The prognosis of Monochorionic co-twin after single intrauterine fetal demise

Abstract

Objective: To analyze the prognosis of surviving monochorionic co-twin after single intrauterine fetal demise (sIUFD). Methods: Retrospectively analyzed the twin pregnancy cases admitted in Peking University Third Hospital between Jan 2008 and Feb 2015. We recorded perinatal characteristics, neuroimage in co-twin, and followed up the neonatal outcome. Results: 47 cases were found, including 45 cases of monochorionic diamniotic (MCDA) and 2 cases of monochorionic monoamniotic (MCMA). Median gestational age at sIUFD was 27 weeks.Median interval between sIUFD and birth was 3.3 weeks.Median gestational age at birth was 34.2 weeks.The causes of sIUFD were: MCMA (2/47, 4.3%), sIUGR (11/47, 23.4%), twin-twin transfusion syndrome (TTTS) (16/47, 34.0%) or TTTS complicated with sIUGR (3/47, 6.4%). In the sIUGR pregnancies, sIUFD occurred all in the growth-restricted fetus.In the TTTS pregnancies, sIUFD always occurred in donors (15/16, 93.8%). There were 41 (87.2%) live-born co-twins.Among the live births, fetal cranial ultrasound showed that 7 neonatus got intraventricular hemorrhage.There were 6 neonatus dead in first 28 days.All of the 35 survivors whose follow up from 12 to 70 months, responses were all received and nobody had cerebral palsy. Conclusion: sIUFD always occurred in the growth-restricted fetus and the donor-twins. There was nobody had cerebral palsy in the survivors.