Expectant management of twin pregnancy with single fetal death.

OBJECTIVE

To evaluate the course and outcome of expectantly managed twin pregnancies with single fetal death in the second half of gestation.

DESIGN

Case-controlled study of 29 consecutive pregnancies from 1973 to 1993, with sonographic evidence of a twin at 20 weeks gestation with antenatal demise later in pregnancy, matched for maternal parity with 58 twin pregnancies without fetal death and delivered in the same year as the index case. Outcome measures included the incidence of complications of pregnancy, gestational age and mode of delivery, placentation, and perinatal outcome.

SETTING

University Hospital Rotterdam.

RESULTS

The frequency and severity of pregnancy-induced hypertensive disorders was significantly higher in the study group than in controls. We found no differences between the study group and controls with regard to median gestational age at delivery (33 weeks versus 34 weeks) and median birthweight of liveborn infants (1880 g versus 2160 g). No consumptive coagulopathy was apparent in our 29 patients. The main cause of neonatal death was prematurity; multicystic encephalomalacia was not observed.

CONCLUSIONS

Our results support expectant management in twin pregnancies complicated by single fetal death.