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Chapter 12 - Single and Double Fetal Loss in Twin Pregnancy

Published online by Cambridge University Press:  11 October 2022

By
Mark D. Kilby ,
Leo Gurney ,
Janice L. Gibson  and
R. Katie Morris
Edited by
Leanne Bricker ,
Julian N. Robinson  and
Baskaran Thilaganathan
Leanne Bricker
Affiliation:
Corniche Hospital, Abu Dhabi
Julian N. Robinson
Affiliation:
Brigham & Women's Hospital, Boston
Baskaran Thilaganathan
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Data from UK confidential enquiries suggest a declining rate of twin stillbirth in monochorionic (MC) and dichorionic (DC) twin pregnancies with improved outcomes possibly reflecting the establishment of national guidelines for the management of multiple pregnancies. Despite this, twin pregnancies are at greater risk of all pregnancy complications, miscarriage and stillbirth than singleton pregnancies. Monochorionic twins, comprising approximately 20% of twin pregnancies, are at particular risk of fetal loss due to the unique pathological complications of a shared placenta: Twin to Twin Transfusion Syndrome (TTTS), early-onset severe selective growth restriction (sGR) and twin anaemia polycythaemia sequence (TAPS). Furthermore, following single intrauterine fetal demise (sIUFD) surviving monochorionic co-twins are exposed to an increased risk of intrauterine death, neonatal death and neurological disability. This chapter examines single and double fetal loss in DC and MC twin pregnancies, outlining the key facts, and covering the difficult issues and management challenges posed by twin demise.

Keywords

Twin pregnancychorionicitysingle intrauterine fetal demisemiscarriagestillbirth.
Type
Chapter
Information
Management of Multiple Pregnancies
A Practical Guide
 , pp. 123 - 134
Publisher: Cambridge University Press
Print publication year: 2022

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