Placental Characteristics Within Monochorionic Twin Pregnancies: a Prospective Cohort Study.
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 65
- 试验地点
- 1
- 主要终点
- What is the impact of intertwin vascular anastomoses on fetal complications and perinatal outcome
研究概览
简要总结
This prospective study aims to collate a comprehensive database of all main monochorionic twin groups to enable comparisons to be made within each twin group and additionally between each group with regards to several placental characteristics, whilst understanding their impact on several fetal outcomes. This study aims to provide new insights in to how the placental architecture influences pregnancy care within the UK pregnancy cohort. Results of this study may impact how clinicians conduct antenatal surveillance for these anatomical placental factors.
Patients of both uncomplicated and complication monochorionic twin groups will be consented at a single site and recruited during the antenatal period. Following delivery the placenta will then be analysed macroscopically and assessed for several anatomical features. This will be compared with the antenatal complications and perinatal outcomes for the respective twin.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •All consecutive placentas of monochorionic twin pregnancies whereby the placenta is transferred to the pathology department for analysis.
排除标准
- •Singleton, dichorionic and higher order pregnancies (e.g. triplet).
- •Fetus with known major congenital anomalies or aneuploidy
结局指标
主要结局
What is the impact of intertwin vascular anastomoses on fetal complications and perinatal outcome
时间窗: Throughout the study period (approximately 2 years)
To determine the prevalence of intertwin vascular anastomoses (overall, artery-artery, artery-vein, vein-vein) on adverse perinatal outcome (e.g. stillbirth and neonatal death) and fetal complications (e.g. small for gestational age). Measures will be as overall percentages and also raw numbers which will be calculated in to odds ratio's when comparing anastomoses versus no anastomoses against the respective perinatal outcome and fetal complication
What is the impact of twin placental sharing on fetal complications and perinatal outcome
时间窗: Throughout the study period (approximately 2 years)
To determine the impact of placental sharing between each twin on adverse perinatal outcome (e.g. stillbirth and neonatal death) and fetal complications (e.g. birthweight discordance and selective growth restriction). Placental sharing will be defined as a percentage of overall share between each twin which sums up to 100%. The difference between each twin's share will be determine by minimising the larger percentage from the smaller percentage. The difference will then be compared to adverse perinatal outcomes and complications such as selective growth restriction using odds ratio's. Birthweight discordance will be defined as a percentage ( difference between the larger twin weight and smaller twin weight, divided by the larger twin weight). This will be compared to placental sharing using a graphical comparison of all placental sharing results, individually compared against each respective birthweight discordance.
What is the impact of abnormal cord insertion on fetal complications and perinatal perinatal outcome
时间窗: Throughout the study period (approximately 2 years
To determine the prevalence of abnormal cord insertion (marginal and velamentous) on adverse perinatal outcome (e.g. stillbirth and neonatal death) and fetal complications (e.g. small for gestational age, selective growth restriction). Measures will be as overall percentages and also raw numbers which will be calculated in to odds ratio's when comparing abnormal cord insertion versus normal cord insertion against the respective perinatal outcome and fetal complication
次要结局
- The influence of residual vascular anastomoses monochorionic twins complicated by twin-twin transfusion syndrome(Throughout the study period (approximately 2 years))
- Examine the relationship between placenta position during laser ablation for monochorionic twins complicated by twin-twin transfusion syndrome and the rate of residual anastomoses development.(Throughout the study period (approximately 2 years))
- The influence of abnormal cord insertion in monochorionic twins complicated by twin-twin transfusion syndrome(Throughout the study period (approximately 2 years))
- The influence of abnormal cord insertion on residual anastomoses development in monochorionic twins complicated by twin-twin transfusion syndrome undergoing laser ablation(Throughout the study period (approximately 2 years))
- Determine the frequency of intertwin anastomoses in monochorionic twin groups(Throughout the study period (approximately 2 years))
- Examine the association between Quintero staging during laser ablation for monochorionic twins complicated by twin-twin transfusion syndrome on residual anastomoses development(Throughout the study period (approximately 2 years))
- The influence of intertwin cord distance on fetal complications(Throughout the study period (approximately 2 years))
- Determine the frequency of abnormal cord insertion in monochorionic twin groups(Throughout the study period (approximately 2 years))
研究者
Jack Hamer
Clinical research fellow
Birmingham Women's NHS Foundation Trust