European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · May 2011
Review Practice GuidelineTwin pregnancies: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF).
The rate of twin deliveries in 2008 was 15.6 per 1000 in France, an increase of approximately 80% since the beginning of the 1970s. It is recommended that chorionicity be diagnosed as early as possible in twin pregnancies (Professional Consensus). The most relevant signs (close to 100%) are the number of gestational sacs between 7 and 10 weeks and the presence of a lambda sign between 11 and 14 weeks (Professional Consensus). ⋯ Active management of the delivery of the second twin is recommended to reduce the interval between the births of the two twins (Level C). In the case of non-cephalic presentation, total breech extraction, preceded by internal version manoeuvres if the twin's position is transverse, is associated with the lowest cesarean rates for second twins (Level C). In the case of high and not yet engaged cephalic presentation and if the team is appropriately trained, version by internal manoeuvres followed by total breech extraction is to be preferred to a combination of resumption of pushing, oxytocin perfusion, and artificial rupture of the membranes, because the former strategy appears to be associated with fewer cesareans for the second twin (Level C).
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Eur. J. Obstet. Gynecol. Reprod. Biol. · May 2011
Comparative StudyRecurrent versus isolated pre-eclampsia and risk of feto-infant morbidity outcomes: racial/ethnic disparity.
We examined the association between recurrent versus isolated pre-eclampsia and feto-infant morbidity outcomes. ⋯ Pre-eclampsia is very severe when it recurs and black women are affected more than white or Hispanic women.