Monochorionic diamnionic twins: a study of perinatal outcomes / 中国新生儿科杂志

ABSTRACT

Objective To study the perinatal outcomes of monochorionic diamnionic ( MCDA ) twins.Method A retrospective study had been conducted to analyze the outcomes of MCDA twins delivered in Hospital from Jan 2011 to Dec 2012.According to whether complicated with twin to twin transfusion syndrome ( TTTS, n=14 ) and/or selective intrauterine growth restriction ( sIUGR, n=41 ) , the infants enrolled in the study were assigned into complicated group (n=55) and uncomplicated group (n=90).The infants with sIUGR were further subdivided into three groups .The outcomes of the neonates were compared between the groups.Result A total of 145 pairs of MCDA twins were delivered , 285 neonates (12 of them died after birth ) and 5 cases of stillbirth. The gestational age at delivery in complicated group were significantly lower than those in uncomplicated group (33.8 ±2.8weeks vs.35.5 ±1.6weeks, P<0.001);The birth weight in complicated group ( the birth weight of the bigger baby was 2072 ±460 g vs.2520 ± 383 g, the smaller one 1620 ±477 g vs.2320 ±373 g ) were significantly lighter than those in uncomplicated group;The incidence of fetal death in complicated MCDA twin pregnancies (7.3% vs.0) was significantly higher than controls .Neonatal outcomes of fetuses complicated with sIUGRⅠ ( n=23 ) were similar to controls.Neonates complicated with TTTS, sIUGRⅡ(n =6) or sIUGRⅢ (n =12) had significantly increased incidence of respiratory distress syndrome , asphyxia, cardiac disorders, retinopathy of prematurity and neonatal death compared with controls .Conclusion Neonates of MCDA with TTTS or sIUGR had more complications compared with uncomplicated MCDA twins .The fetuses with abnormal umbilical artery Doppler blood flow are more vulnerable to stillbirth , neonatal death and other serious adverse outcomes .