[Single live-birth after twin conception]

Area of Science:

• Maternal-Fetal Medicine
• Reproductive Science
• Medical Imaging

Background:

• Multiple gestations carry inherent risks, including the demise of one or more fetuses.
• Intrauterine fetal demise in multiple pregnancies can lead to various maternal and fetal complications.
• The timing of fetal demise significantly influences pregnancy outcomes and management strategies.

Purpose of the Study:

• To review pregnancy outcomes following the demise of one or more fetuses in multiple gestations.
• To correlate the timing of intrauterine demise with specific sonographic findings and complications.
• To discuss the phenomenon of spontaneous fetal reduction in the context of multiple pregnancies.

Main Methods:

• Review of literature on pregnancy outcomes after fetal demise in multiple gestations.
• Analysis of sonographic findings associated with first and second-trimester fetal demise.
• Case examples illustrating complications such as fetus papyraceous and stuck twins.

Main Results:

• First-trimester demise may result in empty chorionic sacs identified sonographically.
• Second-trimester demise can lead to the formation of fetus papyraceous or a 'stuck twin' (growth-retarded, dead fetus).
• These complications contribute to spontaneous fetal reduction in multiple pregnancies.

Conclusions:

• The timing of intrauterine fetal demise is a critical factor in determining pregnancy outcomes.
• Sonographic evaluation is essential for diagnosing complications associated with fetal demise in multiple gestations.
• Fetal demise in multiple pregnancies can result in spontaneous fetal reduction through various mechanisms.