Maternal and neonatal outcome of twin pregnancies complicated by single fetal death

Objective: To study the maternal and neonatal outcome of twin pregnancies c omplicated by the intrauterine death of one fetus after 20 weeks of gestati on. Design: Retrospective, observational study of 7 twin pregnancies out of 185 twin pregnancies with the diagnosis of a single intrauterine death over a 5-years period in a university hospital. Results: The incidence of single fetal death in twin gestation after 20 wee ks was 3.8 % in the study population with a high incidence of intrauterine growth retardation (IUGR) of the remaining fetus and preeclampsia in the fu rther course of pregnancy. The incidence of preterm delivery was 71% with a mean gestational age of 33.0 +/- 1.0 weeks. The median interval from diagn osis of single fetal death to delivery was 10.2 +/- 4.1 days (range 1-28 da ys). 5 of 7 (71%) cases were delivered by cesarean section for standard obs tetrical reasons. Neither perinatal nor neonatal death of the remaining twi n were observed. Two cases of neurologic injury were diagnosed after delive ry by ultrasound and MRI. No maternal coagulopathy related to single fetal death occured. Conclusion: Expectant management of single fetal death in twin pregnancies might be advisible under close surveillance of both, mother and the survivi ng fetus.