American Journal of Obstetrics & Gynecology
Volume 195, Issue 1 , Pages 134-139, July 2006

Prospective risk of intrauterine death of monochorionic-diamniotic twins

  • Teresinha Simões, MD

      Affiliations

    • Department of Maternal-Fetal Medicine Maternity Dr Alfredo da Costa, Lisbon, Portugal
    • ,
  • Njila Amaral, MD

      Affiliations

    • Department of Maternal-Fetal Medicine Maternity Dr Alfredo da Costa, Lisbon, Portugal
    • ,
  • Rita Lerman, MD

      Affiliations

    • Department of Maternal-Fetal Medicine Maternity Dr Alfredo da Costa, Lisbon, Portugal
    • ,
  • Filipa Ribeiro, MD

      Affiliations

    • Department of Maternal-Fetal Medicine Maternity Dr Alfredo da Costa, Lisbon, Portugal
    • ,
  • Elsa Dias, MD

      Affiliations

    • Department of Maternal-Fetal Medicine Maternity Dr Alfredo da Costa, Lisbon, Portugal
    • ,
  • Isaac Blickstein, MD

      Affiliations

    • Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel
    • Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
    • Corresponding Author InformationReprint requests: Isaac Blickstein, MD, Department of Obstetrics and Gynecology, Kaplan Medical Center, 76100 Rehovot, Israel.

Received 25 November 2005; received in revised form 17 January 2006; accepted 24 January 2006. published online 26 April 2006.

Objective

The purpose of this study was to calculate the prospective risk of fetal death in monochorionic-diamniotic twins.

Study design

We evaluated 193 monochorionic diamniotic twin pregnancies that were followed and delivered after 24 weeks. Surveillance included cardiotocography and sonography performed at least once weekly. The prospective risk of fetal death was calculated as the total number of deaths at the beginning of the gestational period divided by the number of continuing pregnancies at or beyond that period.

Results

The fetal death rate was 5 of 193 pregnancies (2.6%; 95% CI, 1.1, 5.9); the prospective risk of stillbirth per pregnancy after 32 weeks of gestation was 1.2% (95% CI, 0.3% - 4.2%).

Conclusion

Under intensive surveillance, the prospective risk of fetal death in monochorionic-diamniotic pregnancies after 32 weeks of gestation is much lower than reported and does not support a policy of elective preterm delivery.

Key words: Monochorionic twins, Intrauterine death, Twin-twin transfusion, Antenatal assessment

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PII: S0002-9378(06)00169-4

doi:10.1016/j.ajog.2006.01.099

American Journal of Obstetrics & Gynecology
Volume 195, Issue 1 , Pages 134-139, July 2006

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