Management of single fetal demise in a multiple gestation.
Intrauterine fetal demise of 1 twin in a multiple gestation is a complex clinical situation. Chorionicity, gestational age at diagnosis, problems specific to the pregnancy, and the emotional needs of the patient can impact management. Strategies to optimize outcomes may include a multidisciplinary team approach and fetal surveillance. The following article reviews (1) adverse fetal and neonatal outcomes associated with intrauterine fetal demise of 1 twin, (2) the potential maternal impact, and (3) the strategies to possibly prevent poor outcomes. It is important to remember that even the most vigilant care may not avoid adverse sequelae in a portion of at-risk pregnancies.
Cleary-Goldman
Jane
J
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, New York Presbyterian Medical Center, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. jec32@Columbia.edu
D'Alton
Mary
M
D000653:Amniotic Fluid; D005260:Female; D005313:Fetal Death / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005330:Fetofetal Transfusion / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005865:Gestational Age; D006801:Humans; D010920:Placenta / Q000098:blood supply / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000523:psychology; D014427:Twins; D014429:Twins, Dizygotic; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal