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Single fetal demise in multiple pregnancy

https://doi.org/10.18705/2311-4495-2019-6-5-

Abstract

Single intrauterine fetal demise (sIUFD) in multiple pregnancy occurs with frequency from 3.7 up to 6.8 % and is associated with an risk of premature birth, death of cotwin and high morbidity and mortality rates in newborns. The time of sIUFD and type of twin gestation would determine perinatal outcomes. The rate of prenatal death of the co-twin is different and depend on the type of multiple pregnancy, accounting 4 % for dichorionic and 12 % in monochorionic pregnancies. However, the correlation between the type of chorionicity, delivery time and the frequency of preterm delivery is not clearly established. The risk of neurological complications in newborns after sIUFD fluctuate significantly in case of the type of chorionicity and could achieve 18 % in monochorionic twins and only 1 % in dichorionic twins. The paper was discussed the main reasons for sIUFD in multiple pregnancy, rather pathophysiological aspects of perinatal morbidity and mortality for cotwin was also discussed. The management of complications, methods of their correction, optimal methods and time of delivery in case of sIUDF in multiple pregnancies was presented.

About the Authors

A. A. Kuznetsov
Saint Petersburg State “Maternity Clinic № 17”; Federal State Budgetary Education Institution of Higher Education «Academician I. P. Pavlov First Saint Petersburg State Medical University» of Ministry of Healthcare of the Russian Federation
Russian Federation

Kuznetsov Alexander A., Doctor of the Maternity Ward

PhD Student of Obstetrics and Gynecology Department,



A. N. Romanovsky
Saint Petersburg State “Maternity Clinic № 17”; North-Western State Medical University named after I. I. Mechnikov; Federal State Budgetary Education Institution of Higher Education «Saint-Petersburg State University»

Romanovsky Artem N., Doctor of the Maternity Ward

Assistant of Department of Women’s Reproductive Health

Assistant of Department of Obstetrics, Gynecology and Reproductology



A. V. Shlykova
Saint Petersburg State “Maternity Clinic № 17”; North-Western State Medical University named after I. I. Mechnikov

Shlykova Anna V., Doctor of the Maternity Ward,

PhD Student of Obstetrics and Gynecology Department of S. N. Davydov



T. A. Kashtanova
Saint Petersburg State “Maternity Clinic № 17”
Kashtanova Tatiana A., Head of the Department of Prenatal Diagnostics


V. V. Shman
Saint Petersburg State “Maternity Clinic № 17”
Shman Vera V., Head of Delivery Department


I. V. Kyanksep
Saint Petersburg State “Maternity Clinic № 17”
Kyanksep Inna V., Doctor of Department of Prenatal Diagnostics


V. E. Movchan
North-Western State Medical University named after I. I. Mechnikov
Movchan Veronika E., Resident of Obstetrics and Gynecology Department of S. N. Davydov


N. E. Derzhavina
Saint Petersburg State “Maternity Clinic № 17”
Derzhavina Nadegda E., Subchief in Medicine


A. A. Savel’eva
Saint Petersburg State “Maternity Clinic № 17”
Savel’eva Anna A., MD, Doctor of Department of Prenatal Diagnostics


F. A. Ovsyannikov
Almazov National Medical Research Centre
Ovsyannikov Fillip A., PhD, Obstetrician-Gynecologist


A. V. Mikhailov
Saint Petersburg State “Maternity Clinic № 17”; North-Western State Medical University named after I. I. Mechnikov

Mikhailov Anton V., Dr. Sc., Professor, Chief

Chief of Department of Women's Reproductive Health

Chief Obstetrician-Gynecologist of the Ministry of Health of the Russian Federation in Saint Petersburg and the North-West Federal District.



References

1. Blickstein I, Keith LG. Multiple pregnancy: epidemiology, gestation, and perinatal outcome. CRC Press, 2005. p. 976.

2. Hillman SC, Morris RK, Kilby MD. Co-twin prognosis after single fetal death: a systematic review and metaanalysis. Obstet Gynecol. 2011;118(4):928–940.

3. Woo HH, Sin SY, Tang LC. Single foetal death in twin pregnancies: review of the maternal and neonatal outcomes and management. Hong Kong Med J. 2000;6(3):293– 300.

4. Kilby MD, Govind A, O’Brien PM. Outcome of twin pregnancies complicated by a single intrauterine death: a comparison with viable twin pregnancies. Obstet Gynecol. 1994;84(1):107–109.

5. Mikhailov AV, Romanovsky AN, Shlykova AN et al. Single fetal death in multiple pregnancy, in: the fetus and neonates as the patients. SPb.: Petropolis, 2015: 931–935. In Russian

6. Blickstein I, Perlman S. Single fetal death in twin gestations. J Perinat Med. 2013;41(1):65–69.

7. Mikhailov AV, Romanovsky AN, Kuznetsov AA et al. The main complications of fetoscopic laser coagulation of placental anastomoses in twin-to-twin transfusion syndrome. Tavricheskij mediko-biologicheskij vestnik=Tauride Medical and Biological Bulletin. 2018;21(2):189–194. In Russian

8. Romero R, Duffy TP, Berkowitz RL et al. Prolongation of a preterm pregnancy complicated by death of a single twin in utero and disseminated intravascular coagulation. Effects of treatment with heparin. N Engl J Med. 1984;310(12):772–774.

9. Ong SS, Zamora J, Khan KS et al. Prognosis for the co-twin following single-twin death: a systematic review. BJOG. 2006;113(9):992–998.

10. Kusuda S, Fujimura M, Sakuma I et al. Morbidity and mortality of infants with very low birth weight in Japan: center variation. Pediatrics. 2006;118(4):e1130–1138.

11. Santema JG, Swaak AM, Wallenburg HC. Expectant management of twin pregnancy with single fetal death. Br J Obstet Gynaecol. 1995;102(1):26–30.

12. Bajoria R, Wee LY, Anwar S et al. Outcome of twin pregnancies complicated by single intrauterine death in relation to vascular anatomy of the monochorionic placenta. Hum Reprod. 1999;14(8):2124–2130.

13. Nicolini U, Pisoni MP, Cela E et al. Fetal blood sampling immediately before and within 24 hours of death in monochorionic twin pregnancies complicated by single intrauterine death. Am J Obstet Gynecol. 1998;179(3Pt1):800– 803.

14. Okamura K, Murotsuki J, Tanigawara S et al. Funipuncture for evaluation of hematologic and coagulation indices in the surviving twin following co-twin’s death. Obstet Gynecol. 1994;83(6):975–978.

15. Nakata M, Sumie M, Murata S et al. A case of monochorionic twin pregnancy complicated with intrauterine single fetal death with successful treatment of intrauterine blood transfusion in the surviving fetus. Fetal Diagn Ther. 2007;22(1):7–9.

16. Mari G, Deter RL, Carpenter RL et al. Noninvasive diagnosis by doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative group for doppler assessment of the blood velocity in anemic fetuses. N Engl J Med. 2000;342(1):9–14.

17. Shek NW, Hillman SC, Kilby MD. Single-twin demise: pregnancy outcome. Best Pract Res Clin Obstet Gynaecol. 2014;28(2):249–263.

18. Mikhailov A, Romanovsky A. Multiple pregnancy under ultrasound umbrella. Donald School Journal of Ultrasound in Obstetrics and Gynecology. 2011;5(3):219–230.

19. Murphy KW. Intrauterine death in a twin: implications for the survivor. In: Multiple pregnancy. London: RCOG Press, 1995:218–230.

20. Patten RM, Mack LA, Nyberg DA et al. Twin embolization syndrome: prenatal sonographic detection and significance. Radiology. 1989;173(3):685–689.

21. Senat MV, Bernard JP, Loizeau S et al. Management of single fetal death in twin-to-twin transfusion syndrome: a role for fetal blood sampling. Ultrasound Obstet Gynecol. 2002;20(4):360–363.

22. Tanawattanacharoen S, Taylor MJ, Letsky EA et al. intrauterine rescue transfusion in monochorionic multiple pregnancies with recent single intrauterine death. Prenat Diagn. 2001;21(4):274–278.

23. Fichera A, Zambolo C, Accorsi P et al. Perinatal outcome and neurological follow up of the cotwins in twin pregnancies complicated by single intrauterine death. Eur J Obstet Gynecol Reprod Biol. 2009;147(1):37–40.

24. D’Alton ME, Newton ER, Cetrulo CL. Intrauterine fetal demise in multiple gestation. Acta Genet Med Gemellol (Roma). 1984;33(1):43–49.


Review

For citations:


Kuznetsov A.A., Romanovsky A.N., Shlykova A.V., Kashtanova T.A., Shman V.V., Kyanksep I.V., Movchan V.E., Derzhavina N.E., Savel’eva A.A., Ovsyannikov F.A., Mikhailov A.V. Single fetal demise in multiple pregnancy. Translational Medicine. 2019;6(5):31-38. (In Russ.) https://doi.org/10.18705/2311-4495-2019-6-5-

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ISSN 2311-4495 (Print)
ISSN 2410-5155 (Online)