Perinatal outcome after first‐trimester risk assessment in monochorionic and dichorionic twin pregnancies: a population‐based register study. (25th February 2015)

• Record Type: Journal Article
• Authors: Kristiansen, MK; Joensen, BS; Ekelund, CK; Petersen, OB; Sandager, P; with the Danish Fetal Medicine Study Group
• Is Part Of: BJOG. Volume 122:Number 10(2015:Oct.)
• Page Start: 1362
• Page End: 1369
• Publication Date: 2015-02-25
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.13326
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo13326-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo13326-sec-0001" sec-type="section"> <title>Objective</title> <p>To evaluate the influence of chorionicity on outcome in twin pregnancies with two live fetuses at the nuchal translucency scan in the first trimester.</p> </sec> <sec id="bjo13326-sec-0002" sec-type="section"> <title>Design</title> <p>Population‐based register study.</p> </sec> <sec id="bjo13326-sec-0003" sec-type="section"> <title>Setting</title> <p>Denmark.</p> </sec> <sec id="bjo13326-sec-0004" sec-type="section"> <title>Population</title> <p>A cohort of 3621 twin pregnancies, 84.3% dichorionic (DC) pregnancies and 15.7% monochorionic (MC) pregnancies (15% diamniotic [MCDA] and 0.7% monoamniotic [MCMA]).</p> </sec> <sec id="bjo13326-sec-0005" sec-type="section"> <title>Methods</title> <p>A cohort study based on data collected from the Danish Fetal Medicine Database from July 2008 to July 2011.</p> </sec> <sec id="bjo13326-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Fetal loss rate before week 22, intrauterine death rate from week 22 to birth, and neonatal mortality.</p> </sec> <sec id="bjo13326-sec-0007" sec-type="section"> <title>Results</title> <p>Significantly more DC than MC pregnancies resulted in at least one live born infant—98.2% versus 92.3% in MCDA (<italic>P </italic>< 0.05) and 66.7% in MCMA pregnancies (<italic>P </italic>< 0.05). The rates of spontaneous loss of both fetuses before week 22 were 0.9, 2.4, and 20.8% for DC, MCDA and MCMA twins, respectively (<italic>P </italic>< 0.05). The rate of intrauterine death of one fetus after week 22 was higher in MCDA twins than DC twins 1.7% versus 0.6% (<italic>P </italic>< 0.05). We found no significant difference in the rate of neonatal death.</p> </sec> <sec id="bjo13326-sec-0008" sec-type="section"> <title>Conclusions</title> <p>The risk of spontaneous loss of both fetuses before week 22 of gestation was significantly higher in MCMA and MCDA pregnancies than in DC pregnancies, and significantly higher in MCMA pregnancies than in MCDA pregnancies. After week 22 the risk of loss of one fetus after week 22 was significantly higher in MCDA pregnancies than in DC pregnancies.</p> </sec> </abstract>