Perinatal Outcomes of Single Intrauterine Fetal Death in Twin Pregnancies: A Tertiary Center Experience

Müjde Can İbanoğlu; Betül Tokgöz; Kadriye Yakut Yücel; Seval Yılmaz Ergani; Erkan Saglam; Aykut Kından; Cantekin İskender; Ali Çağlar

Article Details

Perinatal Outcomes of Single Intrauterine Fetal Death in Twin Pregnancies: A Tertiary Center Experience

Authors:

Müjde Can İbanoğlu | Betül Tokgöz | Kadriye Yakut Yücel | Seval Yılmaz Ergani | Erkan Saglam | Aykut Kından | Cantekin İskender | Ali Çağlar

Publisher:

Selcuk University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Genel Tıp Dergisi Vol.33 Issue 2, pp.219-225

Document Type:

Article

Publication Date:

4/2023

Document Language:

English

Document ID (Org No.):

2001288880

pISSN:

2602-3741

Keywords:

Abstract:

 ABSTRACT Aim: Twin pregnancies are associated with increased perinatal mortality and morbidity compared with singleton pregnancies. Single intrauterine fetal death sIUFD is difficult to treat. This is because the twin who survives after sIUFD is at high risk for mortality, neurological damage, and other complications of preterm birth. Therefore, in this study, we aimed to determine the perinatal consequences for the surviving fetus. We also investigated the association between chorionicity, maternal characteristics, and fetal and maternal concomitant complications in these cases. Methods: We conducted a retrospective case-control observational study that included twin births complicated by sIUFD followed up in the Department of Perinatology. Data, including demographic characteristics and prenatal invasive procedures, weeks of sIUFD, delivery time, fetal sex, interval between delivery and fetal loss, fetal distress, mode of delivery, birth weight, presence of placental pathology or umbilical cord abnormalities, neonatal Apgar scores in the first and fifth minutes, and need for neonatal intensive care unit NICU, were obtained from obstetric records and hospital database. Results: Fifty-three twin pregnancies with a single fetal death were included in the study. The mean age of the pregnants participating in the study was 30  6 years. The mean body mass index BMI of the mother was 28.8 22-43. Twenty-four 45.3 cases were dichorionic DC diamniotic, 20 37.7 were monochorionic MC diamniotic, and 9 17 were monochorionic monoamniotic. The time between IUFD and birth of the live twin was 75 days in MCs and 105 days in DCs p0.150. The mean gestational age at birth of the surviving twin was 30 weeks gestation in MCs and 34 weeks gestation in DCs p0.030. In 23 79.3 MC pregnancies and 15 62.5 DC pregnancies, delivery occurred before 37 weeks p0.176. In addition, deliveries before 34 weeks occurred more frequently in 19 65.5 of MC pregnancies than in 8 33.3 of DC pregnancies p0.020. Conclusion: We have shown that the birth of the live fetus in the MC group occurred at a significantly earlier time, and mortality and morbidity were observed more frequently in this fetus. However, this research explaining the etiology of sIUFD is insufficient.

 ABSTRACT Aim: Twin pregnancies are associated with increased perinatal mortality and morbidity compared with singleton pregnancies. Single intrauterine fetal death sIUFD is difficult to treat. This is because the twin who survives after sIUFD is at high risk for mortality, neurological damage, and other complications of preterm birth. Therefore, in this study, we aimed to determine the perinatal consequences for the surviving fetus. We also investigated the association between chorionicity, maternal characteristics, and fetal and maternal concomitant complications in these cases. Methods: We conducted a retrospective case-control observational study that included twin births complicated by sIUFD followed up in the Department of Perinatology. Data, including demographic characteristics and prenatal invasive procedures, weeks of sIUFD, delivery time, fetal sex, interval between delivery and fetal loss, fetal distress, mode of delivery, birth weight, presence of placental pathology or umbilical cord abnormalities, neonatal Apgar scores in the first and fifth minutes, and need for neonatal intensive care unit NICU, were obtained from obstetric records and hospital database. Results: Fifty-three twin pregnancies with a single fetal death were included in the study. The mean age of the pregnants participating in the study was 30  6 years. The mean body mass index BMI of the mother was 28.8 22-43. Twenty-four 45.3 cases were dichorionic DC diamniotic, 20 37.7 were monochorionic MC diamniotic, and 9 17 were monochorionic monoamniotic. The time between IUFD and birth of the live twin was 75 days in MCs and 105 days in DCs p0.150. The mean gestational age at birth of the surviving twin was 30 weeks gestation in MCs and 34 weeks gestation in DCs p0.030. In 23 79.3 MC pregnancies and 15 62.5 DC pregnancies, delivery occurred before 37 weeks p0.176. In addition, deliveries before 34 weeks occurred more frequently in 19 65.5 of MC pregnancies than in 8 33.3 of DC pregnancies p0.020. Conclusion: We have shown that the birth of the live fetus in the MC group occurred at a significantly earlier time, and mortality and morbidity were observed more frequently in this fetus. However, this research explaining the etiology of sIUFD is insufficient.

 ABSTRACT Aim: Twin pregnancies are associated with increased perinatal mortality and morbidity compared with singleton pregnancies. Single intrauterine fetal death sIUFD is difficult to treat. This is because the twin who survives after sIUFD is at high risk for mortality, neurological damage, and other complications of preterm birth. Therefore, in this study, we aimed to determine the perinatal consequences for the surviving fetus. We also investigated the association between chorionicity, maternal characteristics, and fetal and maternal concomitant complications in these cases. Methods: We conducted a retrospective case-control observational study that included twin births complicated by sIUFD followed up in the Department of Perinatology. Data, including demographic characteristics and prenatal invasive procedures, weeks of sIUFD, delivery time, fetal sex, interval between delivery and fetal loss, fetal distress, mode of delivery, birth weight, presence of placental pathology or umbilical cord abnormalities, neonatal Apgar scores in the first and fifth minutes, and need for neonatal intensive care unit NICU, were obtained from obstetric records and hospital database. Results: Fifty-three twin pregnancies with a single fetal death were included in the study. The mean age of the pregnants participating in the study was 30  6 years. The mean body mass index BMI of the mother was 28.8 22-43. Twenty-four 45.3 cases were dichorionic DC diamniotic, 20 37.7 were monochorionic MC diamniotic, and 9 17 were monochorionic monoamniotic. The time between IUFD and birth of the live twin was 75 days in MCs and 105 days in DCs p0.150. The mean gestational age at birth of the surviving twin was 30 weeks gestation in MCs and 34 weeks gestation in DCs p0.030. In 23 79.3 MC pregnancies and 15 62.5 DC pregnancies, delivery occurred before 37 weeks p0.176. In addition, deliveries before 34 weeks occurred more frequently in 19 65.5 of MC pregnancies than in 8 33.3 of DC pregnancies p0.020. Conclusion: We have shown that the birth of the live fetus in the MC group occurred at a significantly earlier time, and mortality and morbidity were observed more frequently in this fetus. However, this research explaining the etiology of sIUFD is insufficient.

 ÖZET Amaç: İkiz gebelikler, tekil gebeliklere kıyasla artmış perinatal mortalite ve morbidite ile ilişkilidir. Tek intrauterin fetal ölüm sIUFDise yönetilmesi zor bir durumdur. Çünkü SIUFDden sonra hayatta kalan ikiz, mortalite, nörolojik hasar ve diğer erken doğum komplikasyonları açısından yüksek risk altındadır. Bu nedenle bu çalışmada hayatta kalan fetüsün perinatal sonuçlarını belirlemeyi amaçladık. Ayrıca bu olgularda koryonisite, maternal özellikler ve fetal ve maternal eşlik eden komplikasyonlar arasındaki ilişkiyi de inceledik. Yöntemler: Perinatoloji Anabilim Dalında izlenen sIUFD ile komplike ikiz doğumları içeren retrospektif bir vaka kontrollü gözlemsel çalışma yürüttük. Demografik özellikler ve prenatal invaziv prosedürler, intrauterine exitus gerçekleşitiği haftaları, doğum süresi, fetal cinsiyet, doğum ile fetal kayıp arasındaki süre, fetal distres, doğum şekli, doğum ağırlığı, plasenta patolojisi veya göbek kordonu anormallikleri varlığı, neonatal Apgar skorları dahil olmak üzere veriler birinci ve beşinci dakikalar ve yenidoğan yoğun bakım ünitesi YYBÜ ihtiyacı, obstetrik kayıtlardan ve hastane veri tabanından elde edildi. Bulgular: Çalışmaya tek fetal ölümü olan 53 ikiz gebelik dahil edildi. Çalışmaya katılan hastaların yaş ortalaması 30  6 idi. Ortalama vücut kitle indeksi VKİ 28,8 22-43 idi. Yirmi dört 45,3 vaka dikoryonik DC diamniyotik, 20 37,7 vaka monokoryonik MC diamniyotik ve 9 17 vaka monokoryonik monoamniyotik idi. IUFD ile canlı ikizin doğumu arasındaki süre MClerde 75 gün, DClerde 105 gündü p  0.05. Sağ kalan ikizin doğumdaki ortalama gebelik yaşı, MKlerde 30 haftalık, DClerde 34 haftalık gebelik haftasıydı p0.03. 23 79,3 MC gebelikte ve 15 62,5 DC gebelikte doğum 37 haftadan önce gerçekleşti p0,176. Ek olarak, 34 haftadan önceki doğumlar, MC gebeliklerin 19unda 65,5, DC gebeliklerin 8inden 33,3 daha sık meydana geldi p0,02. Sonuç: MC grubunda canlı fetüsün doğumunun anlamlı olarak daha erken gerçekleştiğini ve bu fetüste mortalite ve morbiditenin daha sık görüldüğünü gösterdik. Ancak SIUFD etiyolojisini açıklayan araştırmalar yetersizdir.

Article Details

Perinatal Outcomes of Single Intrauterine Fetal Death in Twin Pregnancies: A Tertiary Center Experience

Authors:

Müjde Can İbanoğlu | Betül Tokgöz | Kadriye Yakut Yücel | Seval Yılmaz Ergani | Erkan Saglam | Aykut Kından | Cantekin İskender | Ali Çağlar

Publisher:

Selcuk University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Genel Tıp Dergisi Vol.33 Issue 2, pp.219-225

Document Type:

Article

Publication Date:

4/2023

Document Language:

English

Document ID (Org No.):

2001288880

pISSN:

2602-3741

Single intrauterine fetal death

twins

perinatal outcomes

monochorionic

dichorionic.Single intrauterine fetal death

twins

perinatal outcomes

monochorionic

dichorionic.

Issues

Article Details

Authors: Müjde Can İbanoğlu | Betül Tokgöz | Kadriye Yakut Yücel | Seval Yılmaz Ergani | Erkan Saglam | Aykut Kından | Cantekin İskender | Ali Çağlar

Publisher: Selcuk University

Main Topics: Klinik Tıp Bilimleri

Journal: Genel Tıp Dergisi Vol.33 Issue 2, pp.219-225

Document Type: Article

Publication Date: 4/2023

Document Language: English

Document ID (Org No.): 2001288880

pISSN: 2602-3741

Issues

Authors:

Müjde Can İbanoğlu | Betül Tokgöz | Kadriye Yakut Yücel | Seval Yılmaz Ergani | Erkan Saglam | Aykut Kından | Cantekin İskender | Ali Çağlar

Publisher:

Selcuk University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Genel Tıp Dergisi Vol.33 Issue 2, pp.219-225

Document Type:

Article

Publication Date:

4/2023

Document Language:

English

Document ID (Org No.):

2001288880

pISSN:

2602-3741