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Related Experiment Videos

When do perinatal deaths in multiple pregnancies occur?

J R Fliegner1

  • 1Department of Obstetrics and Gynaecology, University of Melbourne.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|November 1, 1989
PubMed
Summary

Perinatal mortality in multiple pregnancies is significantly higher than in singletons, primarily due to prematurity and growth restriction. Early interventions before 26 weeks are crucial for improving outcomes in multiple births.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatology
  • Neonatology

Background:

  • Perinatal mortality rates for multiple pregnancies are substantially higher than for singleton births.
  • Key contributors to perinatal loss include extreme prematurity before 30 weeks and intrauterine growth retardation after 32 weeks.

Purpose of the Study:

  • To analyze the causes and timing of perinatal losses in multiple pregnancies.
  • To identify critical gestational windows for intervention and assess the impact of infant birth weight on mortality.

Main Methods:

  • Analysis of perinatal mortality data in multiple births.
  • Comparison of mortality rates based on gestational age and infant birth weight.
  • Evaluation of stillbirth rates in twins relative to gestational age.

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Main Results:

  • Sixty-four percent of perinatal losses before 30 weeks occur before 26 weeks' gestation.
  • Infants in multiple births weighing 500-2,500g have a 10-fold higher mortality rate than singletons.
  • The stillbirth rate in twins beyond 38 weeks' gestation is triple that of singletons.

Conclusions:

  • Prophylactic measures in multiple pregnancies should commence earlier, ideally before 26 weeks' gestation.
  • Infant birth weight is a critical factor influencing perinatal mortality in multiple births.
  • Elective termination of pregnancy by 38 weeks is recommended for twins if spontaneous labor has not initiated.