Perinatal Outcomes of Single Intrauterine Fetal Death in Twin Pregnancies: A Tertiary Center Experience

Authors : Müjde Can İBANOĞLU, Betül TOKGÖZ, Kadriye YAKUT YÜCEL, Seval YILMAZ ERGANİ, Erkan SAGLAM, Aykut KINDAN, Cantekin İSKENDER, Ali ÇAĞLAR

Pages : 219-225

Doi:10.54005/geneltip.1236186

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Publication Date : 2023-04-30

Article Type : Research Paper

Abstract :ABSTRACT Aim: Twin pregnancies are associated with increased perinatal mortality and morbidity compared with singleton pregnancies. Single intrauterine fetal death insert ignore into journalissuearticles values(sIUFD); is difficult to treat. This is because the twin who survives after sIUFD is at high risk for mortality, neurological damage, and other complications of preterm birth. Therefore, in this study, we aimed to determine the perinatal consequences for the surviving fetus. We also investigated the association between chorionicity, maternal characteristics, and fetal and maternal concomitant complications in these cases. Methods: We conducted a retrospective case-control observational study that included twin births complicated by sIUFD followed up in the Department of Perinatology. Data, including demographic characteristics and prenatal invasive procedures, weeks of sIUFD, delivery time, fetal sex, interval between delivery and fetal loss, fetal distress, mode of delivery, birth weight, presence of placental pathology or umbilical cord abnormalities, neonatal Apgar scores in the first and fifth minutes, and need for neonatal intensive care unit insert ignore into journalissuearticles values(NICU);, were obtained from obstetric records and hospital database. Results: Fifty-three twin pregnancies with a single fetal death were included in the study. The mean age of the pregnants participating in the study was 30 insert ignore into journalissuearticles values(± 6); years. The mean body mass index insert ignore into journalissuearticles values(BMI); of the mother was 28.8 insert ignore into journalissuearticles values(22-43);. Twenty-four insert ignore into journalissuearticles values(45.3%); cases were dichorionic insert ignore into journalissuearticles values(DC); diamniotic, 20 insert ignore into journalissuearticles values(37.7%); were monochorionic insert ignore into journalissuearticles values(MC); diamniotic, and 9 insert ignore into journalissuearticles values(17%); were monochorionic monoamniotic. The time between IUFD and birth of the live twin was 75 days in MCs and 105 days in DCs insert ignore into journalissuearticles values(p=0.150);. The mean gestational age at birth of the surviving twin was 30 weeks’ gestation in MCs and 34 weeks’ gestation in DCs insert ignore into journalissuearticles values(p=0.030);. In 23 insert ignore into journalissuearticles values(79.3%); MC pregnancies and 15 insert ignore into journalissuearticles values(62.5%); DC pregnancies, delivery occurred before 37 weeks insert ignore into journalissuearticles values(p=0.176);. In addition, deliveries before 34 weeks occurred more frequently in 19 insert ignore into journalissuearticles values(65.5%); of MC pregnancies than in 8 insert ignore into journalissuearticles values(33.3%); of DC pregnancies insert ignore into journalissuearticles values(p=0.020);. Conclusion: We have shown that the birth of the live fetus in the MC group occurred at a significantly earlier time, and mortality and morbidity were observed more frequently in this fetus. However, this research explaining the etiology of sIUFD is insufficient.
Keywords : Single intrauterine fetal death, twins, perinatal outcomes, monochorionic, dichorionic