Perinatal outcomes of twin pregnancies with single fetal demise and different types of placentation
- Authors: Kostyukov K.V.1, Nikitina A.T.1,2, Cherepanova A.E.2, Gladkova K.A.1
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Affiliations:
- Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
- Issue: No 7 (2023)
- Pages: 40-46
- Section: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/568712
- DOI: https://doi.org/10.18565/aig.2023.45
- ID: 568712
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Abstract
Relevance: Multiple pregnancies carry a higher risk of perinatal morbidity and mortality. In pregnancies complicated by intrauterine death of one of the co-twins, the perinatal outcome of the surviving fetus depends on the type of placentation.
Objective: To investigate the impact of dichorionic and monochorionic twin pregnancies complicated by single fetal demise on perinatal outcomes.
Materials and methods: A retrospective study was conducted at V.I. Kulakov NMRC for OG&P from 2014 to 2022, analyzing 113 twin pregnancies and neonatal outcomes of 99 newborns. The study subjects were divided into groups of dichorionic and monochorionic twin pregnancies. The groups were compared in terms of the course of the antenatal period and outcomes of the neonates.
Results: The study analyzed 20 dichorionic and 93 monochorionic twin pregnancies. Pregnancy rates resulting from assisted reproductive technologies were higher in dichorionic twins (40%) compared to monochorionic twins (18.3%; p<0.05). The mean gestational age at intrauterine death of one co-twin was significantly lower in monochorionic twins (21.9 weeks) compared to dichorionic twins (29.6 weeks; p<0.01). Discordance in body weight of newborns was more prevalent in monochorionic twins (51.6%) compared to dichorionic twins (25%; p<0.05). Low Apgar scores in the 1st minute were more common in monochorionic twins (24%) than in dichorionic twins (10%; p=0.03). However, there was no statistically significant difference in overall morbidity between the two groups (p=0.61).
Conclusion: Monochorionic placentation, compared to dichorionic placentation, is associated with specific complications in twin pregnancies complicated by single fetal demise. In monochorionic twins, the occurrence of single fetal demise happened much earlier than in dichorionic twins. Furthermore, monochorionic placentation was associated with cases of second fetal death and spontaneous demise of one of the co-twins in uncomplicated pregnancies. Neonatal mortality and morbidity rates were similar between the two groups. However, monochorionic placentation was characterized by severe central nervous and cardiovascular complications, as well as sepsis.
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About the authors
Kirill V. Kostyukov
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Author for correspondence.
Email: kostyukov_k@yahoo.com
ORCID iD: 0000-0003-3094-4013
Dr. Med. Sci., Head of the Department of the Ultrasound and Functional Diagnosis
Russian Federation, 117997, Moscow, Ak. Oparin str., 4Arina T. Nikitina
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Email: arinia2000@yandex.ru
student
Russian Federation, 117997, Moscow, Ak. Oparin str., 4; 119991, Moscow, Trubetskaya str., 8-2Alina E. Cherepanova
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Email: acherepanova1@gmail.com
student
Russian Federation, 119991, Moscow, Trubetskaya str., 8-2Kristina A. Gladkova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: k_gladkova@oparina4.ru
Ph.D., Senior Researcher at the Fetal Medicine Unit, Institute of Obstetrics, Head of the 1st Obstetric Department of Pregnancy Pathology
Russian Federation, 117997, Moscow, Ak. Oparin str., 4References
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