About one third of twin pregnancies are resulting from a single fertilized oocyte. Two third of these monozygotic twins share a common placenta and are therefore called monochorionic. Due to placental sharing and the ever-present inter-fetal vascular connections, specific complications may arise and lead to an increased risk of intrauterine death and long-term neurodevelopmental impairment. Specific complications include twin-to-twin transfusion syndrome (TTTS), twin-anemia-polycythemia sequence (TAPS), selective intrauterine growth restriction (sIUGR) and discordant major anomalies, occurring in about 10%, 5%, 20% and 6% of monochorionic diamniotic twins. Prenatal interventions may improve perinatal and long-term outcome of affected fetuses. However, general knowledge about early diagnosis of monochorionic twins and their specific complications is still limited in a significant number of practitioners in Austria and systematic analysis of pregnancy outcomes are not conducted. In this prospective multicenter registry study, the investigators aim to include all monochorionic pregnancies in Austria. Main outcome parameter is the occurrence of complications. Secondary outcomes are gestational age at occurrence of complications, gestational age delivery and neonatal outcome. The investigators also strive for long-term outcome, especially of infants following complicated pregnancies or preterm birth.
Study Type
OBSERVATIONAL
Enrollment
1,000
Medical University of Graz
Graz, Styria, Austria
RECRUITINGBrothers of Saint John of God Eisenstadt
Eisenstadt, Austria
RECRUITINGMedical University Innsbruck
Innsbruck, Austria
RECRUITINGKlinikum Klagenfurt am Wörthersee
Klagenfurt, Austria
RECRUITINGHospital Hochsteiermark
Leoben, Austria
RECRUITINGJohannes Kepler University of Linz
Linz, Austria
RECRUITINGMödling Hospital
Mödling, Austria
RECRUITINGParacelsus Medical University
Salzburg, Austria
RECRUITINGLandesklinikum Sankt Polten
Sankt Pölten, Austria
RECRUITINGMedical University Vienna
Vienna, Austria
RECRUITING...and 3 more locations
occurrence of specific complications
TTTS, sIUGR, TAPS, TRAP, IUFD, malformations, miscarriage
Time frame: from 12 weeks of gestation to delivery
gestational age at delivery
gestational age (weeks+days) at delivery
Time frame: at delivery
birth weight
birth weight in grams
Time frame: at first day of life
body length at birth
body length in cm
Time frame: at first day of life
umbilical artery pH-value
pH-Value derived from umbilical cord blood after birth
Time frame: immediately after birth
cord blood hemoglobin levels
hemoglobin levels derived from umbilical cord blood after birth
Time frame: immediately after birth
APGAR score
APGAR score 1, 5 and 10 min following delivery
Time frame: within 10 min after birth
neonatal complications
occurrence of neonatal complications including neonatal death, cerebral hemorrhage, periventricular leucomalacia, bronchopulmonary dysplasia, sepsis, retinopathy of the newborn, necrotizing enterocolitis, seizures
Time frame: within 1 month after birth
long-term outcome
Neurodevelopmental outcome should be performed at the corrected age of 2 years. If available, neurodevelopment will be assessed by using the Bayley Scales of Infant Development. In other cases the Bayleys or the Ages \& Stages Questionnaires may be used.
Time frame: 2 years of age
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