[SINGLE FETAL DEMISE IN MONOCHORIONIC TWINS].
1Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot and the Hadassah-Hebrew University School of Medicine, Jerusalem.
Harefuah
|June 30, 2017
Summary
Single fetal death in monochorionic twins can harm the survivor. About 30% of surviving twins experience serious injury, often to the brain, due to blood pressure changes.
Area of Science:
- Perinatology
- Fetal Medicine
- Twin Gestation
Background:
- Single fetal demise is more common in monochorionic twins than dichorionic twins.
- Inter-twin vascular anastomoses in monochorionic placentas can cause blood pressure shifts upon one twin's death.
Purpose of the Study:
- To report the incidence of injury in surviving twins following single fetal demise in monochorionic gestations.
- To highlight the risk of ischemic injury, particularly brain injury, in survivors.
Main Methods:
- Review of cases involving single fetal demise in monochorionic twin pregnancies.
- Analysis of outcomes for surviving co-twins, focusing on neurological and systemic injury.
Main Results:
- Approximately 30% of surviving twins sustain serious injury, with brain injury being most common.
- The severity of injury correlates with the magnitude and abruptness of blood pressure changes in the survivor.
- Previous estimates of survivor injury incidence were significantly lower.
Conclusions:
- Single fetal demise in monochorionic twins carries a substantial risk of serious injury to the survivor.
- Early delivery of the survivor is generally not indicated as damage often precedes diagnosis.
- Increased awareness and monitoring for neurological complications in survivors are warranted.
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