Cases of monochorionic / diamniotic twin pregnancies diagnosed with twin-twin transfusion syndrome.

Controls of monochorionic / diamniotic twin pregnancies without a diagnosis of twin-twin transfusion syndrome.

Twin Twin Transfusion Syndrome

Doppler ultrasound assessment of the proximal fetal renal artery to with measurement of the peak systolic velocity, resistive index, pulsatility index, and systolic/diastolic ratio.

Doppler ultrasound of fetal renal artery

Columbia University Medical Center

Renal Artery Dopplers in Twin Twin Transfusion Syndrome

Are Renal Artery Doppler Indices Different Between Monochorionic Diamniotic Twins With Twin-twin Transfusion Syndrome and Monochorionic Diamniotic Twins Without Twin-twin Transfusion Syndrome?

Doppler ultrasound assessment of the proximal fetal renal artery with measurement of the peak systolic velocity for twin A.

Doppler ultrasound assessment of the proximal fetal renal artery with measurement of the resistive index for twin A.

Doppler ultrasound assessment of the proximal fetal renal artery with measurement of the pulsatility index for twin A.

Doppler ultrasound assessment of the proximal fetal renal artery with measurement of the peak systolic velocity for twin B.

Doppler ultrasound assessment of the proximal fetal renal artery with measurement of the resistive index for twin B.

Doppler ultrasound assessment of the proximal fetal renal artery with measurement of the pulsatility index for twin B.

There is no plan to share individual participant data with other researchers.

Russell Miller

Assistant Professor of Obstetrics and Gynecology

Columbia University

W&D should begin when participants wish to conceive. The intervention was standardized by training of research staff. Careful instructions about walking speed and diet would be given to participants assigned to W&D at enrolment and at each consultation.

No recommendations regarding diet or physical activity were given to controls. Antiemetics such as ondansetron would be given to controls complaining of vomiting.

The intervention was standardized by training of research staff and should begin when participants wish to conceive. Careful instructions about walking speed and diet would be given to participants assigned to W&D at enrolment and at each consultation.
Walking & dietary modification: 1. Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those whose jobs required them to seat for long periods should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, such as near term.
2. At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water or sugar-sweetened beverages. Sucralose could be used as a sweetener. Participants were recommended to use ondansetron for nausea and vomiting prevention

Walking & Dietary Modification (W&D)

Controls

Total

Sex: Female, Male

Race (NIH/OMB)

Region of Enrollment

Normal or underweight (BMI <25 kg/m2)

Owerweight (BMI 25–30 kg/m2)

Obese (BMI > 30 kg/m2)

Type 1 diabetes mellitus

Chronic hypertension

Women with live offspring

The intervention was standardized by training of research staff and should begin when participants wish to conceive. Careful instructions about walking speed and diet would be given to participants assigned to W&D at enrollment and at each consultation.
Walking & dietary modification: 1. Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those whose jobs required them to seat for long periods should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, such as near term.
2. At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water, sugar-sweetened beverages and large amount of fruits. Sucralose could be used as a sweetener. Participants were recommended to use ondansetron for nausea and vomiting prevention

Take-home Baby Rate

The intervention was standardized by training of research staff and should begin when participants wish to conceive. Careful instructions about walking speed and diet would be given to participants assigned to W&D at enrollment and at each consultation.
Walking & dietary modification: 1. Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those whose jobs required them to seat for long periods should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, such as near term.
2. At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water, sugar-sweetened beverages or large amount of fruits. Sucralose could be used as a sweetener. Participants were recommended to use ondansetron for nausea and vomiting prevention

Gestational Diabetes Mellitus

Preeclampsia

Mothers Who Used Heparin for Nephrotic Range Proteinuria or Placental Insufficiency

Weight gain >13 kg for underweight, normal weight or overweight mothers and > 9 kg for obese mothers

Excessive Weight Gain

First-trimester Losses

Second and Third-trimester Losses

Live-born Children

Babies Born at Term

Appropriate-for-gestational Age Babies

Hypoglycemia was defined as any blood glucose concentration ≤ 40 mg/dL.

Neonates With Hypoglycemia

Overall Study

Dr. Silvia Hoirisch-Clapauch

The intervention was standardized by training of research staff and should begin when participants wish to conceive. Careful instructions about walking speed and diet will be given to participants assigned to W&D at enrollment and at each consultation.
Walking & dietary modification: 1. Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those whose jobs required them to seat for long periods should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, such as near term.
2. At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water, sugar-sweetened beverages or large amount of fruits. Sucralose could be used as a sweetener. Participants were recommended to use ondansetron for nausea and vomiting prevention

Recurrent Miscarriage

Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those remaining seated most of the day should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, which often occurred near term and when the mother was obese.
At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water or sugar-sweetened beverages. Sucralose could be used as a sweetener. Participants are recommended to use ondansetron for nausea and vomiting prevention

Walking & dietary modification

Hospital Federal dos Servidores do Estado, Ministry of Health

Walking and Dietary Modification for Recurrent Early Miscarriages

Walking and Dietary Modification for Women With Consecutive Early Miscarriages: a Randomized Study

Silvia Hoirisch Clapauch

Principal Investigator

Hospital dos Servidores do Estado do Rio de Janeiro

Participants were not blinded, but visits of the two groups were scheduled so as to not coincide..

placental insufficiency/edema

Renal Artery Dopplers in Twin Twin Transfusion Syndrome

Walking and Dietary Modification for Recurrent Early Miscarriages

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