful in assessing antimicrobial properties for biomaterials with minimum diffusion ability, when traditional assessment methods are not applicable.
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Amnios/metabolismo , Corion/metabolismo , Streptococcus gordonii/fisiología , Amnios/diagnóstico por imagen , Animales , Corion/diagnóstico por imagen , Humanos , Viabilidad Microbiana , Microscopía Confocal , PorcinosRESUMEN
AIM: This study aimed to evaluate the incidence of unexpected critical complications (UCC) in monochorionic diamniotic (MCDA) twin pregnancies according to ultrasonographic scan interval. METHODS: This retrospective single-center cohort study, conducted between January 2005 and April 2015, investigated the incidence of UCC in patients with MCDA twin pregnancies undergoing weekly ultrasound (Group A) and those undergoing biweekly ultrasound (Group B). We also examined the incidence of predictable critical complications according to ultrasound interval. RESULTS: Of all 385 cases, the total incidence of UCC was 20 (5.2%), including 14 cases of twin-twin transfusion syndrome and 6 cases of intrauterine fetal death. The incidence of UCC was 3.9% in Group A and 9.0% in Group B (P = 0.046). In contrast, the incidence of predictable critical complications was 6.7% in Group A and 9.0% in Group B (P = 0.440). CONCLUSION: The incidence of UCC in patients with MCDA twin pregnancies was significantly lower in patients undergoing weekly ultrasound. Our results suggest that weekly ultrasound evaluation for patients with MCDA pregnancy is more effective for early detection of UCC such as intrauterine fetal death and twin-twin transfusion syndrome ; however, further investigations are needed to determine whether weekly ultrasound evaluation can improve clinical outcomes.