Aslan Halil, Gul Ahmet, Cebeci Altan, Polat Ibrahim, Ceylan Yavuz
Department of Perinatology, SSK Bakirkoy Maternity and Children's Hospital, Istanbul,Turkey.
Twin Res. 2004 Feb;7(1):1-4. doi: 10.1375/13690520460741372.
A retrospective study involving 972 twin births was conducted to evaluate the maternal and fetal outcomes of twin pregnancies complicated by single fetal death. The incidence of single fetal death in twin pregnancies after 20 weeks was 3.3%. Preterm birth rates for 37 and 32 gestational weeks were 81.3% and 41.6% respectively. The median interval between the diagnosis of fetal death and the delivery was 11 days (range 1-27 days). Eighteen (56%) infants were delivered by cesarean and 14 (43%) vaginally. Twin-twin transfusion syndrome (TTTS) was the cause of single fetal death in 8 of 32 twin pregnancies (25%). Ten of the surviving co-twins were lost in the neonatal period (31.3%) and half of those neonatal deaths were due to TTTS. TTTS is the major contributor for perinatal mortality in same-sex twins complicated by single fetal death. The death of one twin in utero should not be the only indication for preterm delivery, and in case of severe prematurity with a stable intrauterine environment; expectant management may be advisable until fetal lung maturation ensues.
一项涉及972例双胎分娩的回顾性研究，旨在评估双胎妊娠合并单胎死亡的母儿结局。双胎妊娠20周后单胎死亡的发生率为3.3%。孕37周和32周的早产率分别为81.3%和41.6%。胎儿死亡诊断至分娩的中位间隔时间为11天（范围1 - 27天）。18例（56%）婴儿通过剖宫产分娩，14例（43%）经阴道分娩。双胎输血综合征（TTTS）是32例双胎妊娠中8例（25%）单胎死亡的原因。10例存活的联体双胎在新生儿期死亡（31.3%），其中一半的新生儿死亡归因于TTTS。TTTS是同性双胎妊娠合并单胎死亡围产期死亡的主要原因。宫内单胎死亡不应是早产的唯一指征，对于严重早产且子宫内环境稳定的情况，在胎儿肺成熟之前，期待治疗可能是可取的。
