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Zygosity and Chorionicity in the Prognosis of Triplet Pregnancies: Contribution of Microsatellites

Published online by Cambridge University Press:  21 February 2012

Romain Guilherme*
Affiliation:
Department of Obstetrics and Gynaecology, Robert Debré Hospital, AP-HP, Paris Diderot University, France. [email protected]
Séverine Drunat
Affiliation:
Department of Genetic Biochemistry, Robert Debré Hospital, AP-HP, Paris Diderot University, France.
Anne-Lise Delezoide
Affiliation:
Department of Developmental Biology, Robert Debré Hospital, AP-HP, Paris Diderot University, France.
Camille Le Ray
Affiliation:
Epidemiological Research Unit on Perinatal Health and Women's Health, Curie University, INSERM Unit 149, Paris, France.
Jean-François Oury
Affiliation:
Department of Obstetrics and Gynaecology, Robert Debré Hospital, AP-HP, Paris Diderot University, France.
Dominique Luton
Affiliation:
Department of Obstetrics and Gynaecology, Beaujon Hospital, Paris Diderot University, Clichy, France.
*
*Address for correspondance: Dr Romain Guilherme, Service de Gynécologie Obstétrique, Hôpital de la Pitié-Salpêtrière, 47 boulevard de l'Hôpital, 75013 Paris, France.

Abstract

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We assess the prognostic values of zygosity and chorionicity in triplet pregnancies (TP) with the assistance of microsatellites analysis. 53 consecutive TP whose prenatal care and delivery occurred in our maternity hospital were included in this prospective study. Zygosity of all sets of triplets (alive or stillbirth, after 22 weeks of gestation) was determined by PCR-amplified microsatellites markers analysis. Chorionicity was determined by placental analysis in our fetopathology referral department and validated by molecular analysis of zygosity. Placental conformations, obstetrical and neonatal outcomes of TP were studied according to their zygosity and chorionicity. Monozygotic and to a greater extent, dizygotic TP were associated with an increase in placental ischemic injuries, velamentous cord insertions, twin-twin transfusion syndromes, fetal anomalies, and perinatal mortality when compared with the trizygotic TP (p <0.05). Monochorionic and more significantly, dichorionic TP presented with the same increases as trichorionic TP (p <0.05). Thus chorionicity easily determined by ultrasound evaluation during the first trimester of the pregnancy must remain the main prognosis criterion in TP. Taking into account the rare indications of prenatal diagnosis of zygosity, it became apparent that chorionicity has a greater impact than zygosity when distinguishing high-risk groups of TP.

Type
Articles
Copyright
Copyright © Cambridge University Press 2008