Electronic poster abstracts expectantly and 8 underwent selective ER of the monochorionic pair. Miscarriage rate was lower in the expectantly managed group compared to ER group (8.7% and 25%, respectively) while severe preterm delivery rate was higher in the expectant management group compared to ER group (21.74 % and 0.00%, respectively). Miscarriage rate and preterm delivery rate from previous published studies and from combined data were also calculated (table 1). Conclusions: In dichorionic triplets, ER of the monochorionic pair is associated with an increased rate of miscarriage but with a large reduction in the rate of severe preterm delivery. Since the risk of severe handicap is mostly related to gestational age at birth, ER may reduce handicap rate in these pregnancies.
P18.03Correlation between second trimester ultrasonographic twin EFW difference and early outcomes
Objectives: Numerous studies emphasized increased risk of spontaneous fetal loss as well as perinatal mortality in multifetal pregnancies. However, surveillance strategies and interventions have been rapidly developed as well. The natural course of twin gestations and higher order multifetal pregnancies may have changed currently. Therefore, we evaluated recent data to determine up-to-dated clinical implications of spontaneous fetal loss rates in singletons, twins, and triplets. Methods: A retrospective cohort study was conducted in pregnant women who visited Seoul National University Hospital before 12 weeks of gestation and delivered from January 2006 to March 2014 (n = 1834). We excluded cases who underwent selective fetal reduction, termination of pregnancy (n = 150). Total 1684 cases of singleton (n = 1387), twin (n = 209), and triplet (n = 88) were used for analysis. Fetal loss was defined as spontaneous abortion or stillbirth. Results: Fetal loss rate was 10.8% in singleton pregnancies, 12.0% in twin pregnancies, and 12.5% in triplet pregnancies, which was not different among the groups. In twins, patients with monochorionic twins were at higher risk for fetal loss than those with dichorionic twins (15.4% vs. 6.8%, p = 0.021). In triplet pregnancies, fetal loss rate was 16.7% in monochorionic triplets, 10.3% in dichorionic triplets, and 3.9% in trichorionic triplets (p = 0.033). Conclusions: This study showed no significant difference of fetal loss rate among singleton, twin, and triplet pregnancies. Throughout gestation, fetal loss rate was significantly higher in monochorionic fetuses in both twins and triplets. The result of our data can be effectively used for counseling for women with multifetal pregnancy and for deciding the intensity of fetal surveillance as well. P19.05 Colour dye injection of placental vascular anastomoses in monochorionic twin pregnancy
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