Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(4):247-251
DOI 10.1590/S0100-72032002000400006
Purpose: to compare cervical length measurements in twin pregnancies obtained by transvaginal ultrasound examination in the recumbent and standing positions. Methods: fifty twin pregnancies underwent transvaginal ultrasound examinations to measure the cervical length with the women in recumbent and standing positions. The study was carried out between May 1999 and December 2000. The scans were repeated every 4 weeks and the total number of evaluations was 136. Two groups were analyzed: one included only the first ultrasound examinations carried out in each woman and the second group included all evaluations. Results: in the first group, cervical length measurements in the standing and recumbent positions correlated inversely with the gestational age (recumbent: r=-0.60; p<0.001; standing: r=-0.46; p=0.008). The mean measure in the recumbent position was 35.2 mm (SD=9.9 mm) and 33.4 mm (SD=9.5 mm) in the standing position. When the difference between the measure obtained in the standing and recumbent positions was expressed as percentage of the measure in the recumbent position, there was no significant association with gestational age (p=0.07). When all evaluations were considered, there was a significant association between cervical length in the recumbent and standing positions (r=0.79; p<0.001). The measures in recumbent and standing positions were inversely correlated with gestational age (recumbent: p<0.0001; standing: p<0.0001). The mean cervical length in the recumbent position was 33.5 mm (SD=10.8 mm) and 31.8 mm (SD=9.6 mm) in the standing position. There was no significant association between cervical length difference expressed as percentage of the measure in the recumbent position and gestation. Conclusion: cervical length measure obtained with the patients in the recumbent and standing positions provided similar information.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):107-112
DOI 10.1590/S0100-72032002000200006
Purpose: to analyze the effects of prenatal and perinatal complications and the neurological development of surviving twins when the other had died in utero. Methods: fourteen cases of twin pregnancies where one of the twins had died during the pregnancy were analyzed. These patients gave birth between 1988 and 1994 and were subsequently followed-up by the Department of Obstetrics, Pathology Division, at the Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo. Data from prenatal and perinatal records as well as findings from the deceased twins' autopsies were analyzed. In 1996, requests were made for the children to have a neurological examination as part of the study. The examination included developmental assessment and pathological signs in the motor, sensory and sensitivy areas and superior cortical functions such as praxis and agnosia. Results: ten of the fourteen contacted subjects complied with the request for neurological examination. Of the ten examined children only one had abnormal neurological findings, presenting a light degree of spastic paresis of the left leg. The pregnancy evaluation showed five cases of monochorionic placenta and one case of monoamnionic pregnancy; six of the fourteen cases reached full-term. In six cases (42.8%) one of the fetus died during the second trimester and in the other they died during the third trimester. Only one newborn, who had Apgar 0 at the first minute, developed neurological sequelae. Conclusion: the neurological problem of one fetus may be a consequence of the perinatal complications that this fetus developed. The other newborns did not develop sequelae, possibly because of the conservatory management, trying to make the pregnancy reach 32 weeks or more, thus decreasing the complications of preterm delivery.