Multiple pregnancies with single intrauterine demise. Description of twenty-eight pregnancies

Abstract

Methods: Retrospective study of multiple pregnancies and deliveries with single intrauterine demise, in a five years' study period.

Results: Of a total of 13,840 deliveries in the study period, 355 represented multiple pregnancies with two or more fetuses from conception: 310 twin pregnancies and 45 triplets or higher. Twenty-eight multiple pregnancies were complicated by single intrauterine death: in six cases (group A) as first trimester spontaneous fetal loss, in nine cases (group B) due to selective fetal reduction, and in thirteen pregnancies as spontaneous intrauterine demise occurring in the second or third trimester (group C). In group A, no specific cause of death was proven. In group C, four cases of death were caused by twin transfusion syndrome, three cases by severe intrauterine growth retardation, four cases by placental insufficiency, one case by placental abruption striking one of the twins, whereas the last death was undefined. In group A, mean gestational age at delivery was 33 completed weeks. In group C, five monochorionic pregnancies were delivered at median gestational age 30 weeks and seven dichorionic pregnancies at 34 weeks (the chorionicity was indefinite in one case). The neonatal complications of the forty-two live born babies included prematurity problems only, except for one case of congenital anemia in a transfusion syndrome donor twin. None of the mothers showed signs of intravascular coagulopathy.

Conclusion: The main problem for the surviving twin was prematurity - not the sibling's death.