Conservative management of twin pregnancies with one dead fetus: is it safe?

Background . Fetal death in one of the twins is unusual and the management issue of such a condition is not straightforward. Methods . We reviewed the outcomes of nine twin pregnancies with one dead fetus in whom follow‐up period exceeded 3 weeks. Results . The twinning frequency was 8.9 per thousand deliveries and the frequency of subsequent antepartum death of one fetus was found to be 3.8%. The preterm birth rate was 45.5%and the survival rate was 90.1%. The perinatal mortality rate was 12%. Maternal clotting disorder was observed in one patient and treated successfully with heparin. Conclusions . We suggest that these patients are best managed conservatively unless further hazard to the fetus or mother appears.