Maternal and neonatal outcome of twin pregnancies complicated by a single intrauterine dead fetus.

he incidence of multiple pregnancy has increased pari pasu, the increase in ovulation induction and assisted reproductive techniques. At the same time, its associated maternal and perinatal complications are well documented. One of the unusual complications of the twin gestation is the single intrauterine fetal death, which occurs in the later half of the pregnancy with quoted incidence between 0.5-6.8%.1 This condition may lead to increased maternal complications and increased perinatal morbidity and mortality for the living co-twin.2 The objective of this study was to evaluate the maternal and neonatal outcome in twin pregnancies complicated by a single intrauterine fetal death (IUFD) in the second half of the pregnancy at King Khalid University Hospital (KKUH), Riyadh, Kingdom of Saudi Arabia. During the study period from 1983-2000, 35 twin pregnancies complicated by single IUFD after 20 weeks of gestation were identified from the delivery logbook. Those cases where IUFD occurred during labor were excluded. Data collected from the records included maternal age, parity, blood group, antenatal complications, mode of delivery and blood loss during the delivery. Others were gestation at delivery, gestation at which single IUFD was diagnosed, time interval between diagnosis of IUFD and delivery, birth weight, sex and neonatal complications. The data were coded and entered into an IBM compatible computer. Statistical analysis was by the Statistical Package for the Social Sciences (SPSS) version 7.5 for the mean and standard deviation of quantitative variables. Out of the 35 cases collected during the study period, 30 were booked and diagnosed at the antenatal clinic while 5 were diagnosed during labor. The demographic data, obstetric complications, and fetal or placental characteristics are shown in Table 1. The mean maternal age was 27.74 years, while the mean gestation at diagnosis of IUFD was 29.65 weeks and delivery 34.26 weeks. There were no maternal deaths in this study, while the perinatal mortality was 11.4% with 3 deaths occurring in dizygotic twins. Pre-eclampsia and gestational diabetes occurred in 11.4% of the Table 1 Demographic and obstetric data and some fetal and placental characteristics.