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Outcome of monochorionic diamniotic twin pregnancies followed at a single center
Author(s) -
Fichera Anna,
Prefumo Federico,
Stagnati Valentina,
Marella Daria,
Valcamonico Adriana,
Frusca Tiziana
Publication year - 2015
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.4643
Subject(s) - obstetrics , medicine , single center , center (category theory) , outcome (game theory) , monochorionic twins , pregnancy , gynecology , gestation , biology , genetics , chemistry , mathematics , mathematical economics , crystallography
Objective We aim to evaluate the outcome of a cohort of monochorionic diamniotic twin pregnancies followed from the first trimester onwards at a single center. Method This was a retrospective analysis of prospectively collected data from a series of 300 monochorionic diamniotic twin pregnancies referred to our twin clinic between 2001 and 2012. Pregnancies were followed from the first trimester and fortnightly after 16 weeks of gestation. Data on pregnancy and neonatal outcome were analyzed. Results There were two surviving infants in 259/300 (86.4%) pregnancies, one survivor in 22/300 (7.3%) and no survivors in 19/300 (6.3%) with an overall mortality of 60/600 (10%). Twin–twin transfusion syndrome was diagnosed in 33 cases (11%), isolated intertwin weight discordance ≥ 25% in 35 (11.6%) and major congenital structural anomalies in ten (3.3%). After 32 weeks, the prospective risk of spontaneous fetal intrauterine death was one in 248 (0.4%) per pregnancy. Conclusions Despite specific prenatal fetal monitoring and management, monochorionic diamniotic twin pregnancies have still to be considered at high risk of mortality, although the prospective risk of intrauterine death after 32 weeks is low. Twin–twin transfusion syndrome and congenital anomalies were the main risk factors for mortality. © 2015 John Wiley & Sons, Ltd.