Embarazo múltiple: revisión no sistemática de la literatura
Resumen
Introducción: El embarazo múltiple se define como el desarrollo simultáneo de dos o más fetos en útero.
Cuerpo de la revisión: Su incidencia está estrechamente asociada los métodos de fertilización asistida y a la edad materna. Conlleva múltiples patologías asociadas, ya sea maternas o fetales donde el de mayor importancia es el parto pre-término.
Discusión: El correcto diagnóstico y un estrecho seguimiento del embarazo, asociadas a la decisión del momento y vía de parto son fundamentales para evitar eventuales complicaciones.
Palabras clave:
embarazo múltiple, cigosidad, corionicidadReferencias
(1) Martín JA, Hamilton BE, Ventura SJ, Osteman MJK, Kimeyer S, Mathews TJ, Wilson EC. Births: final data for 2009. Natl Vital Stat Rep. 2011; 60: 1.
(2) Nazer J, Aguila A, Cifuentes L. La frecuencia de nacimientos de gemelos aumentó en un hospital chileno coincidiendo con el consumo periconcepcional de harina fortificada con ácido fólico. Rev Méd Chile. 2006; 134: 48-52.
(3) Schieve LA, Devine O, Boyle CA, Petrini JR, Warner L. Estimation of the contribution of non-assisted reproductive technology ovulation stimulation fertility treatments to US singleton and multiple births. Am J Epidemiol 2009; 170: 1396.
(4) Practice Committee of American Society for Reproductive Medicine. Multiple gestation associated with infertility therapy: an American Society for Reproductive Medicine Practice Committee opinion. Fertil Steril. 2012; 97: 825.
(5) Ory SJ. The national epidemic of multiple pregnancy and the contribution of assisted reproductive technology. Fertil Steril. 2013; 100: 929.
(6) Lisonkova S, Joseph KS, Bell R, Glinianaia SV. Effect of advanced maternal age on perinatal outcomes in twins: the impact of chorionicity. Ann Epidemiol. 2013; 23: 428.
(7) Fox NS, Rebarber A, Dunham SM, Saltzman DH. Outcomes of multiple gestations with advanced maternal age. J Matern Fetal Neonatal Med. 2009; 22: 593.
(8) Hoekstra C, Zhao ZZ, Lambalk CB, Willemsen G, Martin NG, Boomsma DI, Montgomery GW. Dizygotic twinning. Hum Reprod Update. 2008; 14: 37.
(9) Moore RK, Erickson GF, Shimasaki S. Are BMP15 and GDF-9 primary determinants of ovulation quota in mammals? Trends Endocrinol Metab. 2004; 15: 356.
(10) Bulmer MG. The Biology of Twinning in Man. Oxford: Clarendon Press; 1970.
(11) Reddy UM, Branum AM, Klebanoff MA. Relationship of maternal body mass index and height to twinning. Obstet Gynecol. 2005; 105: 593.
(12) BarrettJ, Bocking A. The Society of Obstetricians and Gynaecologists of Canada. Consensus Statement: Management of Twin Pregnancies (Part 1). J Soc Obstet Gynaecol Can. 2000; 22(7): 519-29.
(13) Muñoz H, Urzúa S. Ultrasonografia en el Embarazo Multiple. En: Oyarzu E. Ultrasonografía en Obstetricia. Santiago de Chile: Editorial Mediterráneo; 2003.
(14) Dias T, Ladd S, Mahsud-Dornan S, Bhide A, Papageorghiou AT, Thilaganathan B. Systematic labeling of twin pregnancies on ultrasound. Ultrasound Obstet Gynecol. 2011 Aug; 38(2): 130-3.
(15) Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S. Births: final data for 2004. National vital statistics reports. Vol 55, Número 1. Hyattsville, MD: National Center for Health Statistics; 2006.
(16) Hasbún H, Complicaciones del embarazo gemelar. En: Selección de Temas en Gineco-Obstetricia. Capítulo 18. pp. 363-381.
(17) Sibai BM, Hauth J, Caritis S, Lindheimer MD, MacPherson C, Klebanoff M, VanDorsten JP, Landon M, Miodovnik M, Paul R, Meis P, Thurnau G, Dombrowski M, Roberts J, McNellis D. Hypertensive disorders in twin versus singleton gestations. Am J ObstetGynecol. 2000; 182: 938-942.
(18) Day MC, Barton JR, O'Brien JM, Istwan NB, Sibai BM. The effect of fetal number on the development of hypertensive conditions of pregnancy. Obstet Gynecol. 2005; 106: 927.
(19) American College of Obstetricians and Gynecologists: Multiple gestation: complicated twin, triplet, and high-order multifetal pregnancy. Practice Bulletin No. 56. Obstet Gynecol. 2004; 104: 869-883.
(20) Geenes V, Williamson C. Intrahepatic cholestasis of pregnancy. World J Gastroenterol. 2009; 15: 2049-2066.
(21) Blickstein I. Monochorionicity in perspective. Ultrasound Obstet Gynecol. 2006; 27: 235-238.
(22) Valenzuela P, Becker J, Carvajal J. Pautas de manejo clínico de embarazos gemelares. Revista Chilena de Obstetricia y Ginecología. 2009; 74(1): 52-68.
(23) Quintero RA, Morales WJ, Allen MH, Bornick PW, Johnson PK, Kruger M. Staging of twin-to-twin transfussion syndrome. J Perinatol.1999; 19: 550-555.
(24) Senat MV, Deprest J, Boulvain M, Paupe A, Winer N, Ville Y. A randomized trial of endoscopic laser surgery versus serial amnio- reduction for severe twin-to-twin transfusion syndrome at midgestation. N Engl J Med. 2004; 35(2): 136-144.
(25) Ishii K, Murakoshi T, Takahashi Y, Shinno T, Matsushita M, Naruse H, Torii Y, Sumie M, Nakata M Perinatal Outcome of Monochorionic Twins with Selective Intrauterine Growth Restriction and Different Types of Umbilical Artery Doppler under Expectant Management. Fetal Diagn Ther. 2009; 26: 157-161.
(26) Valsky D, Eixarch E, Martinez JM, Crispi F, Gratacós E. Selective intrauterine growth restriction in monochorionic twins: pathophysiology, diagnostic approach and management dilemmas. Semin Fetal Neonatal Med. 2010; 15: 342–348.
(27) Gratacós E, Antolin E , Lewi L, Martínez JM, Hernandez-Andrade E, Acosta-Rojas R. Monochorionic twins with selective intrauterine growth restriction and intermittent absent or reversed end-diastolic flow (Type III): feasibility and perinatal outcome of fetoscopic placental laser coagulation. Ultrasound Obstet Gynecol. 2008; 31(6): 669-75.
(28) Lopriore E, Middeldorp JM, Oepkes D, Kanhai HH, Walther FJ, Vandenbussche FP. Twin anemiapolycythemia sequence in two monochorionic twin pairs without oligo-polyhydramnios sequence. Placenta. 2007; 28(1): 47-51.
(29) Slaghekke F, Kist WJ, Oepkes D, Pasman SA, Middeldorp JM, Klumper FJ, Walther FJ, Vandenbussche FP, Lopriore E.Twin anemia-polycythemia sequence: diagnostic criteria, classification, perinatal management and outcome. Fetal Diagn Ther. 2010; 27(4): 181-190.
(30) Ong S, Zamora J, Khan K, Kilbyc M. Prognosis for the co-twin following single-twin death: a systematic review. BJOG. 2006; 113: 992- 998.
(31) Bajoria R, Wee LY, Anwar S, Ward S: Outcome of twin pregnancies complicated by single intrauterine death in relation to vascular anatomy of the monochorionic placenta. Hum Reprod. 1999; 14(8): 2124-2130.
(32) Cruceyra M, de-La-Calle M, Rodriguez R, Magdaleno-Dans F, González A. Pronóstico materno y perinatal en la gestación gemelar con muerte de un gemelo intraútero: estudio retrospectivo. Toko Gin Pract. 2011; 70: 58-62.
(33) Breathnach FM, McAuliffe FM, Geary M, Daly S, Higgins JR, Dornan J, Morrison JJ, Burke G, Higgins S, Dicker P, Manning F, Carroll S, Malone FD. Optimum Timing for Planned Delivery of Uncomplicated Monochorionic and Dichorionic Twin Pregnancies. Obstetrics & Gynecology. 2012; 199(1).
(34) Rossi AC, Prefumo F. Impact of cord entanglement on perinatal outcome of monoamniotic twins: a systematic review of the literature. Ultrasound Obstet Gynecol. 2013; 41: 131-135.
(35) Leung TY, Tam WH, Leung TN, Lok IH, Lau TK. Effect of twin-to-twin delivery interval on umbilical cord blood gas in the second twins. BJOG. 2002; 109: 63-7.
(36) American College of Obstetricians and Gynecologists. Special problems of multiple gestation. ACOG educa- tional bulletin No.253. Washington DC: ACOG. 1998.
(37) Scholten I, Chambers GM, van Loendersloot L, van der Veen F, Repping S, Gianotten J, Hompes PG, Ledger W, Mol BW. Impact of assisted reproductive technology on the incidence of multiple-gestation infants: a population perspective. Fertil Steril. 2015; 103: 179.
(38) Cameron AH, Edwards JH, Derom R, Thiery M, Boelaert R. The value of twin surveys in the study of malformations. Eur J Obstet Gynecol Reprod Biol. 1983; 14: 347.
(39) Moayeri SE, Behr B, Lathi RB, Westphal LM, Milki AA. Risk of monozygotic twinning with blastocyst transfer decreases over time: an 8-year experience. Fertil Steril. 2007; 87: 1028.
