Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 13 , ISSUE 3 ( May-June, 2021 ) > List of Articles

RESEARCH ARTICLE

Single Intrauterine Fetal Demise in Twin Pregnancies and Pregnancy Outcomes

Akhila C Reddy, GN Vasanthalakshmi

Keywords : Pregnancy outcomes, Single intrauterine fetal demise, Twin pregnancy

Citation Information : Reddy AC, Vasanthalakshmi G. Single Intrauterine Fetal Demise in Twin Pregnancies and Pregnancy Outcomes. J South Asian Feder Obs Gynae 2021; 13 (3):137-141.

DOI: 10.5005/jp-journals-10006-1890

License: CC BY-NC 4.0

Published Online: 09-09-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim and objective: To study the maternal and fetal outcomes in twin pregnancy with single intrauterine fetal demise. Introduction: Single intrauterine fetal demise (SIUFD) in a twin pregnancy is known to be a serious complication of pregnancy. It is a relatively rare complication of multiple pregnancies (5% of all twin pregnancies). Death may occur anytime and increase mortality and morbidity of the survivor twin either secondary to the cause of death of the co-twin or to preterm labor, or both. Materials and methods: The data are collected from a medical records department, review of literature, and labor ward parturition register, and patients were followed up in the wards. This study is designed as a prospective observational study and is done in Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, study period being from April 2017 to April 2019. Sample size was 206 twin deliveries. Results: During the study period (2017–2019), 206 women had twin deliveries among a total of 9,951 deliveries occurred in tertiary center. Of these 206 twin deliveries, 12 (5.8%) cases were complicated by the death of one fetus. Among the 12 cases, four had gestational hypertension, two had diabetes, one had preeclampsia, two cases had placenta previa, two cases had deranged liver function tests, among that one was associated with acute fatty liver, disseminated intravascular coagulation, acute kidney injury, and atonic postpartum hemorrhage. The same patient underwent obstetric hysterectomy. Regarding the neonatal outcomes, there were six preterm deliveries, four term deliveries, and two neonatal deaths, due to extreme preterm birth. Management should be individualized, and conservative management is preferred by most of the obstetricians. Conclusion: SFD in a twin pregnancy should be managed in a tertiary referral center, where intensive fetal surveillance and adequate neonatal support are available.


PDF Share
  1. Jain D, Purohit RC. Review of twin pregnancies with single fatal death, maternal and fetal outcomes. J Obstet Gynaecol India 2014;64(3):180–183. DOI: 10.1007/s13224-013-0500-5.
  2. Woo HH, Sin SY, Tang LC. Single fetal death in twin pregnancies : review of the maternal and neonatal outcomes and management. Hong Kong Med J 2000;6(3):293–300. PMID: 11025849.
  3. Hillman SC, Morris RK, Kilby MD. Co twin prognosis after single fetal death: a systematic review and meta analysis. Obstet Gynecol 2011;118(4):928–940. DOI: 10.1097/AOG.0b013e31822f129d.
  4. Yaman Tunç S, Ağaçayak E, Yaman Görük N, et al. Single intrauterine demise in twin pregnancies: analysis of 29 cases. Turk J Obstet Gynecol 2015;12(4):226–229. DOI: 10.4274/tjod.35493.
  5. Luu TM, Vohr B. Twinning on the brain: the effect on neurodevelopmental outcomes. Am J Med Genet 2009;151C(2):142–147. DOI: 10.1002/ajmg.c.30208.
  6. Kunaal S, Bangal VB, Sai B, et al. Intrauterine fetal demise of co-twin in multifetal pregnancy. Int J Biomed Res 2012;3(1):52–55. DOI: 10.7439/ijbr.v3i1.258.
  7. O'Donoghue K, Rutherford MA, Engineer N, et al. Transfusional fetal complications after single intrauterine death in monochorionic multiple pregnancy are reduced but not prevented by vascular occlusion. BJOG 2009;116(6):804–812. DOI: 10.1111/j.1471-0528.2009.02128.x.
  8. Babah OA, Olamijulo A, Ayanbode OS, et al. Conservative management of single fetal death in twin pregnancy at a tertiary health institution in southern Nigeria: a case report. IOSR J Dent Med Sci 2014;13(3):79–83. DOI: 10.9790/0853-13347983.
  9. Deveer R, Engin-Ustun Y, Mert I, et al. Twin pregnancies with single fetal death: analysis of 38 cases. Fetal Pediatr Pathol 2013;31(1):71–75. DOI: 10.3109/15513815.2012.671446.
  10. Chauhan SP, Scardo JA, Hayes E, et al. Twins: prevalence, problems, and preterm births. Am J Obstet Gynecol 2010;203(4):305–315. DOI: 10.1016/j.ajog.2010.04.031.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.