Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T02:12:23.305Z Has data issue: false hasContentIssue false

Yolk Sacs in Twin Pregnancy

Published online by Cambridge University Press:  01 August 2014

W. Malinowski*
Affiliation:
Department of Obstretics and Gynecology, Kutno Hospital and the Center for Study of Multiple Birth, Institute of Obstetrics and Gynecology, Medical Academy in Lódź, Poland
*
Department of Obstetrics and Gynecology, Kutno Hospital, Kościuszki 42 St, 99 300 Kutno, Poland

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

OBJECTIVE. The purpose of this study was to evaluate the relationship between the yolk sacs separated or not separated by septum and chorionicity twin pregnancies scanned early in the first trimester, and the relation between size and morphologic features of the yolk sac and the outcome of twin pregnancies.

RESULTS. In all 38 sets of twins two yolk sacs were identified. During the first trimester of a dichorionic twin pregnancy, the yolk sacs were always separated by a septum and not separated (“Eight” sign) in monochorionic twin pregnancy. In five cases, one of yolk sac was abnormally large (> 8mm) and had thin wall. Four of the five mothers spontaneously aborted during the next 2-3 weeks. In one case of monochorionic twin ectopic pregnancy two yolk sacs were seen normally.

CONCLUSION. The sonographic identification of yolk sacs in multiple pregnancies allows an early and efficient recognition of presence and chorionicity of twin pregnancy, both in intra – and extrauterine. Identification of abnormal yolk sac or yolk sacs suggests death of one or all embryos.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1998

References

REFERENCES

1. Bromley, B, Benacerraf, B (1995): Using the number of yolk sacs to determine amnionicity in early first trimester monochorionic twins. J Ultrasound Med 14: 415–9.CrossRefGoogle ScholarPubMed
2. Ferrazzi, E, Brambati, B, Lanzani, A, et al. (1988): The yolk sac in early pregnancy failure. Am J Obstet Gynecol 158: 137140.CrossRefGoogle ScholarPubMed
3. Gonzalez-Crussi, F, Roth, LM (1976): The human yolk sac and yolk sac carcinoma. Hum Pathol 7: 675.CrossRefGoogle ScholarPubMed
4. Gonzalez-Crussi, F (1979): The human yolk sac and yolk sac (endodermal sinus) tumors: A review. Prospect Pediatr Pathol 5: 179215.Google ScholarPubMed
5. Green, JJ, Hobbins, JC (1988): Abdominal ultrasound examination of the first-trimester fetus. Am J Obstet Gynecol 159: 165–7.CrossRefGoogle ScholarPubMed
6. Levi, CS, Lyons, EA, Dashefsky, SM, Lindsay, DJ, Holt, SC (1966): Yolk sac number, size and morphologic features in monochorionic monoamniotic twin pregnancy. Can Assoc Radiol J 47: 98100.Google Scholar
7. Lindsay, DJ, Lovett, IS, Lyons, EA et al. (1992): Yolk sac diameter and shape at endovaginal US: predictors of pregnancy outcome in the first trimester. Radiology 183: 115–7.CrossRefGoogle ScholarPubMed
8. Malinowski, W, Gasior, W (1992): Evaluation of dividing septum in multiple pregnancies with ultrasound for diagnosis of monochorionic pregnancy. Ultrason Pol 2: 41–6.Google Scholar
9. Mantoni, M, Pedersen, JF (1979): Ultrasound visualization of the human yolk sac. J Clin Ultrasound 7; 459–60.CrossRefGoogle ScholarPubMed
10. Monteagudo, A, Timor-Tritsch, IE, Sharma, S (1994): Early and simple determination of chorionic and amniotic type in multifetal gestations in the first fourteen weeks by high-frequency transvaginal ultrasonography. Am J Obstet Gynecol 170: 824–7.CrossRefGoogle ScholarPubMed
11. Reece, EA, Pinter, E, Green, J et al. (1987): Significance of isolated yolk sac visualized by ultrasonography. Lancet 1: 269–72.CrossRefGoogle ScholarPubMed
12. Reece, EA, Scioscia, AL, Pinter, RG at al. (1988): Prognostic significance of the human yolk sac assessed by ultrasonography. Am J Obstet Gynecol 159: 1191–4.CrossRefGoogle ScholarPubMed
13. Timor-Tritsch, IE, Farine, D, Rosen, MG (1988): A close look at early embrionic development with the high-frequency transvaginal transducer. Am J Obstet Gynecol 159: 676–9.CrossRefGoogle Scholar