OBJECTIVE: The purpose of this study was to document pregnancy and neonatal outcome of monochorionic diamniotic twin pregnancies. STUDY DESIGN: This observational study describes a prospective series included in the first trimester in 2 centers of the Eurotwin2twin project. RESULTS: Of the 202 included twin pairs, 172 (85%) resulted in 2 survivors, 15 (7.5%) in 1 survivor, and 15 (7.5%) in no survivors. The mortality was 45 of 404 (11%), and 36 of 45 (80%) were fetal losses of 24 weeks or less, 5 of 45 (11%) between 24 weeks and birth, and 4 of 45 (9%) were neonatal deaths. Twin-to-twin transfusion syndrome (TTTS) occurred in 18 of 202 (9%). The mortality of TTTS was 20 of 36 (55%), which accounted for 20 of 45 (44%) of all losses. Severe discordant growth without TTTS occurred in 29 of 202 (14%). Its mortality was 5 of 58 (9%), which accounted for 5 of 45 (11%) of all losses. Major discordant congenital anomalies occurred in 12 of 202 (6%). Of the 178 pairs that continued after 24 weeks, 10 (6%) had severe hemoglobin differences at birth. After 32 weeks, the prospective risk of intrauterine demise was 2 in 161 pregnancies (1.2%; 95% confidence interval, 0.3-4.6). CONCLUSION: Of the monochorionic twins recruited in the first trimester, 85% resulted in the survival of both twins, and 92.5% resulted in the survival of at least 1 twin. Most losses were at 24 weeks or less, and TTTS was the most important cause of death. After 32 weeks, the risk of intrauterine demise appears to be small.
OBJECTIVE: The purpose of this study was to document pregnancy and neonatal outcome of monochorionic diamniotic twin pregnancies. STUDY DESIGN: This observational study describes a prospective series included in the first trimester in 2 centers of the Eurotwin2twin project. RESULTS: Of the 202 included twin pairs, 172 (85%) resulted in 2 survivors, 15 (7.5%) in 1 survivor, and 15 (7.5%) in no survivors. The mortality was 45 of 404 (11%), and 36 of 45 (80%) were fetal losses of 24 weeks or less, 5 of 45 (11%) between 24 weeks and birth, and 4 of 45 (9%) were neonatal deaths. Twin-to-twin transfusion syndrome (TTTS) occurred in 18 of 202 (9%). The mortality of TTTS was 20 of 36 (55%), which accounted for 20 of 45 (44%) of all losses. Severe discordant growth without TTTS occurred in 29 of 202 (14%). Its mortality was 5 of 58 (9%), which accounted for 5 of 45 (11%) of all losses. Major discordant congenital anomalies occurred in 12 of 202 (6%). Of the 178 pairs that continued after 24 weeks, 10 (6%) had severe hemoglobin differences at birth. After 32 weeks, the prospective risk of intrauterine demise was 2 in 161 pregnancies (1.2%; 95% confidence interval, 0.3-4.6). CONCLUSION: Of the monochorionic twins recruited in the first trimester, 85% resulted in the survival of both twins, and 92.5% resulted in the survival of at least 1 twin. Most losses were at 24 weeks or less, and TTTS was the most important cause of death. After 32 weeks, the risk of intrauterine demise appears to be small.
Authors: Tuangsit Wataganara; Arundhati Gosavi; Katika Nawapun; Pradip D Vijayakumar; Nisarat Phithakwatchara; Mahesh Choolani; Lin Lin Su; Arijit Biswas; Citra N Z Mattar Journal: J Vis Exp Date: 2018-03-21 Impact factor: 1.355
Authors: Erin E Washburn; Teresa N Sparks; Kristen A Gosnell; Larry Rand; Juan M Gonzalez; Vickie A Feldstein Journal: Am J Perinatol Date: 2018-02-08 Impact factor: 1.862
Authors: Erin E Washburn; Teresa N Sparks; Kristen A Gosnell; Larry Rand; Juan M Gonzalez; Vickie A Feldstein Journal: Am J Perinatol Date: 2017-12-29 Impact factor: 1.862
Authors: Marjolijn S Spruijt; Ellen Tameeris; De-Peng Zhao; Johanna M Middeldorp; Monique C Haak; Dick Oepkes; Enrico Lopriore Journal: Fetal Diagn Ther Date: 2017-03-11 Impact factor: 2.587
Authors: Vidya Rajagopalan; Karam Ashouri; Arlyn Llanes; Douglas L Vanderbilt; Natasha Lepore; Stefan Bluml; Hollie A Lai; Jessica Wisnowski; Andrew H Chon; Ramen H Chmait Journal: Prenat Diagn Date: 2020-11-26 Impact factor: 3.050