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J Turk Ger Gynecol Assoc. 2019 Aug 28;20(3):147-153. doi: 10.4274/jtgga.galenos.2018.2018.0053. Epub 2018 Jul 31.

Assesment of pregnancy outcomes among twin pregnancies with single fetal demise regarding chorionicity and fetal death time

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1
Department of Obstetrics and Gynecology, İstanbul Zeynep Kamil Maternity and Pediatric Training and Research Hospital, İstanbul, Turkey

Abstract

Objective:

The objective of this study was to assess maternal and perinatal outcomes of twin pregnancies with single fetal demise in terms of chorionicity and fetal death time.

Material and Methods:

All deliveries between January 2008 and July 2015 were reviewed retrospectively and 85 twin pregnancies with single fetal demise were included. These cases were grouped according to chorionicity and fetal death time.

Results:

The incidence of single fetal demise was 4.7%. The mean delivery week was later in the dichorionic group (34.16±4.65) than in the monochorionic group (31.1±3.83). The ratios of deliveries before the 34th gestational week were 71.4% in monochorionics and 35% in dichorionics. Monochorionics had a 13 times greater risk for having delivery before the 37th gestational week and a 4 times greater risk for having delivery before the 34th gestational week compared with dichorionics. Furthermore, monochorionics had a 7 times greater risk for having abruptio placenta compared with dichorionics. The newborn intensive care unit admission ratios were 61.3% in dichorionics and 85.7% in monochorionics. Also, monochorionics had a 3.7 times greater risk for admission to newborn intensive care unit compared with dichorionics.

Conclusion:

We recommend follow-up of twin pregnancies with single fetal demise in terms of premature birth, regardless of chorionicity. Also, close monitoring is recommended for monochorionic twin pregnancies with single fetal demise in terms of premature birth before 34 weeks of gestation, abruptio placenta, the need for neonatal intensive care, and respiratory distress syndrome.

KEYWORDS:

Single twin demise; twin pregnancy; intrauterine death; perinatal outcomes; pregnancy outcomes

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