Infants of twin pregnancies with one twin demise in the uterus: a retrospective study

Abstract

Many papers have reported that twin pregnancies with one twin demise in the uterus can cause complications in the surviving twin. We retrospectively reviewed charts from 1988 to 1997 at our hospital and found 17 of 302 twin deliveries with one twin intrauterine fetal death. The incidence of intrauterine death of a single twin was 5.7%. Six of the surviving twin (35.3%) had renal function impairment. One died due to acute renal failure. The other five patients recovered normal serum creatinine level. Five patients (29.4%) had abnormal brain imaging findings. One had multicystic encephalomalacia and microcephaly. Three of the five patients were complicated with cerebral palsy. After dividing the patients into complicated (n = 8, 47.1%) and non-complicated (n = 9, 52.9%) groups, we found that the patients with complication had lower Apgar score at 5 minutes and those with monochorionic diamniotic placenta had higher incidences of complication (62.5% vs 12.5%). We conclude that twin pregnancies with one fetal demise in the uterus do result in a higher incidence of complication in the surviving twin, especially if placentation type is monochorionic diamniotic. In managing the surviving twin of the monozygous twin pregnancies with one fetal demise in the uterus, we must be careful to monitor these patients. If complication was suspected, we should arrange the brain and kidney ultrasonography and manage these patients appropriately to decrease the complication risk.