Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Multiple Birth”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources
PubMed1996

Low-dose gonadotrophin stimulation for luteal phase defects--does absence of LH help pregnancy rates?

Based on data suggesting that higher serum LH levels during the follicular phase may decrease subsequent pregnancy rates and increase spontaneous abortion rates, the study presented herein was designed to compare the pregnancy and abortion rates in patients treated with gonadotrophin preparations with and without LH content. Infertile patients with luteal phase defects related to releasing eggs prior to complete follicular maturation were randomized into two treatment arcs: ultra-low-dose (75IU) human menopausal gonadotrophin (hMG) versus pure FSH. However, they were given the right to refuse the recommended treatment and use the other one if they preferred. Pregnancy and spontaneous abortion rates were determined for first cycle of therapy. The pregnancy rates for hMG versus pure FSH was 22.7 percent and 20.3 percent, respectively. The spontaneous abortion rates were also similar (8 percent and 9.1 percent). There were no multiple births resulting from these 36 pregnancies. Ovarian hyperstimulation syndrome was not observed in any of the 164 stimulation cycles. These data demonstrate that the use of an ultra-low-dose gonadotrophin stimulation regimen is an effective method of correcting infertility related to luteal phase defects related to follicular maturation defects since the overall pregnancy rate per first cycle of treatment was 22 percent despite a minimum of 10 months of infertility duration. Furthermore, an ultra-low-dose gonadotrophin regimen is safe for treating luteal phase defects in that there was no ovarian hyperstimulation or multiple births demonstrated. These results also show no advantage of choosing a preparation devoid of LH, thus giving the patient the opportunity to purchase the least expensive medication that is available.

Abortion, Spontaneous↗
PubMed2001

Twinning rates and survival of twins in rural Nepal.

BACKGROUND: Twin pregnancies are common but there are few data on rates of twinning or survival of liveborn twin infants in developing countries. METHODS: The rates of multiple births were calculated in a population-based cohort of married women of childbearing age who were enrolled in a randomized community trial to assess the impact of vitamin A or beta-carotene on maternal and infant health and survival. RESULTS: The rate of twinning was 16.1 per 1000 pregnancies (7.4 if only twin pregnancies resulting in two liveborn infants were used). The rate for triplets and quadruplets was 0.19 and 0.06 per 1000 pregnancies. Twinning rates were higher among women of higher parity, but were not associated with maternal age. Twinning rates among twins where at least one was live born (or increased in utero survival) were 30% (95% CI : -1%, 71%) and 44% (95% CI : 9%, 89%) higher among women receiving vitamin A and beta-carotene supplements than placebo, after adjusting for maternal age, gestational age, and parity. The perinatal mortality rate was 8.54 times higher for twins than singletons, 7.32 higher for neonatal mortality, and 5.84 higher for cumulative 24-week mortality. This difference was reduced but not erased by adjusting for gestational age. No difference in survival of liveborn twin infants was seen by supplement group. A higher mortality rate among male twins was largely explained by gestational age. CONCLUSIONS: Multiple births are relatively common occurrences in rural Nepal, and carry a much higher mortality risk for the infants than for singletons. Vitamin A or beta-carotene supplementation appeared to increase the rate of twinning, or improve the survival of twins in utero, but did not increase twin survival after birth.

Adult↗
PubMed1977

Paediatric preparation for multiple premature births.

We describe the managment of 2 sets of pre-term quadruplets born to 2 women pregnant concurrently following the induction of ovulation with gonadotrophin. Careful antenatal planning was necessary to provide for each of the 8 pre-term infants a standard of neonatal medical and nursing care comparable to that normally available for singleton pre-term infants.

Adult↗
PubMed2002

Childhood malignancy and maternal diabetes or other auto-immune disease during pregnancy.

Among 4380 children born in 1987-1997 of women with a diagnosis of diabetes and alive at the age of one, 10 were registered in the Swedish Cancer Registry before the end of 1998. The odds ratio for having a childhood cancer after maternal diabetes, stratified for year of birth, maternal age, parity, multiple birth, and 500 g birth weight class was 2.25 (95%CI 1.22-4.15). Among 5842 children born during the period 1973-1997 whose mothers had other auto-immune diseases (SLE, rheumatoid arthritis, Crohn, ulcerous colitis, multiple sclerosis or thyroiditis), the number of observed childhood cancers (9) was close to that expected (8.5). Maternal diabetes but not other auto-immune diseases may be a risk factor for childhood cancer.

Autoimmune Diseases↗
PubMed1996

Prevalence and aetiology of neurological impairment in extremely low birthweight infants.

OBJECTIVE: To determine the prevalence and perinatal predictors of cerebral palsy, intellectual impairment, visual impairment and deafness in a cohort of extremely low birthweight (ELBW) infants at two years of age. METHODOLOGY: The study population comprised 199 of the 224 (89%) ELBW infants managed at the Mater's Mothers Hospital, Brisbane, between July 1977 and February 1990 and who survived to two years. The prevalence of cerebral palsy, intellectual impairment, blindness and deafness was measured by clinical,psychometric and audiological assessment and the association with 24 risk factors examined. RESULTS: Cerebral palsy occurred in 20 children (10%). Risk of cerebral palsy was associated with ventricular dilatation, intraventricular haemorrhage, necrotizing enterocolitis and multiple birth, though only ventricular dilatation (OR 4.41; 95% CI 1.32-14.8) remained significant in the adjusted analysis. Intellectual impairment occurred in 20 children (10%) and was independently associated with ventricular dilatation (OR 15.0; 95% CI 2.2-102.8), ventilation F(i)(2) > 80% (OR 3.4; 95% CI 1.01-11.5), vaginal delivery (OR 3.5; 95% Cl 1.09-11.4) and male sex (OR 6.1; 95% Cl 1.67-22.3). No perinatal predictor was statistically associated with risk of deafness. Retinopathy of prematurity (OR 36.9; 95% Cl 2.8-495.5) was associated with risk of later visual impairment. CONCLUSIONS: Intellectual impairment was associated with a broad range of perinatal variables. Cerebral palsy was associated with fewer variables, all of which were also associated with intellectual impairment. Neurologic injury was associated with male sex and multiple birth, which are not biological insults themselves, but may be markers of susceptibility to injury.

Blindness↗
PubMed1991

Investigation and treatment of a multiple limb birth.

We report a baby born with three fully developed normally functioning legs. The third leg was attached to the baby's sacrum via an iliac bone at the site of a spina bifida. A primitive perineum was present. Innervation of the limb was via a sacral hiatus with a myelomeningocele. A rudimentary peritoneal sac was found at operation containing a blind loop of bowel suspended by a mesentery. The additional leg was found to have no cortical representation using somatic evoked potentials although lumbar responses were normal. Magnetic resonance imaging demonstrated a bifid spinal cord in the lumbo-sacral region. Associated abnormalities were a haemangioma of the L orbit and a vascular mass in the cerebellum.

Abnormalities, Multiple↗
PubMed2026

Pictographs: feasibility and acceptability of a novel method of newborn identification to reduce wrong-patient errors in the NICU.

Wrong-patient errors cause serious harm in newborns. These errors involve ordering and administering tests, procedures, medications, and breast milk to an unintended patient. Newborns receiving care in neonatal intensive care units (NICUs) are at particularly high risk. Although more distinct newborn naming conventions as recommended by the Joint Commission significantly reduce wrong-patient orders, name similarities among multiple-birth infants and truncation of differentiating information in some electronic health record (EHR) systems contribute to this persistent increased risk. Accordingly, novel newborn identifiers are urgently needed. We propose Pictographs - images that are appealing, recognizable, and appropriate - to serve as visual identifiers for newborns in NICUs. Pictographs are selected by caregivers, uploaded into the EHR, and displayed at bedside. As part of a multicenter randomized controlled trial assessing effectiveness of Pictographs to prevent wrong-patient order errors, we initially evaluated feasibility and acceptability of Pictographs at two study sites. Pictographs as novel visual identifiers for newborns in the NICU were generally well received by caregivers and clinicians, and the vast majority of caregivers selected a Pictograph for their infant(s), which was posted at the bedside and uploaded into the EHR. Ordering clinicians - the primary target of the intervention to prevent wrong-patient errors - recognized the potential for Pictographs to provide a visual cue when placing orders, particularly for multiple-birth infants. Here, we describe the rationale, implementation, framework, feasibility, usefulness, and acceptability of Pictographs among key stakeholders. If found effective for preventing wrong-patient errors, Pictographs could be adopted as a patient safety solution in hospitals worldwide.

Female↗
PubMed1986

Fertility, embryo survival and litter size in lines of Targhee sheep selected for weaning weight or litter size.

Conception rate, prenatal survival and litter size were recorded for 444 ewes of two age groups from five lines of grade Targhee sheep: two unselected control lines, HC1 and DC(C); two lines selected for 20 yr for increased 120-d weight, HW and DH(W); and a line selected for 18 yr for increased multiple births, T. Line T was equal or superior to the control lines in conception rate, prenatal survival and litter size in both age groups, although most of the differences were not significant. The W selected lines were inferior to the C and T lines in fertility and tended to be lower in prenatal survival, among mature ewes, resulting in a significantly lower number of lambs born per corpus luteum in the W lines than in the other two groups. Among yearlings, C ewes were non-significantly lower in fertility than T and W ewes, while W ewes were significantly lower than C and T ewes in prenatal survival. The T line ewes had higher overall reproductive performance than either of the other two groups. Ewes with two ovulations had a significantly higher conception rate than ewes with single ovulations. Gestation period was exceptionally uniform with a coefficient of variation of 1.3% and little difference due either to line or litter size. It was concluded that selection for multiple births improved overall reproductive performance, whereas selection for increased growth rate had an adverse effect on several components of reproduction, leading to a net decline in fitness.

Animals↗
PubMed2002

Non-invasive amino acid turnover predicts human embryo developmental capacity.

BACKGROUND: IVF is limited by low success rates and a confounding high multiple birth rate contributing to prematurity, increased neonatal mortality and child handicap. These problems could be overcome if single embryos of known developmental competence could be selected for transfer on day 2/3 of development, but current methods, which rely on morphological appearance, are poor predictors of viability. METHODS: We have measured non-invasively the depletion/appearance (i.e. turnover) of a physiological mixture of 18 amino acids by single human embryos during in-vitro culture using high performance liquid chromatography. RESULTS: From the time of transfer (day 2/3), embryos with future competence to develop to the blastocyst stage (day 5/6) exhibit amino acid flux patterns distinct from those of embryos with similar morphological appearance which arrest. Significantly, the profiles of Ala, Arg, Gln, Met and Asn flux predict blastocyst potentiality at >95%. The amino acid most consistently depleted throughout development by those embryos which form blastocysts was leucine. Of the amino acids which were produced, the most striking was alanine, which appeared in increasing amounts throughout development. CONCLUSIONS: Non-invasive amino acid profiling has the potential to select developmentally competent single embryos for transfer, thereby increasing the success rate and eliminating multiple births in IVF.

Amino Acids↗
PubMed2001

Predictive value of human chorionic gonadotrophin beta-hCG in early pregnancy after assisted conception.

OBJECTIVE: This study was designed to evaluate the predictive value of beta-hCG levels in predicting the pregnancy outcome. METHODS: A retrospective analysis was done on 423 pregnant patients following assisted conception (stimulated in vitro fertilization [SIVF] and stimulated intra uterine insemination [SIUI]). These were monitored with plasma beta-hCG on day +18 post hCG injection. Ongoing pregnancy was defined as greater than 20 weeks. RESULTS: Four hundred twenty three patients had a positive serum quantitative beta-hCG level 18 days post hCG injection. Of these 321 (75.9%) were ongoing pregnancies. The spontaneous miscarriages were 98 (23.2%), and four ectopic pregnancies were recorded. Of the successful pregnancies, 279 were single births, and 42 were multiple births (15.1%), that is either twins (31) or triplets (11). Tables were calculated to help predicting the pregnancy outcome. CONCLUSIONS: It can be shown that +18 levels of beta-hCG in cases of assisted conception are useful and provide predictive information concerning pregnancy outcome which should be helpful for the staff and the infertility patients.

Abortion, Spontaneous↗
PubMed1980

Multiple birth-risk factors and handedness in elementary school children.

The relationships between a set of birth-risk factors, i.e., sex, parity, and maternal age, and handedness were computed for 600 elementary school children. None of these birth-risk variables (or relevant combinations of them) were significantly related to handedness. These data further question the validity of the hypothesis that left-handedness results from stressful prenatal and birth conditions.

Adult↗
PubMed1997

Cell death and birth in multiple sclerosis brain.

The hallmark of the brain pathology in multiple sclerosis is the white matter plaque, characterized by myelin destruction and oligodendrocyte loss. To examine the role that cell death plays in the development of MS lesions, we used the in situ TUNEL technique, a method that sensitively detects DNA fragmentation associated with death at the single cell level. We found that patchy areas within acute MS lesions have massive numbers of inflammatory and glial cells undergoing cell death. The punched out areas of some long-standing chronic lesions also had labeled glial cells showing that the attack was not a single event. Immunocytochemical identification of the dying cells with glial specific marker co-labeling showed that 14-40% were the myelin-sustaining oligodendroglial cell. Confocal microscopic evaluation of fluorescein-labeled TUNEL positive cells revealed nuclei with morphologic characteristics of apoptosis, and electrophoresed MS brain DNA produced a ladder characteristic of apoptotic DNA cleavage confirming that substantial numbers of labeled cells, but not necessarily all, were dying by apoptotic mechanisms rather than cell necrosis. Companion studies using a marker for cell proliferation on MS lesions revealed that unexpectedly large populations of perivascular inflammatory cells and parenchymal glial cells had entered the cell proliferation cycle. These findings establish that two opposing glial cell responses - relentless cell death and coincident brisk cellular proliferation - are important features of MS pathology. In the end, however, glial cell loss prevails, and we suspect apoptosis may be the critical death mechanism responsible for the depletion of myelin observed in this condition.

Animals↗
PubMed2005

Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants.

OBJECTIVE: Compared with preterm formula (PF), mother's milk (MM) is associated with lower rates of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) among premature infants. Because not all mothers of premature infants produce sufficient milk to supply their infants throughout hospitalization, we reasoned that pasteurized donor human milk (DM) would be a suitable alternative. METHODS: Extremely premature infants (<30 weeks of gestation) whose mothers intended to breastfeed were assigned randomly to receive either pasteurized DM or PF if the supply of their own MM became insufficient during the study (birth to 90 days of age or hospital discharge). Infection-related events (LOS, NEC, meningitis, presumed sepsis, or urinary tract infection) that occurred after the attainment of a milk intake of 50 mL/kg, dietary intake, growth, skin-to-skin contact, and duration of hospital stay were compared. The primary analysis compared groups DM and PF on an intent-to-treat basis. If no differences were noted, then these groups were combined and compared with the reference group, group MM. If differences were noted, then the subsequent analyses compared each group with group MM. RESULTS: Of 243 infants, 70 (29%) received only MM; group DM included 81 infants and group PF included 92 infants. Because of poor weight gain, 17 infants (21%), all in group DM, were switched to PF. There were no differences in birth weight, gestational age, multiple births, and age at attainment of feeding of 50 mL/kg among groups. There were no differences between group DM and group PF in LOS and/or NEC, other infection-related events, hospital stay, or number of deaths. Group DM received a greater intake of milk and more nutritional supplements but had a slower rate of weight gain, compared with group PF. Compared with groups DM and PF, group MM had fewer episodes of LOS and/or NEC and total infection-related events and a shorter duration of hospital stay. Group MM also had fewer Gram-negative organisms isolated from blood cultures than did the other groups. CONCLUSIONS: In this randomized, blinded trial of feeding of extremely premature infants, we found that, as a substitute for MM, DM offered little observed short-term advantage over PF for feeding extremely premature infants. Advantages to an exclusive diet of MM were observed in terms of fewer infection-related events and shorter hospital stays.

Double-Blind Method↗
PubMedDate not supplied

Increasing use of antenatal corticosteroid therapy between 1990 and 1993 in Vermont Oxford Network.

OBJECTIVE: The purpose of this study was to determine whether the frequency of antenatal corticosteroid treatment changed between 1990 and 1993 and to identify patient characteristics associated with the use of this treatment. STUDY DESIGN: A total of 17,335 infants born in the years 1990 to 1993 with birth weights of 1500 gm or less and gestational ages of 24 to 34 weeks who were cared for at one of the 94 institutions participating in the Vermont Oxford Network were included in the study. Ninety-one infants were excluded from analysis because of missing data, resulting in a final sample of 17,244 infants. RESULTS: The percentage of infants whose mothers received antenatal corticosteroid treatment increased steadily during the 4-year study period (19.3% in 1990, 24.8% in 1991, 28.6% in 1992, and 34.1% in 1993; p < 0.001 by chi square test for trend in proportions). The results of a logistic regression analysis indicated that increasing year of birth, inborn location of birth, prenatal care, and multiple birth were associated with an increased use of antenatal corticosteroid treatment; black race and small size for gestational age were associated with decreased use of the treatment. In 1993, the median percentage of infants at an individual institution whose mothers received antenatal corticosteroid treatment was 25%; 10% of institutions had percentages less than 7% and 10% had percentages higher than 60%. CONCLUSION: Although the use of antenatal corticosteroid treatment increased steadily during the study period, this treatment was still used infrequently at many institutions in 1993. Considerable improvements in outcomes for preterm infants can be achieved if the recommendations of the National Institutes of Health Consensus Development Panel regarding more widespread use of antenatal corticosteroid treatment are adopted by health professionals who provide medical care to pregnant women.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[The success of maternal feeding with very low birth weight premature infants, singletons and twins: a 10-year experience].

UNLABELLED: There are very few reports about the feasibility of maternal milk feeding in very low birthweight preterm infants (VLBW), especially in twins. Therefore we conducted a cohort retrospective study to evaluate the feeding patterns of the 226 VLBW discharged from our neonatal intensive care unit from 1987 to 1996. Their gestational age was 30 +/- 2.6 weeks, birthweight 1166 +/- 224 g and they were hospitalized for 67 +/- 37 days (means +/- 1 SD). Of the 226 VLBW 49% were males, 39% had birthweight below 10 degrees centile for gestational age and 56% were born to non-residents in our area. There were 181 single births and 45 (20%) multiple births, of which 16 from pregnancies with 3 or more fetuses. Of the total cases 22% were discharged feeding maternal milk (MM) exclusively and 21% on mixed-feeding, maternal + formula milk (FM). Percentages were respectively 23% and 18% for single newborns, 11% and 29% for twins. Singletons and twins were discharged on FM with comparable percentages (59 and 60%). With passing years we have noticed a significant increase (chi square for linear trend < 0.01) for maternal milk feeding. In the last 2 years 49% of singletons and 38% of twins were discharged on MM, 14% and 24% on MM + FM, and only 37% and 38% on FM only. Between singletons and twins there were no statistically significant differences as far as feeding at discharge is concerned. CONCLUSIONS: most mothers, if correctly informed and encouraged, are able to breast-feed, exclusively or partially, their VLBW offspring, including twins, in the first months of life.

Breast Feeding↗
PubMed1988

Extension of maternity leave.

In 1987, the period when prenatal maternity allowance is paid in Finland was extended from 25 to 30 days. The total period when maternity allowance is paid is now 263 days. In 1988, the period when maternity allowance is paid was extended another 60 days in the case of multiple births.

Demography↗