By Isaac Blickstein MD, Louis Keith MD PhD
The booklet offers a medical method of the various many aspects of a number of gestations. The textual content comprises chapters on psychosocial points, embryonic loss and perinatal mortality, invasive and noninvasive analysis, progress aberration, fetal surgical procedure, the anomaly of previous maternal age, chance of cerebral palsy, and neonatal morbidity of very low beginning weight multiples. All chapters are written by means of gurus and directed towards clinicians in perform.
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Additional info for Multiple Gestations, An Issue of Obstetrics and Gynecology Clinics (The Clinics: Internal Medicine)
Example text
Vermont Oxford Network. Timing of initial surfactant treatment for infants 23 to 29 weeks’ gestation: is routine practice evidence based? Pediatrics 2004;113(6):1593 – 602. [18] Martin JA, Park MM. Trends in twin and triplet births: 1980–1997. Natl Vital Stat Rep 1999; 47(24):1 – 16. [19] Luke B, Keith L. The contribution of singletons, twins and triplets to low birth weight, infant mortality and handicap in the United States. J Reprod Med 1992;37:661 – 5. [20] Imaizumi Y. Perinatal morality in triplet births in Japan: trends and factors influencing mortality.
Births: final data for 2002. ) twins (Fig. 2). These dates coincide with changes in other important milestones in the in utero development of multiples. Function of the utero-placental unit Fetal growth is determined by constitutional characteristics modulated by the function of the utero-placental unit. The constitutional determinants explain the variance of normal human fetuses and why not all small-for-gestational-age (SGA) infants result from an intrauterine growth restriction process. The function Singletons Birth weight 3500 Twins Triplets 2500 1500 500 25 27 29 31 33 35 Gestational age (wks) 37 39 Fig.
This hypothesis suggests that within a limited uterine environment, the combination of one larger and one smaller twin may reduce uterine overdistension and increase gestational age. The indirect support of this assumption is that discordant twins (N 25%) are delivered at a more advanced gestational age compared with concordant twins of the same total twin birth weight (representing the uterine volume) [19]. A comparison of pairs from the US Matched Multiple Birth Data File, grouped at intervals of 250 g total birth weight, found that the mean gestational age of discordant pairs was significantly higher across the entire range of total birth weights examined (b 4750 g) [19].