Outcome of Twin Pregnancy with Single Fetal Death: A Comparison with Viable Twin Pregnancies

Abstract

OBJECTIVE: To study the perinatal and maternal outcomes in the death of one fetus in a twin pregnancy. METHODS: this was a retrospective, observational study. Comparison was made to viable twin pregnancy. RESULTS: Of a total 840 live deliveries, 64 were documented as twin births at a gestation of greater that 18 week twin pregnancy with single fetal death were observe. Of the 12 twin pregnancies in which a fetal death occurred, postmortem examination showed severe six (%50) torsion of the umbilical cord. There was an increase in the incidence of congenital structural abnormalities among those twin pregnancies (p<.001). A significant proportion of these twin pregnancies had monochorionic placentas (p<.001). The death of one fetus in a twin pregnancy can affect both the mother and the cotwin . There was not an increased risk of pregnancy induced hypertension in two groups. CONCLUSION: the choice of management for the mother and the viable cotwin is difficult. The risk of a single fetal death in twin pregnancies is increased with a monochorionic placenta structural abnormality. Postmortem examination showed severe torsion and constriction of the umbilical cord at the fetal and congenital abnormality. Regular surveillance and conservative management Seem advisable.