Multiple pregnancies with single intrauterine demise - Description of twenty-eight pregnancies

Methods. Retrospective study of multiple pregnancies and deliveries with si ngle intrauterine demise, in a five years' study period. Results. Of a total of 13,840 deliveries in the study period, 355 represent ed multiple pregnancies with two or more fetuses from conception: 310 twin pregnancies and 45 triplets or higher. Twenty-eight multiple pregnancies we re complicated by single intrauterine death: in six cases (group A) as firs t trimester spontaneous fetal loss, in nine cases (group B) due to selectiv e fetal reduction, and in thirteen pregnancies as spontaneous intrauterine demise occurring in the second or third trimester (group C). In group A, no specific cause of death was proven. In group C, four cases of death were c aused by twin transfusion syndrome, three cases by severe intrauterine grow th retardation, four cases by placental insufficiency, one case by placenta l abruption striking one of the twins, whereas the last death was undefined . In group A, mean gestational age at delivery was 33 completed weeks. In g roup C, five monochorionic pregnancies were delivered at median gestational age 30 weeks and seven dichorionic pregnancies at 34 weeks (the chorionici ty was indefinite in one case). The neonatal complications of the forty-two live born babies included prematurity problems only, except for one case o f congenital anemia in a transfusion syndrome donor twin. None of the mothe rs shelved signs of intravascular coagulopathy. Conclusion. The main problem for the surviving twin was prematurity - not t he sibling's death.