scholarly journals Maternal and neonatal outcome of twin pregnancies with single fetal demise

2021 ◽  
Vol 10 (8) ◽  
pp. 3095
Author(s):  
Gunjan Rai ◽  
Sudhir Mansingh ◽  
Bikram Bhardwaj
Keyword(s):  
Twin Pregnancy ◽  
Fetal Death ◽  
Neonatal Outcome ◽  
Successful Outcome ◽  
Fetal Demise ◽  
Neonatal Complication ◽  
At Command ◽  
Fetal Complications ◽  
Live Fetus ◽  
Twin Pregnancies

 Background: In current study we managed twin pregnancies having single fetal demise with a successful outcome. Generally monochorionic and monoamniotic pregnancies are having high probability of complications, so we have to be more watchful in these pregnancies. Termination of pregnancy is not the only option as we can manage and prolong pregnancies with a good outcome by strict monitoring of patients. Aim of our study was to look for fetomaternal outcome in twin pregnancies with single fetal demise.Methods: This is a retrospective study done between July 2017 to June 2020 at Command hospital, Panchkula, Haryana. Total 3249 deliveries have been conducted during above said period. Out of which 47 deliveries were having twin pregnancy. We had six twin pregnancies who reported with one fetal demise. These cases were managed with regular monitoring of coagulation profile and strict fetal surveillance for surviving twin. The cases were studied for antenatal, postnatal and any neonatal complication.Results: No antenatal, postnatal maternal or any neonatal complication observed in this study. During study period we delivered total 3249 patients, out of which 47 were twin pregnancy. Out of these 47 (1.44%) twins’ pregnancies 33 (70.31%) were DADC and 14 (29.69%) DAMC. We studied six twin pregnancies who had single fetal demise. Conclusions: Even with single fetal demise pregnancies can be continued till term with strict monitoring for maternal and fetal complications. Termination is not the only answer in twin pregnancies with single fetal demise. Although our study was small, it indicates that in case of twin pregnancy with single fetal death and under good surveillance, the live fetus can be salvaged. 

Maternal and neonatal outcome of twin pregnancies complicated by single fetal death

1999 ◽  
Vol 27 (3) ◽  
Author(s):  
R. Axt ◽  
D. Mink ◽  
J. Hendrik ◽  
K. Ertan ◽  
M. von Blohn ◽  
...  
Keyword(s):  
Fetal Death ◽  
Neonatal Outcome ◽  
Twin Pregnancies

Perinatal Outcome of Twin Pregnancies Complicated by Rupture of Membranes at 13–20 Weeks: Is Selective Termination an Appropriate Management Option?

2020 ◽  
Vol 41 (04) ◽  
pp. e17-e22
Author(s):  
Michal Zajicek ◽  
Simcha Yagel ◽  
Dan Valsky ◽  
Moshe Ben-Ami ◽  
Yoav Yinon ◽  
...  
Keyword(s):  
Survival Rate ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Clinical Signs ◽  
Expectant Management ◽  
Inclusion Criteria ◽  
Fetal Demise ◽  
Management Group ◽  
Gestational Age At Delivery ◽  
Twin Pregnancies

Abstract Objective To evaluate the outcome of twin pregnancies that were complicated by rupture of membranes at 13–20 weeks of gestation and were managed by expectant management or by selective termination. Methods A retrospective cohort study of all bichorionic twin pregnancies that were referred to three fetal medicine units between 2001 and 2016, due to rupture of membranes of one sac at 13–20 weeks of gestation. Women without clinical signs of infection who opted for expectant management or selective termination were included. Results 20 patients met the inclusion criteria. 7 of them were managed expectantly and 13 underwent selective termination. In the expectant management group there was one case of fetal demise and two cases of neonatal death, resulting in a survival rate of 79 %. The median gestational age at delivery was 30 weeks. 3 neonates suffered from prematurity-related complications and 2 suffered from oligohydramnios-related orthopedic complications. Following selective termination the survival rate was 50 % (all fetuses that were not reduced), the median gestational age at delivery was 39 weeks, and the neonatal outcome was favorable. The maternal outcome was favorable in both groups. Conclusion Selective termination in twin pregnancies complicated by rupture of membranes at 13–20 weeks has a favorable outcome and should be offered.

scholarly journals Maternal determinants and fetal outcome of twin pregnancy: a five-year survey

2017 ◽  
Vol 6 (6) ◽  
pp. 2459
Author(s):  
Rachel Mathew ◽  
Vinitha Wills ◽  
Jacob Abraham
Keyword(s):  
Perinatal Mortality ◽  
Twin Pregnancy ◽  
Mode Of Delivery ◽  
Age Groups ◽  
Fetal Outcome ◽  
Normal Weight ◽  
Maternal Risk ◽  
Younger Age ◽  
Fetal Complications ◽  
Twin Pregnancies

Background: Study prevalence of twin pregnancy, maternal risk factors and fetal outcome in twin pregnancy.Methods: A retrospective study of mothers with twin pregnancies who delivered during the period of 5 years. There were 109 mothers who gave birth to 218 babies. Maternal details, antenatal complications and fetal outcomes were analysed.Results: There were 5432 deliveries which included 109 twin births. Prevalence of twinning was 20/1000 deliveries. The mean age was 28.11 (±SD 4.89) with 69.7% in the younger age groups. No association with parity, BMI and ovulation induction was found. Most common complication was preterm delivery (64.2%) with mean gestational age being 35.07 (±SD 2.32). Others were diabetes (25.7%), hypertension (22.9%), hypothyroidism (14.6%) and postpartum hemorrhage (13.7%). Cesarean section was the commonest mode of delivery (78.0%) with fetal malpresentation (26.6%), fetal distress (20.2%) and hypertension (12.0%) being the commonest indications for termination. Among the hypertensive mothers, 23 delivered by Cesarean and only 2 delivered vaginally which was statistically significant (p- 0.03 OR 5.20). Dichorionicity was commoner than monochorionicity (66.1% vs. 33.9%). Among 218 fetuses delivered, 214 were live births and 4 still born. There were low birth weight Babies (70.6%), normal weight (15.3%), VLBW babies (11.5%) and 2.7% ELBW babies. Fetal complications were IUGR (11.46%), discordant twins (6.8%), congenital anomalies (1.8%), single fetal demise (1.8%) and Intra uterine death of a twin (0.4%). Perinatal mortality rate was 1.65 per thousand births.Conclusions: Prevalence of twin pregnancy was 20/1000 deliveries. Twin pregnancies were seen to be more in the younger age group. Preterm labor, diabetes and hypertension were the main complications with cesarean the most common mode of delivery. Dichorionicity led to less fetal complications and low perinatal mortality.

scholarly journals Management of twin pregnancy with a hydatidiform mole and surviving healthy co-existent fetus

2017 ◽  
Vol 6 (12) ◽  
pp. 5636
Author(s):  
Hale Goksever Celik ◽  
Gözde Meriç Demirezen ◽  
Baki Erdem ◽  
Alev Atış Aydın ◽  
Volkan Ülker
Keyword(s):  
Maternal Morbidity ◽  
Twin Pregnancy ◽  
Hydatidiform Mole ◽  
Uterine Cavity ◽  
First Trimester ◽  
Molar Pregnancy ◽  
Complete Mole ◽  
Live Fetus ◽  
Twin Pregnancies ◽  
Normal Placenta

Twin pregnancies with complete mole and a coexisting live fetus are rare obstetric conditions seen in 1 case of 22000 to 100000 pregnancies. In our case, a twin molar pregnancy was diagnosed in the first trimester by ultrasound. In a 27-year-old patient with the first pregnancy, a 12-week live fetus with a normal placenta and a twin molar pregnancy appearance were observed on a routine ultrasonographic examination of the uterine cavity. Twin molar pregnancies are reported to be terminated by live birth in the literature, but termination of pregnancy is an important option to prevent maternal morbidity since molar pregnancy may lead to complications ranging from theca lutein cysts to gestational trophoblastic neoplasia.

scholarly journals Intrauterine Single Fetal Demise in Twin Pregnancy

2018 ◽  
Vol 6 (1) ◽  
pp. 53-57
Author(s):  
Roksana Haque ◽  
Md Mizanur Rahman ◽  
Khaleda Akhter
Keyword(s):  
Fetal Death ◽  
Preterm Labour ◽  
Post Partum ◽  
Fetal Monitoring ◽  
First Trimester ◽  
Third Trimester ◽  
Fetal Demise ◽  
First Case ◽  
Fetal Complications ◽  
Second Twin

Intrauterine demise of one of the twin fetuses during second or third trimester of pregnancy is an uncommon complication. Fetal death of a twin during the first trimester is not an uncommon event and does not appear to impair the development of the second twin. However, fetal death during second or third trimester may increase the risk of IUGR, microcephaly, cerebral encephalomalacia, pre eclampsia, preterm labour, perinatal mortality. We present two cases with single fetal demise. Death of one of the two fetuses occurred at 23 weeks of gestation in the first case and at 33 weeks in the second case. Both patients were managed conservatively with close fetal monitoring and serial assessment of mother’s clotting profile. Cesarean section was done especially due to patients’ interest at 34 weeks and 35 weeks respectively. A fetus papyraceous was found in the first case. Both the cases were dichorionic diamniotic pregnancies with no maternal and fetal complications during pregnancy or the post partum period.Delta Med Col J. Jan 2018 6(1): 53-57

scholarly journals Prolonged latency period of 70 days in a diamniotic and dichorionic twin pregnancy complicated by early second trimester rupture of membrane in one sac and its outcome

2015 ◽  
Vol 1 (8) ◽  
pp. 317
Author(s):  
Manisha Sahu ◽  
Sasmita Das ◽  
Kabita Chananya
Keyword(s):  
Conservative Management ◽  
Twin Pregnancy ◽  
Latency Period ◽  
Bed Rest ◽  
Lung Hypoplasia ◽  
Second Trimester ◽  
Assisted Reproduction Technique ◽  
Long Latency ◽  
Live Fetus ◽  
Twin Pregnancies

A patient with diamniotic dichorionic twin (DADC) pregnancy was on regular antenatal checkup from conception, admitted to emergency department at 21 weeks with leaking PV. On per speculum and pervaginal examination it was found that clear liquor was draining from os &amp; cervix was long and os was closed. USG revealed twin A sac having  live fetus of 20 weeks with no liquor and twin B sac having live fetus with plenty of liquor. Considering the emotional aspect of parents we decided for conservative management   which includes combination of antibiotics, micronized progesterone as tocolytic, probiotics, L- arginine and absolute bed rest. Caesarean section was performed at 31 weeks as she entered in labour and had cord prolapse. She delivered two live twin babies after a long latency period of 70 days. Twin ‘A’ baby could not be saved because of lung hypoplasia due to prolonged Oligohydraminous but twin ‘B’ was discharged safely along with mother. Since last decade assisted reproduction technique has increased in numbers of twin pregnancies and its complications. The most important are preterm labour and PPROM. On literature review there is no clear cut guide line for management of PPROM in early second trimester in twin pregnancies. This case is reported because of its long latency period of 70 days from PPROM in early 2<sup>nd</sup> trimester in a twin pregnancy to delivery by conservative management and can save the baby in intact sac. Also we can add our experience to currently available limited literature regarding management of such patient.

scholarly journals Ultrasonographic diagnosis of twins in two pregnant bitches: case report

2020 ◽  
Vol 72 (1) ◽  
pp. 102-106
Author(s):  
L. Pavan ◽  
B. Gasser ◽  
V.J.C. Santos ◽  
M.C. Maronezi ◽  
P. Silva ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Fetal Death ◽  
The Other ◽  
Multiple Pregnancies ◽  
Monochorionic Twins ◽  
Monochorionic Twin ◽  
Ultrasonographic Diagnosis ◽  
Placental Site ◽  
Twin Pregnancies ◽  
Two Bodies

ABSTRACT Multiple pregnancies in humans account for only 3% of pregnancies, 97-98% of which are twin pregnancies and the morbimortality is higher in the monochorionic twins when compared to dichorionic ones. The canine species is naturally multiparous, but the diagnosis of monochorionic twin pregnancy is not common. The objective of this report was to describe the ultrasonographic diagnosis of monochorionic twin pregnancies in two bitches [Pug (case 1) and Shih tzu (case 2)]. It was possible to verify the presence of one gestational vesicle containing two fetuses in each female by observing two heads or two bodies within the same placental site. These fetuses presented adequate viability and normal organogenesis. Their development was similar to the other fetuses. In case 1 they were stillborn and smaller than the other five live-born fetuses. The twins in case 2 were born alive, but they also appeared smaller when compared to the littermates. The gestational risks associated with this condition in pregnant bitches are still unknown, however, there are reports of fetal death in monochorionic pregnancies in this species. Therefore, ultrasonographic exam during pregnancy allows an early monochorionic diagnosis and monitoring the fetal viability could bring health benefits to both the female and the littermates.

Sudden fetal death of a co-twin as a complication of intrafetal laser surgery and placenta examination with dye

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Hakan Erenel ◽  
Sevim Ozge Korkmaz ◽  
Mehmet Fatih Karsli ◽  
Aysegul Ozel ◽  
Cihat Sen
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Congenital Anomalies ◽  
Laser Surgery ◽  
Twin Pregnancy ◽  
Fetal Death ◽  
Growth Restriction ◽  
Fetal Anomaly ◽  
Distinct Entity ◽  
Fetal Demise

Abstract Monochorionic (MC) twin pregnancy is a distinct entity and has certain differences from dichorionic twins due to the unique placental angioarchitecture. It is characterized by twin-to-twin transfusion syndromes (twin oligohydramnios-polyhydramnios sequence and twin anemia-polycythemia sequence), acardiac twinning, selective fetal growth restriction and congenital anomalies. Selective termination is an option in MC twins complicated by selective fetal growth restriction and discordant fetal anomaly. Fetal demise of the co-twin can occur even after uncomplicated surgery. A selective fetal termination using an intrafetal laser was performed in the case of an MC twin pregnancy complicated by twin oligohydramnios-polyhydramnios sequence and hydrocephalus in the donor twin. Fetal demise of the co-twin was observed after surgery. The placenta was examined with dye injections after abortion and showed vascular anastomoses causing unexpected fetal demise.

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