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Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options
Author(s) -
Lust Annelies,
De Catte Luc,
Lewi Liesbeth,
Deprest Jan,
Loquet Philippe,
Devlieger Roland
Publication year - 2008
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.1967
Subject(s) - anencephaly , obstetrics , monochorionic twins , medicine , birth weight , gestation , gestational age , fetus , low birth weight , pregnancy , gynecology , biology , genetics
The aim of this study was to evaluate the effect of selective feticide (SF) compared to expectant management (EM) on perinatal outcome in dichorionic and monochorionic twins discordant for anencephaly. For this purpose, we conducted a systematic review of literature and added ten unpublished cases. As a result, we found that in dichorionic twins, mean gestational age (GA) at birth in the SF group was 38.0 weeks versus 34.9 weeks ( P = 0.0002). Mean birth weight was 2922 g in the SF group versus 2474 g ( P = 0.03). In monochorionic twins, mean GA at birth was 35.2 weeks versus 32.7 weeks ( P = 0.1). Mean birth weight was 2711 g versus 1667 g ( P = 0.0001). We conclude that while SF does not reduce perinatal mortality, it does result in significantly longer gestations and higher birth weight, and appears to be the management of choice in dichorionic twins discordant for anencephaly. In monochorionic twins, SF also increases birth weight, but in view of the complexity of this group, no clear recommendations can be made. Copyright © 2008 John Wiley & Sons, Ltd.