Timur Hakan, Aksoy Rifat Taner, Tokmak Aytekin, Timur Burcu, Coskun Bugra, Uygur Dilek, Danisman Nuri
University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.; Ordu university.
Ginekol Pol. 2018;89(1):30-34. doi: 10.5603/GP.a2018.0006.
Multiple pregnancies are known to be associated with adverse maternal and perinatal complications. How-ever, data regarding the outcomes of spontaneously reduced twin pregnancies are limited. In the current study we aimed to evaluate the consequences of the vanishing twin syndrome (VTS) in dichorionic diamniotic twin pregnancies for both mother and baby in our perinatal center.
A total of 711 pregnancies were included into the study. 51 cases of vanishing twin syndrome constituted Group 1, 235 cases of normal twins constituted Group 2, and 425 singleton pregnancies formed Group 3. The pregnancies that had multifetal reduction and monochorionic twinning were excluded from both study group and twin control group. The collected data were as follows: age, gravidity, parity, gestational week at birth, delivery route, birth weight, obstetric complications, and maternal and perinatal outcomes.
No significant difference was observed between the groups regarding mean maternal age (p > 0.05). Mean birth weight, gestational age at birth and preterm birth ratio were significantly lower in the Group 2 when compared with Group 1 and Group 3 (all p < 0.001). Adverse perinatal outcomes including very low birth weight (VLBV) and low Apgar scores were more common in Group 1 (p < 0.05), but no significant difference was found between the groups in terms of neona-tal intensive care unit admission and perinatal mortality ratios (p > 0.05). Obstetric complications such as preeclampsia, gestational diabetes and intrauterine growth restriction were significantly higher in Group 2 than in Group 1 and Group 3 (all p < 0.05). However, severe maternal morbidities were similar among three groups (p = 0.141).
VTS is seems to be associated with VLBV and low Apgar scores. However, the incidence of severe maternal and perinatal morbidity and mortality in pregnancies with VTS is similar to other pregnancies.
众所周知，多胎妊娠与不良的孕产妇和围产期并发症相关。然而，关于自然减胎双胎妊娠结局的数据有限。在本研究中，我们旨在评估双绒毛膜双羊膜囊双胎妊娠中消失双胎综合征（VTS）对我们围产期中心母婴双方的影响。
本研究共纳入711例妊娠。51例消失双胎综合征患者组成第1组，235例正常双胎组成第2组，425例单胎妊娠组成第3组。多胎减胎妊娠和单绒毛膜双胎妊娠被排除在研究组和双胎对照组之外。收集的数据如下：年龄、孕次、产次、出生孕周、分娩方式、出生体重、产科并发症以及孕产妇和围产期结局。
各组间平均孕产妇年龄无显著差异（p>0.05）。与第1组和第3组相比，第2组的平均出生体重、出生孕周和早产率显著更低（均p<0.001）。包括极低出生体重（VLBV）和低Apgar评分在内的不良围产期结局在第1组中更常见（p<0.05），但各组间在新生儿重症监护病房入住率和围产期死亡率方面无显著差异（p>0.05）。第2组的子痫前期、妊娠期糖尿病和胎儿生长受限等产科并发症显著高于第1组和第3组（均p<0.05）。然而，三组间严重孕产妇发病率相似（p=0.141）。
VTS似乎与VLBV和低Apgar评分相关。然而，VTS妊娠中严重孕产妇和围产期发病率及死亡率与其他妊娠相似。
