Antepartal fetal death of one twin

Abstract

Twenty-four cases with antepartal fetal death of one twin are reported. Of the stillborn fetuses 5 were delivered as a fetus papyraceus, 13 had severe and 6 no maceration. The cesarean section rate was 25%. The placenta was monochorionic in 12 cases. Structural defects were found in one monochorionic co-twin of a fetus papyraceus. Otherwise the neonatal morbidity of the liveborn co-twins was not increased if the low gestational age averaging 34 weeks, was taken into account. No manifestations of defective hemostasis were observed in the mothers.

Intrauterine death of a single fetus in twin pregnancies

“…The incidence of 0.10% in our study population referred to all births is compatible with the figures reported by LUMME and SAARIKOVSKI (0.03%) [8] and LITSCHGI and STUCKI (0.07%) [6]. Referred to all twin births in the observation period, we recorded an incidence of 5.4% compared to values of 2.2% [8] and 6.8% [6].…”

“…Other study groups report rates of between 9% [11] and 93% [1]. The incidence of caesarean sections is largely determined by the obstetrician's attitude to the delivery of breech presentations [8]: in our study population, this positional anomaly was the sole indication in four cases. It was also the sole indication for caesarean section in half of the cases reported by D'ALTON, while LITSCHGI and STUCKI performed caesarean section in only one case of breech presentation.…”

“…The second twin is at particular risk in this respect. The rate of intrauterine deaths is also about 2 -3 times higher than that for single pregnancies [8]. The intrauterine demise of a twin raises diverse questions concerning the risk to the surviving twin and the mother and the method of delivery.…”

“…Referred to all twin births in the observation period, we recorded an incidence of 5.4% compared to values of 2.2% [8] and 6.8% [6].…”

“…Apart from individual case reports, the literature does also contain reports on larger study populations [1,6,8,11]. Both the further management of the pregnancy taking into account the risk for the surviving twin and the mother and the procedure to be employed at delivery are of particular clinical interest.…”