Perinatal outcome of monochorionic in comparison to dichorionic twin pregnancies

Research output: Contribution to journalArticle

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Abstract

Objective: The aim of this study is to compare the neonatal outcomes of monochorionic and dichorionic twin pregnancies. Methods: A retrospective cohort study involving 51 twin pregnancies followed and delivered at Sultan Qaboos University Hospital was conducted between January 2006 and December 2011. Result: Thirty six (71%) pregnancies were dichorionic diamniotic (DCDA), 14 (27%) were monochorionic diamniotic (MCDA), and one (2%) was monochorionic monoamniotic (MCMA). The antepartum complications noted in the 15 monochorionic twins were discordant fetal growth in 2 (14%) cases, low birth weight in 11 (73%) babies, pre-eclampsia in three mothers (21%) and twin to twin transfusion syndrome in four (29%) cases. Fetal respiratory distress affected eight (57%) of the pregnancies. Six (40%) twin sets were delivered before 30 weeks, 4 (27%) sets at 31 to 32 weeks, 2 (13%) sets at 34-35 weeks, 2 (13%) sets at 36-37 weeks, and 1 (7%) at 37-38 weeks. Fifteen mothers delivered 16 live infants, 9 (30%) stillbirths and 5 (17%) died after birth. Most neonatal deaths were due to neonatal sepsis and pulmonary hypoplasia. Dichorioinic twins, (DC) morbidity was seen in 11% and 40% for monochoroinic twins (MC). Mortality rate was 17% for DC and 47% for MC twins. Conclusions: Perinatal morbidity and mortality remain high among monochorionic twins. This is likely due to frequent twin-to-twin transfusion syndrome, prematurity, fetal growth restriction and intrauterine fetal death. Improved fetal and neonatal management may result in improved outcomes.

Original languageEnglish
Pages (from-to)173-177
Number of pages5
JournalOman Medical Journal
Volume28
Issue number3
DOIs
Publication statusPublished - 2013

Fingerprint

Twin Pregnancy
Fetofetal Transfusion
Fetal Development
Mothers
Morbidity
Pregnancy
Fetal Distress
Fetal Death
Stillbirth
Perinatal Mortality
Low Birth Weight Infant
Pre-Eclampsia
Cohort Studies
Retrospective Studies
Parturition
Lung
Mortality

Keywords

  • Dichorionic
  • Monochorionic
  • Outcome
  • Twins

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Perinatal outcome of monochorionic in comparison to dichorionic twin pregnancies. / Al-Riyami, Nihal; Al-Rusheidi, Asmaa; Al-Khabori, Murtadha.

In: Oman Medical Journal, Vol. 28, No. 3, 2013, p. 173-177.

Research output: Contribution to journalArticle

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abstract = "Objective: The aim of this study is to compare the neonatal outcomes of monochorionic and dichorionic twin pregnancies. Methods: A retrospective cohort study involving 51 twin pregnancies followed and delivered at Sultan Qaboos University Hospital was conducted between January 2006 and December 2011. Result: Thirty six (71{\%}) pregnancies were dichorionic diamniotic (DCDA), 14 (27{\%}) were monochorionic diamniotic (MCDA), and one (2{\%}) was monochorionic monoamniotic (MCMA). The antepartum complications noted in the 15 monochorionic twins were discordant fetal growth in 2 (14{\%}) cases, low birth weight in 11 (73{\%}) babies, pre-eclampsia in three mothers (21{\%}) and twin to twin transfusion syndrome in four (29{\%}) cases. Fetal respiratory distress affected eight (57{\%}) of the pregnancies. Six (40{\%}) twin sets were delivered before 30 weeks, 4 (27{\%}) sets at 31 to 32 weeks, 2 (13{\%}) sets at 34-35 weeks, 2 (13{\%}) sets at 36-37 weeks, and 1 (7{\%}) at 37-38 weeks. Fifteen mothers delivered 16 live infants, 9 (30{\%}) stillbirths and 5 (17{\%}) died after birth. Most neonatal deaths were due to neonatal sepsis and pulmonary hypoplasia. Dichorioinic twins, (DC) morbidity was seen in 11{\%} and 40{\%} for monochoroinic twins (MC). Mortality rate was 17{\%} for DC and 47{\%} for MC twins. Conclusions: Perinatal morbidity and mortality remain high among monochorionic twins. This is likely due to frequent twin-to-twin transfusion syndrome, prematurity, fetal growth restriction and intrauterine fetal death. Improved fetal and neonatal management may result in improved outcomes.",
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