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Effects of Single Fetal Death on Mother and Live Co-twin in Twin Pregnancy

Journal of the Korean Pediatric Society 2002;45(12):1512-1518.
Published online December 15, 2002.
Effects of Single Fetal Death on Mother and Live Co-twin in Twin Pregnancy
So Youn Kim, Hae Yul Chung, Hee Jo Back, Ic Sun Choi, Chang Yee Cho, Young Youn Choi
Departments of Pediatrics, Chonnam National University Medical School, Gwangju, Korea
쌍태 임신에서 일측 태아의 자궁내 사망이 산모와 생존아에 미치는 영향
김소연, 정해율, 백희조, 최익선, 조창이, 최영륜
전남대학교 의과대학 소아과학교실
Correspondence: 
Young Youn Choi, Email: yychoi@chonnam.ac.kr
Abstract
Purpose
: Twins have a higher mortality and morbidity than singletons. Co-twin with one fetal death is particularly at risk. We investigated the neonatal outcome of live co-twins when one fetus had died after the 20th gestational week, and associated risk factors.
Methods
: A retrospective study was performed in fifteen cases of twin pregnancy with single intrauterine fetal deaths after the 20th gestational week during the period from January 1996 to December 2000 at Chonnam University Hospital.
Results
: Gestational age was 33.7?.2 weeks, birth weight was 1,992?92 g. Interval between one fetal death being detected and the delivery of a live co-twin was 32.4?9.5 days. There were 11 cases(73.3%) of premature babies less than 37 gestational weeks. Main causes of preterm delivery were preterm labor and premature rupture of membranes. Hematologic findings suggesting disseminated intravascular coagulopathy(DIC) were not found in all mothers before delivery, and was not associated with DIC and encephalomalacia of the live co-twin. Perinatal outcome of fifteen live co-twins was as follows : six were normal(40%), three were DIC(20.0%), three were encephalomalacia(20.0%), one suffered intrauterine growth retardation, there was one case of twin to twin transfusion syndrome, and one of congenital heart disease(atrial septal defect with pulmonary stenosis). The occurrence of DIC and encephalomalacia in live co-twins was not related to placental chorionicity, birth weight, gestational week, and the interval between the detection one fetal death and the delivery of a live co-twin.
Conclusion
: We could not find any maternal hematologic problems in twin pregnancies complicated by one fetal death. Twenty percent of live co-twins showed DIC and encephalomalacia. However, its associated risk factors were not found. We need to investigate more closely the cases of live co-twins with one intrauterine fetal death.
Key Words: Twin pregnancies, Intrauterine fetal death, Outcome of live co-twin


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