Risk of Fetal Loss after Amniocentesis in Twins Comparing with Singleton Pregnancy

Abstract

Introduction: Amniocentesis is one of the most widely used diagnostic interventions but despite its many advantages, it has side effects such as fetal loss. The importance of fetal loss after amniocentesis in twin pregnancies is very important and some researchers believe that in twin pregnancies, the risk of fetal loss after amniocentesis is higher than singleton. Therefore, the present study examined the rate of fetal loss after amniocentesis in twin pregnancies compared to singleton pregnancies.
 
 Methods: This prospective descriptive-analytical study was performed on 712 mothers with singleton (628 cases) and twin (84 cases) pregnancies who referred to the obstetrics and gynecology clinic of Imam Khomeini Hospital in Ahvaz with Amniocentesis due to several reason during 2016-2020. A questionnaire containing information such as age, gestational age, number of pregnancies, childbirth and abortion, the cause of the diagnostic test, quarterly screening and NT ultrasound, and the result of amniocentesis were completed for patients. Patients were followed up during the first week, two weeks, and 60 days after amniocentesis, and finally data were analyzed by SPSS version24.
 
 Results: The mean age of the patients was 31.96 ± 6.33 years and the mean gestational age at amniocentesis for all patients was 15.37 ± 0.7. The mean NT in patients in the two groups did not differ significantly (1.60±0.44 vs 1.54±4.64, p=0.56). the prevalence of preterm in twin mothers was 13.1% and, in the singleton was 1.75% (p = 0.01). The occurrence of fetal loss was 2.4% in the twin group and 2.07% in the singleton group which was not statistically significant (p = 0.56). in the twin group, one (50%) fetal loss occurred in the first week and another one (50%) occurred between 15 and 60 days. But in the singleton group, 7 cases (63.6%) in the first week, 1 case (9%) in 15 to 60 days, and 3 cases (27.3) after more than 60 days lost the fetus. Previous pregnancy records in twins showed that the mean Gravid (p = 0.01), Parity (p = 0.01) and Living child (p = 0.02) in preterm twins' patients were statistically significantly lower than in the term patients.
 
 Conclusion: Our findings show that fetal loss following amniocentesis in twin pregnancies does not increase significantly compared to singleton pregnancies. However, our findings require repeated study in bigger sample size and as multi-centered as possible then It can be generalized to wider communities.