Twin pregnancies discordant for anencephaly-management, pregnancy outcome and review of literature.
OBJECTIVE
To examine the prognosis of conservative management in twin pregnancies discordant for anencephaly, we review the literature and report on four of our own cases, which were analyzed retrospectively.


RESULTS
In the University Hospital of Erlangen, six twin pregnancies discrepant for anencephaly were observed during an 8-year period (1992-2000). Four of these pregnancies were managed conservatively. Preterm delivery occurred in all of the cases, but the unaffected fetuses all had favorable long-term outcome. Delayed interval delivery was performed in two cases due to extreme immaturity in the healthy fetus.


CONCLUSIONS
Our data show that in twin pregnancies with early diagnosis of anencephaly in one fetus, the risk of premature delivery of the healthy fetus may be more increased than is already known in the literature. Therefore, selective fetocide of the anencephalic fetus is a management option, at least in dichorionic pregnancies, to prevent polyhydramnios and to reduce the risk of preterm delivery.
Leeker
Maren
M
Department of Obstetrics and Gynecology, University of Erlangen-Nuremberg, Germany.
Beinder
Ernst
E
D000328:Adult; D000757:Anencephaly / Q000175:diagnosis / Q000628:therapy*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D014427:Twins