morphine and Diseases-in-Twins

Intrapartum asphyxia is increased in several situations such as intrauterine growth retardation, preterm labor, postdate pregnancy or maternal diabetes. In all these cases, fetal heart rate monitoring should be preferred to intermittent auscultation. Fetal scalp blood pH or lactates can be used to identify fetuses at risk of intrapartum asphyxia. However, fetal scalp blood sampling should not delay delivery in case of severe abnormal fetal heart rate as fetal asphyxia could occur rapidly in theses high-risk pregnancies. Data is insufficient to recommend fetal pulse oximetry or ECG analysis. Research should be undertaken to evaluate their performance in these situations.

Topics: Diseases in Twins; Female; Fetal Blood; Fetal Growth Retardation; Fetal Hypoxia; Fetal Monitoring; Heart Rate, Fetal; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Labor, Obstetric; Lactates; Meconium; Obstetric Labor, Premature; Pregnancy; Pregnancy in Diabetics; Pregnancy, High-Risk; Pregnancy, Prolonged; Scalp

The authors report a case of isolated imperforate anus with perineal fistula in monozygotic twins. Only 4 other well-documented cases of monozygotic twins concordant for isolated anorectal malformation have been reported in the literature. In all these cases the defect occurred below the levator ani muscle. This case confirms previous reports on the incidence of low anorectal anomalies in monozygotic twins where the defect was isolated. A review of the literature relating to this condition in twins and siblings points toward low anomalies and more severe malformations having different genetic backgrounds.

Topics: Adult; Anal Canal; Anus, Imperforate; Cutaneous Fistula; Diseases in Twins; Female; Humans; Male; Meconium; Perineum; Pregnancy; Rectal Fistula; Twins, Monozygotic

In term newborns meconium ileus is frequently associated with cystic fibrosis. Reports on meconium ileus in preterm infants being diagnosed with cystic fibrosis early after birth are very scarce. Associations between genotype and phenotype in cystic fibrosis and its particular comorbidities have been reported.. Two extremely preterm twin infants (26 weeks of gestation) born from a Malaysian mother and a Caucasian father were presented with typical signs of meconium ileus. Despite immediate surgery both displayed a unique and finally lethal course. Mutation analysis revealed a novel, probably pathogenic cystic fibrosis mutation, p.Cys524Tyr. The novel mutation might explain the severity of disease next to typical sequelae of prematurity.. Preterm neonates with meconium ileus have to be evaluated for cystic fibrosis beyond ethnical boundaries, but may take devastating clinical courses despite early treatment. The novel, potentially pathogenic CF mutation p.Cys524Tyr might be associated with severe meconium ileus in neonates. Disease-modifying loci are important targets for intestinal comorbidity of cystic fibrosis.

Topics: Cystic Fibrosis; Cystic Fibrosis Transmembrane Conductance Regulator; Diseases in Twins; Fatal Outcome; Humans; Ileus; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Male; Meconium; Mutation

Cystic fibrosis (CF) is an autosomal recessive disease caused by a mutation in the CFTR gene, resulting in an alteration of a protein involved in sodium and chloride transport in the apical plasma membrane of epithelial cells in respiratory and intestinal tracts. It primarily presents respiratory compromise, affecting other systems in different ways. Meconium ileus is a gastrointestinal manifestation that occurs in 10-20% of patients, which is not entirely attributable to a specific CFTR mutation.. To report a case of monozygotic twins diagnosed with CF (F508) in whom phenotypic variation is evident based on the expression of meconium ileus, showing that there are external modifiers in the development of this complication.. monoamniotic monochorionic twin pregnancy which resulted in preterm births. One of the patient presented meconium ileus at birth leading to CF suspicion and establishing the diagnosis by (F508/F508) molecular analysis in both twins.. Phenotypic variability in these twins supports the hypothesis proposed by different authors that there are other gene expression-modulation factors of the disease as well as environmental modifiers that must be taken into account when dealing with this disease.

Topics: Cystic Fibrosis; Cystic Fibrosis Transmembrane Conductance Regulator; Diseases in Twins; Humans; Ileus; Infant, Newborn; Male; Meconium; Mutation; Phenotype; Twins, Monozygotic

Intrauterine intussusception with a leading point of Meckel's diverticulum is a rare cause of ileal atresia, which may cause bowel obstruction and perforation. We report such a case complicated by meconium peritonitis. The fetal ultrasonogram revealed ascites, dilated bowel loops and intra-abdominal calcification at a gestational age of 30 weeks. The patient was delivered at 37 weeks and laparotomy was performed to manage the intestinal obstruction. The operative findings showed that Meckel's diverticulum had induced intussusception associated with the ileal atresia with meconium peritonitis. The ileum was resected with end-to-end anastomosis. The postoperative course was uneventful. In this patient, ascites and intraperitoneal calcification were caused by ileal atresia, which may have been induced by intrauterine intussusception.

Topics: Diseases in Twins; Female; Fetal Diseases; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Intussusception; Meckel Diverticulum; Meconium; Peritonitis; Ultrasonography

Enterolithiasis (multiple calcifications of intraluminal meconium) is a rare, prenatal ultrasonographic finding. In this study, our aim was to evaluate the prenatal diagnostic features and discuss the management of the patients.. The data of two cases of prenatally diagnosed fetal enterolithiasis were collected from ultrasound scan, magnetic resonance imaging (MRI) and neonatal or postnatal autopsy records. The findings were evaluated in both prenatal and postnatal periods. Chromosomal analysis was performed in one case. An evaluation of primary and secondary malformations was done. Coexisting anomalies were searched for via radiology, neonatal surgery and histopathology.. Malformations in two cases (both males) with partial and complete urorectal septum malformation (URSM) sequence were described. The absence of an anal opening and presence of a fistula between the urinary and gastrointestinal tract were common findings. These features were considered as primary malformations contributing to the formation of enterolithiasis. Secondary anomalies (urinary and gastrointestinal system malformations, pulmonary hypoplasia, genital and other coexisting anomalies) were evaluated.. The prenatal detection of enterolithiasis carries a poor prognosis. Most of the previously reported cases were invariably associated with major fetal malformations of the urinary and gastrointestinal tract. It is a warning sign for large bowel obstruction with or without enterourinary fistula. Therefore, adequate gastrointestinal and urologic studies must be undertaken after birth for the final diagnosis. There is a high mortality rate in the reported cases, mostly attributed to associated anomalies, and all survivors required neonatal surgery. It is important to differentiate the partial from the full URSM sequence because the prognosis in the partial URSM sequence is generally good, with long-term survival being common.

Topics: Adult; Calcinosis; Diseases in Twins; Female; Fetal Diseases; Humans; Intestinal Diseases; Intestines; Magnetic Resonance Imaging; Male; Meconium; Oligohydramnios; Pregnancy; Prenatal Diagnosis; Rectum; Ultrasonography, Prenatal; Urinary Tract

Meconium peritonitis occurring in pregnancies following artificial reproductive techniques (ART) is rare. We report the first case of meconium peritonitis following intracytoplasmic sperm injection (ICSI).. A 37-year-old woman attended our in vitro fertilization (IVF) program because her husband suffered from hypospermatogenetic azoospermia due to cancer surgery and radiotherapy. The patient achieved a twin pregnancy through ICSI from testicular sperm extraction at our IVF center. Meconium peritonitis, fetal ascites, polyhydramnios, bowel dilatation, hydrocele and intraabdominal calcification were noted in one of the twins on ultrasound at 30 weeks' gestation. Cesarean section due to breech presentation in labor was performed at 36 weeks' gestation. A normal female and male infant with a distended abdomen were delivered. Emergency laparotomy was performed on the male twin because of dyspnea. A 0.2-cm perforation was found in the terminal ileum. Ileotomy was performed and closed after 27 days.. Prenatal diagnosis of meconium peritonitis is possible through careful ultrasonographic examination, and early surgical intervention and intensive postoperative support are required to improve the prognosis.

Topics: Adult; Breech Presentation; Cesarean Section; Diseases in Twins; Female; Humans; Ileum; Infant, Newborn; Intestinal Perforation; Male; Meconium; Oligospermia; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Prognosis; Sperm Injections, Intracytoplasmic; Ultrasonography, Prenatal

A case of twin-to-twin transfusion syndrome with intrauterine death of one twin and meconium peritonitis and intravascular disseminated coagulation in the other twin is reported. Meconium peritonitis follows to bowel perforation, caused by segmental severe hypoplasia of muscular layer. The Authors suggest that this structural alteration of bowel wall could be an expression of inequal distribution of some cells between the two twins, during embrional development.

Topics: Adult; Colon; Colonic Diseases; Diseases in Twins; Disseminated Intravascular Coagulation; Fatal Outcome; Female; Fetal Death; Fetal Diseases; Fetofetal Transfusion; Hemoperitoneum; Humans; Ileal Diseases; Ileum; Immunoenzyme Techniques; Infant, Newborn; Intestinal Perforation; Meconium; Muscle, Smooth; Peritonitis; Polyhydramnios; Postoperative Complications; Pregnancy; Twins, Monozygotic

Topics: Adult; Cystic Fibrosis; Diseases in Twins; Enterostomy; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Intestinal Obstruction; Meconium; Pregnancy; Radiography

Topics: Adult; Cystic Fibrosis; Diseases in Twins; Female; Humans; Intestinal Obstruction; Intestine, Small; Male; Meconium; Pregnancy; Pregnancy Trimester, Third; Prenatal Diagnosis; Twins, Monozygotic; Ultrasonography

Topics: Brain Diseases; Candidiasis; Cerebral Aqueduct; Diseases in Twins; Female; Humans; Infant, Newborn; Meconium; Meningitis; Parenteral Nutrition; Peritonitis

Topics: Adult; Amniotic Fluid; Bilirubin; Colon; Diseases in Twins; Erythroblastosis, Fetal; Female; Humans; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis

Topics: Adult; Diseases in Twins; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Radiography

Topics: Apgar Score; Diseases in Twins; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Radiography

Topics: Adolescent; Adult; Child; Child, Preschool; Cystic Fibrosis; Diseases in Twins; Female; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Life Expectancy; Longitudinal Studies; Male; Meconium; Pregnancy; Racial Groups; Registries; Sex Factors; Twins, Dizygotic; Twins, Monozygotic; United States

Topics: Cystic Fibrosis; Diseases in Twins; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Intestinal Atresia; Intestine, Small; Male; Meconium; Peritonitis