Outcome of Surviving Twins with Antenatal Death of the Co-Twin: Comparison with Normal Twins.

Koo,  Soo Hyun; Ma,  Tae Ho; Lee,  Hee Chul; Kim,  Kyung Ah; Ko,  Sun Young; Lee,  Yeon Kyung; Shin,  Son Moon

Original Article

Journal of the Korean Society of Neonatology 2004;11(2):144-151.
Published online November 1, 2004.

Outcome of Surviving Twins with Antenatal Death of the Co-Twin: Comparison with Normal Twins.

Soo Hyun Koo, Tae Ho Ma, Hee Chul Lee, Kyung Ah Kim, Sun Young Ko, Yeon Kyung Lee, Son Moon Shin

¹Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Cheil Hospital, Seoul Korea. ykleeped@hanmail.net
²Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Seoul Hospital, Seoul, Korea.

일측태아 사망이 동반된 쌍태임신에서 생존아의 예후에 대한 임상적 고찰:정상 쌍생아와의 비교

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Abstract

PURPOSE
In twin pregnancies with single fetal death after 20th weeks, the surviving co-twin has an ischemic change of multiple organ, neurological abnormality, high perinatal morbidity and mortality. The purpose of this study was to evaluate the clinical status and the outcome of live co-twins and to compare them with the normal viable twins.
METHODS
A retrospective analysis by evaluating medical records was done for those twin pregnancies with single fetal demise after 20 weeks (n=20) during January 2000 to June 2003 at Samsung Cheil Hospital. Normal viable twins (n=847) born during the same study period were used as a control group. RESULTS: 867 of 31, 219 live deliveries were documented as twin births. 20 twin pregnancies were complicated by the death of one fetus after 20th weeks. In these 20 twin pregnancies, two surviving co-twins died after birth. There was an increased incidence of monochorionic placenta, prematurity, VLBW (very low birth weight), admission rate in neonate and mortality among the surviving co-twins as compared to the normal viable twins (P<0.001). However, there was no significant difference between surviving co- twins with dichorionic placenta and normal viable twins. CONCLUSION: The perinatal morbidity and mortality of surviving twins were higher than the normal twins in the monochorionic twins whose co-twin's death occurred after 20th weeks suggests that chorionicity of placenta might be an important factor to predict the outcome of surviving co-twin's.

Key Words: Twin pregnancies; Fetal death; Monochorionic; Dichorionic