Clinical characteristics and outcome of twin pregnancies complicated by single intrauterine death.

AIM: To investigate the clinical characteristics and outcome of twin pregnancies complicated by single intrauterine death and how to improve the outcomes of surviving twins. Three thousand three hundred and eighty-four women who delivered twin pregnancies at Women's Hospital, Zhejiang University, School of Medicine were included. Clinical and demographic data on gestational age, etiology, morbidity and mortality for mothers and fetuses were collected.

RESULTS: The median gestational age for detecting a single intrauterine death in twin pregnancy was 29 weeks and the average gestational age of pregnancy termination was 32 weeks. At least one complication occurred in 93 of 134 mothers (69.4%). The leading causes of a single intrauterine death were umbilical cord abnormality (21.6%), congenital anomalies (17.9%), twin-twin transfusion syndrome (TTTS) (8.2%) and velamentous placenta (7.4%). Of the 134 cases, in 115 cases the remaining twin survived. The birth weight of the surviving twin was significantly higher in pregnancies that continued for more than 1 week after single intrauterine death compared to that ended within 1 week after intrauterine death.

CONCLUSIONS: Extension of gestation for the surviving twin fetus as long as possible in ensuring the health of the surviving twin and mother, will improve the prognosis of surviving twin after a single intrauterine death.