General Obstetrics and Gynecology: ObstetricsPersistance of adverse obstetric and neonatal outcomes in monochorionic twins after exclusion of disorders unique to monochorionic placentation
Section snippets
Material and methods
Data were prospectively collected in all twins monitored at our tertiary care center between April 1994 and January 2002. This database review was approved by our ethics board committee. Twin pregnancies complicated by TTTS, chromosomal and structural anomalies, monoamniotic twins, and intrauterine fetal death of 1 co-twin were not included in the analysis as well as any transfer to our center that occurred after 21 week's gestation. The diagnosis of TTTS was made according to Quintero's
Results
During the study period, 781 twin pregnancies were delivered at our center. Of these, 278 cases were excluded from the study because of the diagnosis of TTTS (n = 77), intrauterine fetal death of 1 or both fetuses (n = 31), chromosomal or structural anomalies (n = 20), monoamniotic twins (n = 21), or for transfer to our center after 21 weeks' gestation (n = 106). Twenty-three twin pairs were lost to follow-up. The study included 503 sets of twins with 378 dichorionic (DC) and 125 monochorionic
Comment
Our study examined a cohort of twin pregnancies followed at a single tertiary care center with a consistent method of managing twins and providing appropriate neonatal support. We compare the perinatal outcome in DC and MC twins after exclusion of conditions unique to MC twins such as TTTS and TRAP sequence. These peculiar complications of MC twin gestation play an important role in terms of morbidity and mortality in twins. We observed a higher risk of perinatal morbidity in MC diamniotic
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Presented at the Twenty-fourth Annual Meeting of the Society for Maternal-Fetal Medicine in New Orleans, La, February 2-7, 2004.