Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options

Lust, A.; Catte, Luc De; Lewi, Liesbeth; Deprest, Jan; Loquet, Philip; Devlieger, Roland

doi:10.1002/pd.1967

Cited by 43 publications

(45 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, SF appears to be the management of choice in DC twins discordant for anencephaly. SF also increased birth weight in MC twins, but no clear recommendations were made in this review because of the complexity of this group (Lust et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Perinatal Outcome of Discordant Anomalous Twins: A Single-Center Experience in a Developing Country

Fernandes¹,

Carvalho²,

Flosi³

et al. 2016

Twin Res Hum Genet

View full text Add to dashboard Cite

A dramatic increase in twin pregnancies has been observed in the past few decades, primarily related to assisted reproductive techniques (ART) and increased average maternal age during pregnancy. Multiple pregnancies, compared to singleton pregnancies, are associated with greater perinatal morbidity and mortality. The present study evaluated the perinatal outcomes of pregnancies with discordant anomalous twins in a tertiary maternity ward in a developing country. Data were retrospectively collected from the Instituto Fernandes Figueira/FIOCRUZ, Brazil between January 2002 and December 2014. We identified 74 twin pregnancies with discordant anomalous twins. Final data analysis was based on 40 pregnancies. Congenital defects were classified according to the International Classification of Diseases: ICD-10: the digestive system was responsible in 27 (34%) cases; the central nervous system was responsible in 18 (22%) cases; the urinary tract was responsible in 14 (17%) cases; and the circulatory system was responsible in 14 (17%) cases. A total of 19 deaths occurred during the study period, and delivery before 30.4 weeks was a significant prediction of fetal death (p = .01). The presence of hydrops in the affected fetus was related to a higher number of deaths in healthy fetuses and contributed to a worse prognosis. The presence of this condition was the cause of 12 (55.6%) deaths in healthy fetuses. A 10 times higher risk of death of a normal co-twin was observed in cases of death of the anomalous twin (p = .002, OR 10.55, 95% CI: 1.9-58.52).

show abstract

Section: Discussionmentioning

confidence: 99%

“…There is an exceptional and challenging obstetric condition among twins that is described as discordant malformation, which occurs when one fetus is apparently normal and the co-twin carries a malformation that is identified using antenatal ultrasound. (Diana et al, 2010;Lust et al, 2008).…”

mentioning

confidence: 99%

Perinatal Outcome of Discordant Anomalous Twins: A Single-Center Experience in a Developing Country

Fernandes¹,

Carvalho²,

Flosi³

et al. 2016

Twin Res Hum Genet

View full text Add to dashboard Cite

show abstract

“…However, recent studies on anencephaly and prenatal management options have emphasized this issue (Lust et al, 2008;Vandecruys et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…Selective feticide (SF) of the anomalous fetus may risk the unaffected fetus and can result in pregnancy loss (Evans et al, 1994;Keith et al, 2002). There are limited reports in the literature regarding the management and perinatal outcomes of twin pregnancies discordant for fetal anomalies (Chang et al, 2004;Gul et al, 2005;Heydanus et al, 1993;Lust et al, 2008;Malone et al, 1996;Malone & D'Alton, 1997;Nassar et al, 2000;Sun et al, 2009;Vandecruys et al, 2006).…”

mentioning

confidence: 99%

“…Twin Research and Human Genetics October 2010 (Eddleman et al, 2002;Evans et al, 1994;Lust et al, 2008;Vandecruys et al, 2006). The death of the malformed fetus increases the risk of mortality and morbidity with severe brain damage of the normal cotwin (Evans et al, 1994;Lust et al, 2008;Vandecruys et al, 2006), thus SF appears to be the preferred management option for MC twins.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Twin Pregnancies Complicated by a Single Malformed Fetus: Chorionicity, Outcome and Management

Gedikbaşı¹,

Akyol

Yıldırım³

et al. 2010

Twin Res Hum Genet

View full text Add to dashboard Cite

T he objective of this study was to evaluate the impact of one abnormal fetus in a twin pregnancy, to compare impact of chorionicity and clinical outcome of intervention and expectant management. Thirty-seven dichorionic (DC) twins and 18 monochorionic (MC) twins complicated with one malformed fetus were evaluated for gestational age, birthweight and perinatal outcome. Six hundred and forty-two twin pregnancies were evaluated in the database. The control groups consisted of 429 DC and 86 MC twins without anomalous fetus. Mean birthweight and gestational age at birth for DC control group were (n = 429; 2137g and 34.71 weeks), DC study group, n = 37; 2117g (p = .338) and 33.97 weeks (p = .311), and DC study group with major malformations, n = 30; 2019g (p = .289) and 33.3 weeks (p = .01), and showed only significance for gestational age. There was no statistical significance between MC control group, n = 86; 2097g and 34.93 weeks, and MC study group, n = 18; 2237g (p = .338), and 34.42 weeks (p = .502). Because of limited data, the preliminary evaluation for expectant management and intervention, and survival of at least one normal fetus showed no impact. We conclude that, although, all DC twin pregnancies have a risk for preterm delivery, DC twins complicated with major malformation of one twin, have a lower mean gestational age at birth. Preliminary results for intervention does not improve fetal outcome for DC and MC twins and needs further evaluation with greater studies of impact or review.

show abstract

Management of monochorionic twins discordant for structural fetal anomalies

et al. 2020

View full text Add to dashboard Cite

Objective: To review the perinatal management and outcomes of monochorionic twin pregnancies (MC) discordant for congenital anomalies (DCA). Methods: Retrospective, study of all MC DCA cases referred to our tertiary referral center from 1997 to 2018. We excluded cases complicated with twin-to-twin transfusion syndrome, twin anemia-polycythemia sequence, twin reversed arterial perfusion sequence or selective intra-uterine growth restriction. Patients were counseled about the possibility of expectant (EM) or interventional management (selective feticide [SF] or termination of the entire pregnancy [TOP]). Results: One hundred eight of 4157 (2.6%) MC pregnancies were discordant for anomaly. Fifty two of 108 n(48.1%) underwent SF at a mean gestational age of 31.4 ± 5.9 weeks while 52/108(48.1%) opted for EM. Livebirth rate of the healthy co-twin was similar between the two groups (SF: 88.5% vs EM: 82.7%, P = .87). In the SF group, six healthy co-twins (6/52, 11.5%) died 5.3 ± 3.1 days after SF of the abnormal co-twin. In the EM group, in-utero demise of the abnormal twin occurred in 9 of 52 (17.3%) of the cases and was followed by the spontaneous demise of the healthy co-twin in 4 of 9 (44.4%) of these cases. Conclusion: Selective feticide does not seem to significantly alter survival of the healthy co-twin compared to EM.

show abstract

Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options

Cited by 43 publications

References 31 publications

Perinatal Outcome of Discordant Anomalous Twins: A Single-Center Experience in a Developing Country

Perinatal Outcome of Discordant Anomalous Twins: A Single-Center Experience in a Developing Country

Twin Pregnancies Complicated by a Single Malformed Fetus: Chorionicity, Outcome and Management

Management of monochorionic twins discordant for structural fetal anomalies

Contact Info

Product

Resources

About