Fernández-Miranda MC, Cruceyra BM, Rodríguez-González R, Magdaleno-Dans F, Omeñaca TF, González GA

Language: Spanish
References: 17
Page: 254-262
PDF size: 275.81 Kb.

ABSTRACT

Background: happens in the womb when the death of one of the twins, it is necessary to consider the factors that influence the perinatal outcome of surviving fetus.
Objective: To review the outcome of twin pregnancies complicated by single fetal intrauterine death and how it can increase morbidity to its co-twin and its mother.
Material and Methods: A retrospective analysis of the fifty one twin pregnancies complicated by single fetal intrauterine death in the second or third trimester in our centre from December 1999 to December 2010.
Results: Of the total amount of 1996 twin pregnancies attended in our centre, 51 were complicated by single fetal intrauterine death (2.5%). In 68,7% of the cases we found several maternal complications, such as 12,2% of preeclampsia and 12% of coagulopathies. As for the dead foetus, there was a 47% of malformations, a 19,6% of intrauterine fetal growth restriction and there was a 9,8% of cases complicated by Twin-Twin Transfusion Syndrome. In the group of the surviving co-twin, 9,8% developed intrauterine growth restriction, 9,8% oligohydramnios and 9,8% Doppler alterations. There was a high risk of prematurity with 43,1% of the births under 34 weeks and 13,7% under 30 weeks of pregnancy. The percentage of caesarean was 64,7%. There was 3 cases of co-twin died intra-uterus, and one more died postpartum. A 10% of the newborns had some kind of neurological disability.
Conclusions: It seems that surviving co-twin prognosis is mainly compromised by prematurity and its consequences. There should be more prospective research to inform decision-making and evaluate and control the potential maternal and fetal risks.

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