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Tytuł:
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The Effect of Chorionicity on Maternal Cardiac Adaptation to Uncomplicated Twin Pregnancy: A Prospective Longitudinal Study.
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Autorzy:
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Ghi T; Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy, .
Dall'Asta A; Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy.
Franchi L; Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy.
Fieni S; Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy.
Gaibazzi N; Cardiology Unit, University Hospital of Parma, Parma, Italy.
Siniscalchi C; Cardiology Unit, University Hospital of Parma, Parma, Italy.
Pedrazzi G; Department of Neurosciences, University of Parma, Parma, Italy.
Montaguti E; Department of Obstetrics and Gynaecology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Degli Esposti D; Department of Internal Medicine, Aging, and Kidney Diseases, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Carpano MG; Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy.
Suprani A; Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy.
Orabona R; Department of Obstetrics and Gynaecology, Maternal-Fetal Medicine Unit, University of Brescia, Brescia, Italy.
Prefumo F; Department of Obstetrics and Gynaecology, Maternal-Fetal Medicine Unit, University of Brescia, Brescia, Italy.
Vizzardi E; Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Cardiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Bonadei I; Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Cardiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Sciatti E; Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Cardiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Borghi C; Department of Internal Medicine, Aging, and Kidney Diseases, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Frusca T; Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy.
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Źródło:
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Fetal diagnosis and therapy [Fetal Diagn Ther] 2019; Vol. 45 (6), pp. 394-402. Date of Electronic Publication: 2018 Aug 17.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Basel ; New York : S. Karger, 1991-
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MeSH Terms:
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Maternal Health*
Pregnancy/*physiology
Pregnancy, Twin/*physiology
Adult ; Chorion/anatomy & histology ; Chorion/physiology ; Diastole ; Echocardiography ; Female ; Humans ; Longitudinal Studies ; Stroke Volume
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Contributed Indexing:
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Keywords: Chorionicity; Diastolic function; Maternal echocardiography; Maternal haemodynamics; Placenta; Twin pregnancy
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Entry Date(s):
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Date Created: 20180820 Date Completed: 20200106 Latest Revision: 20200106
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Update Code:
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20240104
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DOI:
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10.1159/000490462
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PMID:
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30121656
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Objective: The objective of this study was to longitudinally evaluate maternal echocardiographic findings in uncomplicated twin gestations according to chorionicity.
Methods: Healthy women with twin pregnancy were assessed with transthoracic echocardiography across the first, second, and third trimesters. Cardiac findings were compared within each group and between monochorionic (MC) and dicho-rionic (DC) pregnancies.
Results: Overall, 19 MC and 48 DC uncomplicated twin pregnancies were included. In the MC group, no significant maternal haemodynamic changes were documented across gestation, with the exception of a decrease in ejection fraction. Compared to DC pregnancies, in the MC set lower cardiac output (second and third trimester, p = 0.001 and p = 0.006, respectively) and higher total vascular resistance (first trimester, p = 0.032) were observed. Regarding the diastolic function in MC twins, significantly higher values were observed for mitral E/A ratio (third trimester, p = 0.014), septal mitral E1/A1 ratio (third trimester, p = 0.030), lateral mitral E1 (second and third trimester, p = 0.014 and p = 0.029, respectively), and E1/A1 ratio (third trimester, p = 0.006).
Conclusions: Maternal cardiac adaptation in twin pregnancy seems to differ significantly according to chorionicity. In particular, in MC pregnancies the impairment of diastolic function is less pronounced, presumably due to the lower circulating volume.
(© 2018 S. Karger AG, Basel.)
