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Mehrlingsschwangerschaften

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Perikonzeptionelle Frauenheilkunde

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Zusammenfassung

Mehrlingsschwangerschaften haben in den vergangenen Jahrzehnten in der westlichen Welt deutlich zugenommen. Ursächlich hierfür sind neben der Zunahme reproduktionsmedizinischer Maßnahmen auch das steigende Alter der Mütter. Zwillingsschwangerschaften stellen eine der wesentlichen Herausforderungen in der heutigen Perinatalmedizin dar. Neben den Gefahren für die Mutter steht insbesondere die Gefährdung der Kinder im Vordergrund. Darüber hinaus ergeben sich bei höhergradigen Mehrlingsschwangerschaften erhebliche psychosoziale Belastungssituationen.

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Literatur

  • Arabin B (2009) Monoamniotic multiple pregnancies. Z Geburtshilfe Neonatol 213: 255–62

    Article  PubMed  CAS  Google Scholar 

  • Arabin B, Bilardo C (2008) Besonderheiten der monoamnialen Mehrlingsschwangerschaft. München: Urban und Fischer

    Google Scholar 

  • Arabin B, Hack K (2009) Is the location of cord entanglement associated with antepartum death in monoamniotic twins? Ultrasound Obstet Gynecol 33: 246–7

    Article  PubMed  CAS  Google Scholar 

  • Arabin B, Laurini RN, Van Eyck J (1999) Early prenatal diagnosis of cord entanglement in monoamniotic multiple pregnancies. Ultrasound Obstet Gynecol 13: 181–6

    Article  PubMed  CAS  Google Scholar 

  • Bahlmann F (2004) Feto-fetales Transfusionssyndrom. Überwachung und Therapie. Gynäkologe 37: 725–736

    Article  Google Scholar 

  • Bajoria R, Ward S, Sooranna SR (2001) Atrial natriuretic peptide mediated polyuria: pathogenesis of polyhydramnios in the recipient twin of twin-twin transfusion syndrome. Placenta 22: 716–24

    Article  PubMed  CAS  Google Scholar 

  • Bajoria R, Wigglesworth J, Fisk NM (1995) Angioarchitecture of monochorionic placentas in relation to the twin-twin transfusion syndrome. Am J Obstet Gynecol 172: 856–63

    Article  PubMed  CAS  Google Scholar 

  • Barigye O, Pasquini L, Galea P, Chambers H, Chappell L, Fisk NM (2005) High risk of unexpected late fetal death in monochorionic twins despite intensive ultrasound surveillance: a cohort study. PLoS Med 2: e172

    Article  PubMed  Google Scholar 

  • Baxi LV, Walsh CA (2010) Monoamniotic twins in contemporary practice: a single-center study of perinatal outcomes. J Matern Fetal Neonatal Med 23: 506–10

    Article  PubMed  Google Scholar 

  • Benirschke K, Kaufmann P, Baergen RN (2006) Pathology of the human placenta, 5th edition. Heidelberg: Springer

    Google Scholar 

  • Breathnach FM, Malone FD (2012) Fetal growth disorders in twin gestations. Semin Perinatol 36: 175–81

    Article  PubMed  Google Scholar 

  • Carroll SG, Soothill PW, Abdel-Fattah SA, Porter H, Montague I, Kyle PM (2002) Prediction of chorionicity in twin pregnancies at 10-14 weeks of gestation. BJOG 109: 182–6

    PubMed  Google Scholar 

  • Chalouhi GE, Stirnemann JJ, Salomon LJ, Essaoui M, Quibel T, Ville Y (2010) Specific complications of monochorionic twin pregnancies: twin-twin transfusion syndrome and twin reversed arterial perfusion sequence. Semin Fetal Neonatal Med 15: 349–56

    Article  PubMed  CAS  Google Scholar 

  • Chow JS, Benson CB, Racowsky C, Doubilet, PM Ginsburg E (2001) Frequency of a monochorionic pair in multiple gestations: relationship to mode of conception. J Ultrasound Med 20: 757–60 quiz 761

    PubMed  CAS  Google Scholar 

  • De Lia JE, Cruikshank DP Keye WR Jr (1990) Fetoscopic neodymium: YAG laser occlusion of placental vessels in severe twin-twin transfusion syndrome. Obstet Gynecol 75: 1046–53

    PubMed  CAS  Google Scholar 

  • De Villiers SF, Slaghekke F, Middeldorp JM, Walther FJ, Oepkes D, Lopriore E (2012) Arterio-arterial vascular anastomoses in monochorionic placentas with and without twin-twin transfusion syndrome. Placenta 33: 652–4

    Article  PubMed  CAS  Google Scholar 

  • Derom C, Vlietinck R, Derom R, Van Den Berghe H, Thiery M (1988) Population-based study on sex proportion in monoamniotic twins. N Engl J Med 319: 119–20

    Article  PubMed  CAS  Google Scholar 

  • DGGG (2010) Fetozid bei Mehrlingen. Stellungnahme aus rechtlicher Sicht. Frauenarzt 48 (5): 504–507

    Google Scholar 

  • Dias T, Mahsud-Dornan S, Bhide A, Papageorghiou AT, Thilaganathan B (2010) Cord entanglement and perinatal outcome in monoamniotic twin pregnancies. Ultrasound Obstet Gynecol 35: 201–4

    Article  PubMed  CAS  Google Scholar 

  • Elliott JP, Urig MA, Clewell WH (1991) Aggressive therapeutic amniocentesis for treatment of twin-twin transfusion syndrome. Obstet Gynecol 77: 537–40

    PubMed  CAS  Google Scholar 

  • Evans MI, Lau TK (2010) Making decisions when no good choices exist: delivery of the survivor after intrauterine death of the co-twin in monochorionic twin pregnancies. Fetal Diagn Ther 28: 191–5

    Article  PubMed  Google Scholar 

  • Faber R, Stepan H (2004) Umbilical cord entanglement in monoamniotic twins. Ultrasound Obstet Gynecol 24: 592–3

    Article  PubMed  CAS  Google Scholar 

  • Fisk NM, Duncombe GJ, Sullivan MH (2009) The basic and clinical science of twin-twin transfusion syndrome. Placenta 30: 379–90

    Article  PubMed  CAS  Google Scholar 

  • Fisk NM, Tan TY, Taylor MJ (2004) Stage-based treatment of twin-twin transfusion syndrome. Am J Obstet Gynecol 190: 1491–2

    Article  PubMed  Google Scholar 

  • Galea P, Jain V, Fisk NM (2005) Insights into the pathophysiology of twin-twin transfusion syndrome. Prenat Diagn 25: 777–85

    Article  PubMed  Google Scholar 

  • Hack KE, Derks JB, Elias SG, Franx A, Roos EJ, Voerman SK, Bode CL, Koopman-Esseboom C, Visser GH (2008) Increased perinatal mortality and morbidity in monochorionic versus dichorionic twin pregnancies: clinical implications of a large Dutch cohort study. BJOG 115: 58–67

    Article  PubMed  CAS  Google Scholar 

  • Hecher K, Diehl W, Zikulnig L, Vetter M Hackeloer BJ (2000) Endoscopic laser coagulation of placental anastomoses in 200 pregnancies with severe mid-trimester twin-to-twin transfusion syndrome. Eur J Obstet Gynecol Reprod Biol 92: 135–9

    Article  PubMed  CAS  Google Scholar 

  • Hecher K, Plath H, Bregenzer T, Hansmann M, Hackeloer BJ (1999) Endoscopic laser surgery versus serial amniocenteses in the treatment of severe twin-twin transfusion syndrome. Am J Obstet Gynecol 180: 717–24

    Article  PubMed  CAS  Google Scholar 

  • Kaufmann P (2007) Plazentation und Eihautverhältnisse. In: Mehrlingsschwangerschaften. Prä- und perinatales Management. München: Elsevier

    Google Scholar 

  • Krampfl E, Hirtenlehrer K, Stohmer H (2004) Mehrlinge. In: Schneider H, Husslein P, Schneider KTM (Hrsg.) Die Geburtshilfe, 2. Aufl. Heidelberg: Springer

    Google Scholar 

  • Kuwata T, Matsubara S, Suzuki M (2010) 3D color Doppler of monoamniotic twin cord entanglement. Arch Gynecol Obstet 281: 973–4

    Article  PubMed  Google Scholar 

  • Lewi L, Blickstein I, Van Schoubroeck D, Gloning KP, Casteels M, Brandenburg H, Fryns JP, Deprest J (2006a) Diagnosis and management of heterokaryotypic monochorionic twins. Am J Med Genet A 140: 272–5

    Article  Google Scholar 

  • Lewi L, Gratacos E, Ortibus E, Van Schoubroeck D, Carreras E, Higueras T, Perapoch J, Deprest J (2006b) Pregnancy and infant outcome of 80 consecutive cord coagulations in complicated monochorionic multiple pregnancies. Am J Obstet Gynecol 194: 782–9

    Article  Google Scholar 

  • Lopriore E, Vandenbussche FP, Tiersma ES, De Beaufort AJ, De Leeuw JP (1995) Twin-to-twin transfusion syndrome: new perspectives. J Pediatr 127: 675–80

    Article  PubMed  CAS  Google Scholar 

  • Maiz N, Nicolaides KH (2010) Ductus venosus in the first trimester: contribution to screening of chromosomal, cardiac defects and monochorionic twin complications. Fetal Diagn Ther 28: 65–71

    Article  PubMed  Google Scholar 

  • Maschke C, Diemert A, Hecher K, Bartmann P (2011) Long-term outcome after intrauterine laser treatment for twin-twin transfusion syndrome. Prenat Diagn 31: 647–53

    Article  PubMed  Google Scholar 

  • Morikawa M, Yamada T, Sato S, Minakami H (2012) Prospective risk of intrauterine fetal death in monoamniotic twin pregnancies. Twin Res Hum Genet 15: 522–6

    Article  PubMed  Google Scholar 

  • NICE (2011) CG129 Multiple pregnancy: full guideline. http://guidance.nice.org.uk/CG129/Guidance/pdf/English

  • Ong SS, Zamora J, Khan KS, Kilby MD (2006) Prognosis for the co-twin following single-twin death: a systematic review. BJOG 113: 992–8

    Article  PubMed  CAS  Google Scholar 

  • Pasquini L, Wimalasundera RC, Fichera A, Barigye O, Chappell L, Fisk NM (2006) High perinatal survival in monoamniotic twins managed by prophylactic sulindac, intensive ultrasound surveillance, and Cesarean delivery at 32 weeks’ gestation. Ultrasound Obstet Gynecol 28: 681–7

    Article  PubMed  CAS  Google Scholar 

  • Peeters SH, Middeldorp JM, Lopriore E, Klumper FJ, Oepkes D (2012) Monochorionic Triplets Complicated by Fetofetal Transfusion Syndrome: A Case Series and Review of the Literature. Fetal Diagn Ther 32 (4): 239–245

    Article  PubMed  Google Scholar 

  • Quigley J (1935) Monoamniotic twin pregnancy. American Journal of Obstetrics and Gynaecology 29: 354–362

    Google Scholar 

  • Quintero RA (2013) Management of twin-twin transfusion syndrom. Presentation at the XI World Congress of Perinatal Medicine, Moscow, June 19th – 22nd 2013

    Google Scholar 

  • Quintero RA, Comas C, Bornick PW, Allen MH, Kruger M (2000) Selective versus non-selective laser photocoagulation of placental vessels in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol 16: 230–6

    Article  PubMed  CAS  Google Scholar 

  • Quintero RA, Morales WJ, Allen MH, Bornick PW, Johnson PK, Kruger M (1999) Staging of twin-twin transfusion syndrome. J Perinatol 19: 550–5

    Article  PubMed  CAS  Google Scholar 

  • Raio L (2011) Komplizierte monochoriale Zwillinge. Eine diagnostisch-therapeutische Herausforderung. Gynäkologe 2: 22–26

    Google Scholar 

  • RCOG (2008) Monochorionic Twin Pregnancy, Management (Green-top 51). www.rcog.org.uk

  • Roberts D, Neilson JP, Kilby M, Gates S (2008) Interventions for the treatment of twin-twin transfusion syndrome. Cochrane Database Syst Rev: CD002073

    Google Scholar 

  • Robyr R, Boulvain M, Lewi L, Huber A, Hecher K, Deprest J, Ville Y (2005) Cervical length as a prognostic factor for preterm delivery in twin-to-twin transfusion syndrome treated by fetoscopic laser coagulation of chorionic plate anastomoses. Ultrasound Obstet Gynecol 25: 37–41

    Article  PubMed  CAS  Google Scholar 

  • Robyr R, Quarello E, Ville Y (2005) Management of fetofetal transfusion syndrome. Prenat Diagn 25: 786–95

    Article  PubMed  CAS  Google Scholar 

  • Rossi AC, D’Addario V (2013) Survival Outcomes of Twin-Twin Transfusion Syndrome Stage I: A Systematic Review of Literature. Am J Perinatol 30 (1): 5–10

    PubMed  Google Scholar 

  • Sebire NJ, Souka A, Skentou H, Geerts L, Nicolaides KH (2000) Early prediction of severe twin-to-twin transfusion syndrome. Hum Reprod 15: 2008–10

    Article  PubMed  CAS  Google Scholar 

  • Simpson LL (2013) Twin-twin transfusion syndrome. Am J Obstet Gynaecol 208: 3–13

    Article  Google Scholar 

  • Stamilio D M, Fraser WD, Moore TR (2010) Twin-twin transfusion syndrome: an ethics-based and evidence-based argument for clinical research. Am J Obstet Gynecol 203: 3–16

    Article  PubMed  Google Scholar 

  • Suzuki S, Ishikawa G, Sawa R, Yoneyama Y, Asakura H, Araki T (1999) Umbilical venous pulsation indicating tight cord entanglement in monoamniotic twin pregnancy. J Ultrasound Med 18: 425–7

    PubMed  CAS  Google Scholar 

  • Vayssiere C, Plumere C, Gasser B, Neumann M, Favre R Nisand I (2004) Diagnosing umbilical cord entanglement in monoamniotic twins: becoming easier and probably essential. Ultrasound Obstet Gynecol 24: 587–9

    Article  PubMed  CAS  Google Scholar 

  • Weber MA, Sebire NJ (2010) Genetics and developmental pathology of twinning. Semin Fetal Neonatal Med 15: 313–8

    Article  PubMed  Google Scholar 

  • Weiner CP, Ludomirski A (1994) Diagnosis, pathophysiology, and treatment of chronic twin-to-twin transfusion syndrome. Fetal Diagn Ther 9: 283–90

    Article  PubMed  CAS  Google Scholar 

  • Wieacker P, Wilhelm C, Prompeler H, Petersen KG, Schillinger H, BreckwoldtM (1992) Pathophysiology of polyhydramnios in twin transfusion syndrome. Fetal Diagn Ther 7: 87–92

    Article  PubMed  CAS  Google Scholar 

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  1. Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Osnabrück, Am Finkenhügel 1, 49076, Osnabrück, Deutschland

    J. Yassin & Y. Garnier

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  1. J. Yassin
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  2. Y. Garnier
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  1. Grevenbroicher Endokrinologikum IVF-Zentrum, green-ivf, Grevenbroich, Germany

    Christian Gnoth

  2. Klinik u. Polikl. f. für Gyn. u. Gebh., Universitätsklinik Köln, Köln, Germany

    Peter Mallmann

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Yassin, J., Garnier, Y. (2014). Mehrlingsschwangerschaften. In: Gnoth, C., Mallmann, P. (eds) Perikonzeptionelle Frauenheilkunde. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38023-5_35

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  • DOI: https://doi.org/10.1007/978-3-642-38023-5_35

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