11/21. Delivery of a healthy twin after intrauterine demise and expulsion of a first twin.We report on a diamniotic-dichorionic twin pregnancy after in vitro fertilization. The first twin was diagnosed with down syndrome and spontaneously aborted at 24 weeks of gestation after intrauterine death at week 18. The second healthy twin was delivered by cesarean section 11 weeks later. We discuss management aspects and review the literature.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
12/21. Persistent gestational trophoblastic disease after an androgenetic/biparental fetal chimera: a case report and review.We present a case of a dichorionic/diamniotic twin pregnancy in which one twin presented with ultrasound findings suggestive of molar changes in the placenta. The placenta of twin A seemed to be grossly enlarged and cystic, and twin A was small for gestation. After an inevitable abortion, a detailed histological and genetic evaluation was performed on the fetus and placenta from twin A, including traditional cytogenetic techniques, microsatellite marker analysis, fluorescent in situ hybridization, and p57 immunostaining. It was determined that twin A was a chimera with a biparental XX cell line and an androgenetic XY cell line. The 2 cell lines were present in both the placenta and the fetus. The patient later developed and was treated for persistent gestational trophoblastic disease, which has been shown to have an increased risk after an androgenetic conception. Cases of mosaicism or chimerism involving an androgenetic cell line may be difficult to diagnose histologically but are critical to identify because of the increased risk for persistent gestational trophoblastic disease. Therefore, we emphasize the importance of using multiple molecular, cytogenetic, and immunohistochemical techniques when diagnosing cases involving such unusual placental abnormalities. To our knowledge, this is the first reported case of persistent gestational disease after a fetal chimera.- - - - - - - - - - ranking = 0.043816134437477keywords = conception (Clic here for more details about this article) |
13/21. hypospadias after assisted reproduction incorporating in vitro fertilization and gamete intrafallopian transfer.OBJECTIVE: To determine incidence of hypospadias in infants born as a result of assisted reproductive technology (ART). DESIGN: Prospective data collection. SETTING: parents with various forms of infertility attended an in-hospital in vitro fertilization program. patients: Two of the 53 male infants, conceived as a result of ART over a 3-year period, were born with hypospadias. INTERVENTIONS: Patient no. 1 underwent follicular stimulation (17 ampules of human menopausal gonadotropin (hMG), followed by 10,000 IU of human chorionic gonadotropin (hCG) 60 hours after the last hMG). Patient no. 2 underwent follicular stimulation with clomiphene citrate 100 mg/d from days 3 to 7, followed by 14 ampules of hMG starting day 6, and 10,000 IU of hCG 30 hours after her last hMG. MAIN OUTCOME MEASURES: All infants were examined in the immediate postpartum period for congenital anomalies. RESULTS: infant no. 1, one of a set of dizygotic twins, had penoscrotal hypospadias, with normal renal sonogram and chromosomal studies. infant no. 2 had glandular hypospadias with the urinary meatus displaced to the border of the glans. CONCLUSION: This high incidence raises concern about possible links between assisted reproduction and hypospadias.- - - - - - - - - - ranking = 5keywords = fertilization (Clic here for more details about this article) |
14/21. pathology of intragestational intervention in twin-to-twin transfusion syndrome.Selective intervention in multiple pregnancy is being used to enhance the chances of survival of at least one conceptus when the risks for the combined conceptuses and mother are considered too great. These procedures have been applied to induced polyembryonic conceptions (selective continuance) and discordant dichorionic twins (selective birth). We report attempts at selective intervention in three monochorionic twin gestations affected by twin-to-twin transfusion syndrome. In all three cases, both fetuses seemed doomed and the mother was in significant distress. The selected survivor in the first case is doing well; both twins were stillborn in the second case; in the third case, the selected survivor died as a neonate but the other twin survived and is doing well. We suggest possible explanations for the clinical outcome of each case based on detailed pathologic examination of the delivered placentas and autopsy examination of the nonsurviving twins. The shared chorionic circulation is the source of both the clinical disorder and the potential complications of any attempt to alleviate the disorder. This situation is unique to monochorionic twins, and we discuss the implications of this for intrauterine therapy of twin-to-twin transfusion syndrome.- - - - - - - - - - ranking = 0.043816134437477keywords = conception (Clic here for more details about this article) |
15/21. Monozygotic twins discordant for partial trisomy 1.A 25-year-old primigravida delivered monozygotic twins discordant for multiple anomalies and partial trisomy 1 mosaicism. The phenotype of partial trisomy 1 includes craniofacial, central nervous system, and ocular anomalies. The most likely explanation for these findings is that the translocation occurred after twinning occurred. This observation emphasizes that monozygotic twins are not necessarily genetically identical. They are identical at conception, but subsequent mutation and rearrangement of the genome may cause substantial phenotypic differences.- - - - - - - - - - ranking = 0.043816134437477keywords = conception (Clic here for more details about this article) |
16/21. hydatidiform mole: cytogenetic marker analysis in twin gestation. Report of two cases.A hydatidiform mole associated with a fetus proved to be the result of twin gestation. On microscopic examination of the placenta the case was classified as a partial hydatidiform mole. Chromosomal markers were, however, consistent with a normal conception and a mole of diploid androgenetic origin. Chromosome analysis of a morphologic complete molar specimen yielded two cell lines, one consistent with a normal conception and one with diploid androgenesis. Twinning in molar specimens must therefore be considered, regardless of macroscopic appearance. The prenatal diagnosis of a coexisting fetus and molar placenta poses a real clinical problem; analyses must distinguish between a partial mole plus a triploid fetus and a normal fetus occurring with a partial or a complete mole. The distinction is important for decisions made during pregnancy and may be of prognostic significance after termination. The usefulness of chromosome marker analysis in distinguishing between the various origins is pointed out, and it is suggested that twin pregnancy with hydatidiform mole is more frequent than its description in the literature would suggest.- - - - - - - - - - ranking = 0.087632268874954keywords = conception (Clic here for more details about this article) |
17/21. Transmission of human immunodeficiency virus from parents to only one dizygotic twin.The acquired immunodeficiency syndrome-related complex was identified in a mother and one of her nonidentical twins. Generalized lymphadenopathy was first noted in the infant at age 17 months, and that of the mother was incidentally discovered 6 months later. The father, who had had homosexual contacts before the conception of the twins, appeared to be in good health. No one in the family had constitutional symptoms or showed signs of opportunistic infection. Both parents and the patient had hypergammaglobulinemia, low T-helper-to-suppressor-cell ratio, and positive serum antibody to human immunodeficiency virus. Attempts to isolate the virus from all family members were unsuccessful. The twin brother was in good health with a normal immunologic profile and negative antibody to human immunodeficiency virus.- - - - - - - - - - ranking = 0.043816134437477keywords = conception (Clic here for more details about this article) |
18/21. pregnancy associated with exstrophy of the bladder and obstructive renal failure.I have reported a case of pregnancy in a patient with exstrophy of the bladder. Early establishment of renal function and status is most important, and detailed counseling of the patient is preferred ideally before conception. The patient should be reassured that her defect has not been proven to have a genetic link. patients with ureterosigmoidostomy diversion should be observed closely for renal obstructive symptoms.- - - - - - - - - - ranking = 0.043816134437477keywords = conception (Clic here for more details about this article) |
19/21. hydatidiform mole with a surviving coexistent fetus following in-vitro fertilization.A case of a hydatidiform mole with a surviving coexistent fetus following in-vitro fertilization and embryo transfer is reported. The diagnosis was established at 12 weeks gestation and pregnancy was maintained until 31 weeks, during which time transient hyperthyroidism and lung metastasis developed. No difference was observed in pronucleus formation and early embryonic development between the two embryos, which resulted in a complete mole and a normal fetus. dna finger-print analysis, karyotype analysis and histopathological examination confirmed that the pregnancy was a twin of a complete mole and a normal conception. dna fingerprint analysis was performed with a single-locus probe cocktail. All dna bands from the tumour were of paternal origin, and the bands from the placenta were of paternal and maternal origin.- - - - - - - - - - ranking = 5.0438161344375keywords = fertilization, conception (Clic here for more details about this article) |
20/21. Clinical features of multiple conception with partial or complete molar pregnancy and coexisting fetuses.The estimated incidence of twin pregnancy consisting of hydatidiform mole and a coexisting fetus is 1 per 22,000-100,000 pregnancies. Since 1965, nine patients with this entity have been treated at the new england Trophoblastic Disease Center (NETDC), boston. One patient had a partial hydatidiform mole coexisting with a normal placenta and fetus. The other eight patients had twin pregnancies with a complete hydatidiform mole (CHM) and coexisting fetus. We compared the clinical outcomes in these 8 patients and 14 additional published case reports of multiple gestations composed of CHM and coexisting fetuses with a group of 71 patients with singleton CHM treated at NETDC. Twelve of the 22 patients (55%) with CHM and coexisting fetuses developed persistent gestational trophoblastic tumor, requiring chemotherapy. Five of these patients developed metastases requiring multiple cycles of chemotherapy to achieve remission. The presenting symptoms of multiple conception with CHM and coexisting fetuses were similar to those in patients with a singleton conception and complete mole. However, as compared to singleton CHM, patients having a multiple conception with CHM and coexisting fetuses were diagnosed at a later gestational age, had higher preevacuation beta-human chorionic gonadotropin levels and had a greater propensity to develop persistent tumor. These data indicate that patients with multiple conceptions consisting of CHM and coexisting fetuses are at high risk of developing persistent gestational trophoblastic tumor.- - - - - - - - - - ranking = 0.35052907549982keywords = conception (Clic here for more details about this article) |
| <- Previous || Next -> |