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[Chorionicity and adverse perinatal outcome]
Isabel Ferreira1, Carla Laureano, Miguel Branco
1Serviço de Obstetrícia, Maternidade Bissaya-Barreto, Coimbra.
Acta Medica Portuguesa
|October 7, 2005
Summary
Monochorionic twins face higher risks of complications and mortality compared to dichorionic twins. Early identification of chorionicity and enhanced prenatal care are crucial for improving outcomes in twin pregnancies.
Area of Science:
- Obstetrics
- Perinatology
- Maternal-Fetal Medicine
Background:
- Diamniotic monochorionic twins exhibit elevated rates of morbidity and mortality.
- Understanding chorionicity is vital for managing twin pregnancies.
Purpose of the Study:
- To compare adverse obstetric and perinatal outcomes in twin pregnancies based on chorionicity.
- To evaluate the impact of monochorionic versus dichorionic placentation on twin pregnancy complications.
Main Methods:
- Retrospective study of 140 diamniotic twin deliveries over three years.
- Comparison of monochorionic and dichorionic groups based on epidemiological data, obstetric outcomes, gestational age, delivery type, and neonatal morbidity/mortality.
- Statistical analysis using chi-squared and t-student tests.
Main Results:
- Monochorionic twins (34%) showed significantly higher rates of amniotic fluid pathology, discordant growth, and preterm delivery compared to dichorionic twins (66%).
- Neonates in the monochorionic group had lower birth weight, increased weight discordancy, higher incidence of intraventricular hemorrhage, and IUGR.
- Perinatal mortality was substantially higher in monochorionic pregnancies (93.7/1000) versus dichorionic (21.7/1000).
Conclusions:
- Monochorionic twin pregnancies are associated with significantly increased morbidity and mortality.
- Accurate identification of chorionicity is essential.
- High-standard prenatal surveillance in specialized centers is imperative for monochorionic twins.