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Influence of chorionicity on perinatal outcome in a large cohort of Danish twin pregnancies
Author(s) -
Oldenburg A.,
Rode L.,
Bødker B.,
Ersbak V.,
Holmskov A.,
Jørgensen F. S.,
Larsen H.,
Larsen T.,
Laursen L.,
Mogensen H.,
Petersen O. B.,
Rasmussen S.,
Skibsted L.,
Sperling L.,
Stornes I.,
Zingenberg H.,
Tabor A.
Publication year - 2012
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.10057
Subject(s) - medicine , obstetrics , fetus , gestation , twin pregnancy , pregnancy , incidence (geometry) , gynecology , cohort , live birth , genetics , physics , optics , biology
Objective To assess outcome in twin pregnancies according to chorionicity. Methods A cohort was retrieved from local ultrasound databases at 14 obstetric departments in Denmark, comprising all twin pregnancies with two live fetuses scanned between weeks 11 and 14 in the period 1 January 2004 to 31 December 2006. Outcome data were retrieved from the National Board of Health. Results Among 2038 twin pregnancies, 1757 (86.2%) were dichorionic (DC) and 281 (13.8%) were monochorionic diamniotic (MC). In MC pregnancies, the rate of spontaneous fetal loss in both second and third trimesters was more than threefold higher than the comparable rate in DC pregnancies: 6.0% vs. 1.9% for at least one fetus in the second trimester ( P < 0.001) and 2.1% vs. 0.7% in the third trimester ( P = 0.03). In 98.4% of DC pregnancies and in 91.1% of MC pregnancies, at least one infant was liveborn. Amongst pregnancies with two live fetuses at 24 weeks, the proportion with two live infants at 28 days after delivery was 97.5% and 95.1%, respectively. Conclusions The increased incidence of fetal loss in MC pregnancies compared with DC pregnancies predominantly occurs before 24 weeks' gestation. After this stage, although the risk of intrauterine fetal death is still higher in MC than in DC pregnancies, if both fetuses are alive at 24 weeks, the chance of a woman having two live infants 1 month after delivery is similar in MC and DC pregnancies. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.