Problemi speciali
I gemelli: eterogeneità clinica e approccio multidisciplinare
TWINS: CLINICAL HETEROGENEITY AND MULTIDISCIPLINARY APPROACH
E. Piro, G. Corsello
Dipartimento Materno-Infantile, Università di Palermo
Giugno 2008 - pagg. 375 -380
Abstract
The incidence of multiple pregnancy has increased during the last 15 years, particularly
in relation to the advances in assisted reproductive technologies. Twins are conceived in
about 1 in 80 pregnancies. Multiple gestations are high risk pregnancies, which may be
complicated by pre-eclampsia, anemia, postpartum hemorrhage, pre-maturity, intrauterine
growth restriction (IUGR), small for gestational age (SGA) newborn, neonatal morbidity
and high perinatal, neonatal and infant mortality. Main complication is the twin-to-twin transfusion
syndrome (TTTS) in monochorionic twin gestations; it is associated to high perinatal
mortality and increased neurological, cardiovascular and renal dysfunctions or defects. An accurate long-term developmental surveillance program is particularly indicated
for at-risk twins.
Parole chiave
Suggerite dall'AI
Bibliografia
1. Anand D, Platt MJ, Pharoah PO. Comparative
development of surviving co-twins of vanishing
twin conceptions, twins and singletons.
Twin Res Hum Genet 2007;10:210-5.
2. ART (Assisted Reproductive Technology) fact sheet dell’Eshre (European Society of Human Reproduction and Embriology), 2006.
3. Rustico MA, Baietti MG, Coviello D, Orlandi E, Nicolini U. Managing twins discordant for fetal anomaly. Prenat Diagn 2005;25:766- 71.
4. Spitz L. Conjoined twins. Prenat Diagn 2005;25:814-9.
5. Anand D, Platt MJ, Pharoah PO. Vanishing twin: a possible cause of cerebral impairment. Twin Res Hum Genet 2007;10:202-9.
6. Goldman JC, D’Alton ME, Berkowitz RL. Prenatal Diagnosis and Multiple Pregnancy. Seminars in Perinatology 2005; 29:312-20.
7. Sperling L, Kiil C, Larsen LU, et al. Detection of chromosomal abnormalities, congenital abnormalities, and transfusion syndrome in twins. Ultrasound Obstet Gynecol 2007;29: 217-26.
8. Mastroiacovo P, Castilla EE, Arpino C, et al. Congenital malformations in twins: an international study. Am J Med Genet 1999;83:117- 24.
9. Zankl A, Brooks D, Bolthauser E, Largo R, Schinzel A. Natural history of twin disruption sequence. Am J Med Genet 2004;127:133-8.
10. Sebire NJ, Snijders RJM, Hughes K, Sepulveda W, Nicolaiedis KH. The hidden mortality of mono chorionic twin pregnancies. Br J Obstet Gynaecol 1997;104:1203-7.
11. Galea P, Jain V, Fisk NM. Insights into the pathophysiology of twin-twin transfusion syndrome. Prenat Diagn 2005;25:777-85.
12. Urig MA, Clewell WH, Elliot JP. Twin-twin transfusion syndrome. Am J Obstet Gynecol 1990;163:1522-6.
13. Lougheed J, Sinclair BG, Fung Kee Fung K. Acquired right ventricular outflow tract obstruction in the recipient twin in twin-twin transfusion syndrome. J Am Coll Cardiol 2001; 38:1533-8.
14. Chescheir NC. Twin-to-twin transfusion syndrome: a model for the fetal origins of adult health. Paediatr Perinat Epidemiol 2005; 19S:32-6.
15. Simpson LL, Marx GR, Elkadry EA, D’Alton ME. Cardiac dysfunction in twin-twin transfusion syndrome: a prospective longitudinal study. Obstet Gynecol 1992;92:557-62.
16. Ash K, Murdison K, McLean D. Hypertrophic cardiomyopathy in twin-twin transfusion syndrome. Am J Obstet Gynecol 1995; 172S:350.
17. Delsing B, Lopriore E, Blom N, Te Pas AB, Vandenbussche FP, Walther FJ. Risk of persistent pulmonary hypertension of the neonate in twin-to-twin transfusion syndrome. Neonatology 2007;92:134-8.
18. Quintero RA, Dickinson JE, Morales WJ, et al. Stage-based treatment in twin-twin transfusion syndrome. Am J Obstet Gynecol 2003; 188:1333-40.
19. Karageyim Karsidag AY, Kars B, et al. Brain damage to the survivor within 30 min of co-twin demise in monochorionic twins. Fetal Diagn Ther 2005;20:91-5.
20. Corona-Rivera J, Corona-Rivera E, Romero- Velarde E, Hernandez-Rocha J, Bobadilla-Morales L, Corona-Rivera A. Report and review of the fetal brain disruption sequence. Eur J Pediat 2001;160:664-7.
21. Robyr R, Quadrello E, Ville Y. Management of fetal transfusion syndrome. Pren Diagn 2005;25:786-95.
22. Kline-Fath BM, Calvo-Garcia MA, O’Hara SM, Crombleholme TM, Racadio JM. Twintwin transfusion syndrome: cerebral ischemia is not the only fetal MR imaging finding. Pediatr Radiol 2007;37:45-7.
23. Wee LY, Taylor MJO, Wanderheyden T, Wimalasundera R, Gardiner HM, Fisk NM. Reversal of twin-twin transfusion syndrome: frequency, vascular anatomy, associated anomalies and outcome. Prenat Diagn 2004;24: 104-10.
24. Seen S, Esen UI, Sturgiss SN. Twin reversed arterial perfusion (TRAP) syndrome. Int J Clin Pract 2002;56:818-9.
25. Loos RJF, Derom C, Derom R, Vietnick R. Determinants of birthweight and intrauterine growth in liveborn twins. Paediatr Perinat Epidemiol 2005;19:15-22.
26. Acosta-Rojas R, Becker J, Munoz-Abellana B, Ruiz C, Carreras E, Gratacos E; Catalunya and Balears Monochorionic Network. Twin chorionicity and the risk of adverse perinatal outcome. Int J Gynaecol Obstet 2007;96:98- 102.
27. Ong SS, Zamora J, Khan KS, Kilby MD. Prognosis for the co-twin following single-twin death: a systematic review. BJOG 2006;113: 992-8.
28. Banek CS, Hecher K, Hackeloer BJ, Bartmann P. Long-term neurodevelopmental outcome after intrauterine laser treatment for severe twin-twin transfusion syndrome. Am J Ostet Gynecol 2003;188:876-80.
29. Hikino S, Ohga S, Kanda T, et al. Longterm outcome of infants with twin-to-twin transfusion syndrome. Fetal Diagn Ther 2007;22: 68-74.
30. Yokoyama Y, Wada S, Sugimoto M, Saito M, Matsubara M, Sono J. Comparison of motor development between twins and singleton in Japan: a population-based study. Twin Res Hum Genet 2007;10:379-84.
31. Piro E. Lo Screening di Sviluppo. Atti del I Convegno “La Pediatria dello Sviluppo e del Comportamento”. Napoli, 22-24 novembre 2007; in corso di stampa.
32. Einaudi MA, Busuttil M, Monnier AS, Chanus I, Palix C, Gire C. Neuropsychological screening of a group of preterm twins: comparison with singletons. Childs Nerv Syst 2007; in corso di stampa.
33. Iannone G, Tripaldi C, Chindemi A, et al. Long-term neuropsychological outcome in preterm twins. Scientific World Journal 2006; 6:899-907.
34. AAP Policy Statement: Identifying Infants and Young Children With Developmental Disorders in the Medical Home: an Algorithm for Developmental Surveillance and Screening. Pediatrics 2006;118:405-20.
2. ART (Assisted Reproductive Technology) fact sheet dell’Eshre (European Society of Human Reproduction and Embriology), 2006.
3. Rustico MA, Baietti MG, Coviello D, Orlandi E, Nicolini U. Managing twins discordant for fetal anomaly. Prenat Diagn 2005;25:766- 71.
4. Spitz L. Conjoined twins. Prenat Diagn 2005;25:814-9.
5. Anand D, Platt MJ, Pharoah PO. Vanishing twin: a possible cause of cerebral impairment. Twin Res Hum Genet 2007;10:202-9.
6. Goldman JC, D’Alton ME, Berkowitz RL. Prenatal Diagnosis and Multiple Pregnancy. Seminars in Perinatology 2005; 29:312-20.
7. Sperling L, Kiil C, Larsen LU, et al. Detection of chromosomal abnormalities, congenital abnormalities, and transfusion syndrome in twins. Ultrasound Obstet Gynecol 2007;29: 217-26.
8. Mastroiacovo P, Castilla EE, Arpino C, et al. Congenital malformations in twins: an international study. Am J Med Genet 1999;83:117- 24.
9. Zankl A, Brooks D, Bolthauser E, Largo R, Schinzel A. Natural history of twin disruption sequence. Am J Med Genet 2004;127:133-8.
10. Sebire NJ, Snijders RJM, Hughes K, Sepulveda W, Nicolaiedis KH. The hidden mortality of mono chorionic twin pregnancies. Br J Obstet Gynaecol 1997;104:1203-7.
11. Galea P, Jain V, Fisk NM. Insights into the pathophysiology of twin-twin transfusion syndrome. Prenat Diagn 2005;25:777-85.
12. Urig MA, Clewell WH, Elliot JP. Twin-twin transfusion syndrome. Am J Obstet Gynecol 1990;163:1522-6.
13. Lougheed J, Sinclair BG, Fung Kee Fung K. Acquired right ventricular outflow tract obstruction in the recipient twin in twin-twin transfusion syndrome. J Am Coll Cardiol 2001; 38:1533-8.
14. Chescheir NC. Twin-to-twin transfusion syndrome: a model for the fetal origins of adult health. Paediatr Perinat Epidemiol 2005; 19S:32-6.
15. Simpson LL, Marx GR, Elkadry EA, D’Alton ME. Cardiac dysfunction in twin-twin transfusion syndrome: a prospective longitudinal study. Obstet Gynecol 1992;92:557-62.
16. Ash K, Murdison K, McLean D. Hypertrophic cardiomyopathy in twin-twin transfusion syndrome. Am J Obstet Gynecol 1995; 172S:350.
17. Delsing B, Lopriore E, Blom N, Te Pas AB, Vandenbussche FP, Walther FJ. Risk of persistent pulmonary hypertension of the neonate in twin-to-twin transfusion syndrome. Neonatology 2007;92:134-8.
18. Quintero RA, Dickinson JE, Morales WJ, et al. Stage-based treatment in twin-twin transfusion syndrome. Am J Obstet Gynecol 2003; 188:1333-40.
19. Karageyim Karsidag AY, Kars B, et al. Brain damage to the survivor within 30 min of co-twin demise in monochorionic twins. Fetal Diagn Ther 2005;20:91-5.
20. Corona-Rivera J, Corona-Rivera E, Romero- Velarde E, Hernandez-Rocha J, Bobadilla-Morales L, Corona-Rivera A. Report and review of the fetal brain disruption sequence. Eur J Pediat 2001;160:664-7.
21. Robyr R, Quadrello E, Ville Y. Management of fetal transfusion syndrome. Pren Diagn 2005;25:786-95.
22. Kline-Fath BM, Calvo-Garcia MA, O’Hara SM, Crombleholme TM, Racadio JM. Twintwin transfusion syndrome: cerebral ischemia is not the only fetal MR imaging finding. Pediatr Radiol 2007;37:45-7.
23. Wee LY, Taylor MJO, Wanderheyden T, Wimalasundera R, Gardiner HM, Fisk NM. Reversal of twin-twin transfusion syndrome: frequency, vascular anatomy, associated anomalies and outcome. Prenat Diagn 2004;24: 104-10.
24. Seen S, Esen UI, Sturgiss SN. Twin reversed arterial perfusion (TRAP) syndrome. Int J Clin Pract 2002;56:818-9.
25. Loos RJF, Derom C, Derom R, Vietnick R. Determinants of birthweight and intrauterine growth in liveborn twins. Paediatr Perinat Epidemiol 2005;19:15-22.
26. Acosta-Rojas R, Becker J, Munoz-Abellana B, Ruiz C, Carreras E, Gratacos E; Catalunya and Balears Monochorionic Network. Twin chorionicity and the risk of adverse perinatal outcome. Int J Gynaecol Obstet 2007;96:98- 102.
27. Ong SS, Zamora J, Khan KS, Kilby MD. Prognosis for the co-twin following single-twin death: a systematic review. BJOG 2006;113: 992-8.
28. Banek CS, Hecher K, Hackeloer BJ, Bartmann P. Long-term neurodevelopmental outcome after intrauterine laser treatment for severe twin-twin transfusion syndrome. Am J Ostet Gynecol 2003;188:876-80.
29. Hikino S, Ohga S, Kanda T, et al. Longterm outcome of infants with twin-to-twin transfusion syndrome. Fetal Diagn Ther 2007;22: 68-74.
30. Yokoyama Y, Wada S, Sugimoto M, Saito M, Matsubara M, Sono J. Comparison of motor development between twins and singleton in Japan: a population-based study. Twin Res Hum Genet 2007;10:379-84.
31. Piro E. Lo Screening di Sviluppo. Atti del I Convegno “La Pediatria dello Sviluppo e del Comportamento”. Napoli, 22-24 novembre 2007; in corso di stampa.
32. Einaudi MA, Busuttil M, Monnier AS, Chanus I, Palix C, Gire C. Neuropsychological screening of a group of preterm twins: comparison with singletons. Childs Nerv Syst 2007; in corso di stampa.
33. Iannone G, Tripaldi C, Chindemi A, et al. Long-term neuropsychological outcome in preterm twins. Scientific World Journal 2006; 6:899-907.
34. AAP Policy Statement: Identifying Infants and Young Children With Developmental Disorders in the Medical Home: an Algorithm for Developmental Surveillance and Screening. Pediatrics 2006;118:405-20.
Corrispondenza: giocors@aliceposta.it