EXPECTANT MANAGEMENT OF TWIN PREGNANCIES DISCORDANT FOR ANENCEPHALY

Objective: To study the clinical course and perinatal outcome of twin pregnancies discordant for anencephaly, without selective termination. Methods: We conducted a descriptive retrospective study of 14 cases o f dichorionic twin pregnancies discordant for anencephaly, which were managed expectantly in five Israeli perinatal centers. Results: None o f the patients miscarried. The mean gestational age at delivery was 35 .9 +/- 2.8 weeks (range 29-39). Only three patients (21%) delivered be fore 35 weeks' gestation. Polyhydramnios occurred in six of the anence phalic amniotic sacs. Nevertheless, most occurrences were mild and non e necessitated therapeutic amniocentesis. The mean birth weight of the normal fetus was 2610 +/- 690 g (range 1100-3200). One apparently nor mal twin had a cardiac anomaly and died shortly after birth, and one w as electively delivered at 33 weeks because of severe intrauterine gro wth retardation and subsequently developed cerebral palsy. The rest ha d normal short- and long-term outcomes. Conclusion: Expectant manageme nt of a twin gestation discordant for anencephaly diagnosed at the sec ond trimester is associated with a favorable outcome for the unaffecte d fetus.