Perinatal outcomes of twin pregnancies discordant for major fetal anomalies.
OBJECTIVE
The aim of this study was to determine perinatal outcomes of twin pregnancies discordant for a major fetal anomaly and to compare with twins without anomaly.


METHODS
All twin pregnancies admitted or referred to the maternal-fetal unit were prospectively entered into a computer database. Chorionicity, fetal anomaly, mean gestational age at delivery, birth weight and perinatal survival rate were reviewed.


METHODS
Mean gestational age at delivery, birth weight and perinatal survival rate of twins with and without anomaly.


RESULTS
There were 48 cases of monochorionic diamniotic (MCDA), 2 cases of monochorionic monoamniotic (MCMA) and 217 twins with dichorionic (DC) placentation. Out of 267 twin pregnancies, there were 17 (6.3%) twins with fetal anomaly. Twins discordant for a major fetal anomaly were diagnosed in 13 cases (4.8%). We observed 3 cases with MCDA and 10 cases with DC placentation and the incidence of discordance for a major fetal anomaly as 4.6% (10/217) in DC and 6.0% (3/50) in MC twin pregnancies. We identified 8 cases (62%) with craniospinal, 2 (15%) with gastrointestinal, 2 (15%) with urinary system, and 1 case (8%) with both craniospinal and gastrointestinal anomalies. There were significant differences between the normal co-twin of the major anomaly group (n = 13) and twins without anomaly group (n = 235) in mean gestational age at delivery (32 vs. 34 weeks; p = 0.029), mean birth weight (1,640 vs. 2,030 g; p = 0.022) and perinatal survival rate (69.2 vs. 91.1%; p = 0.018), respectively.


CONCLUSIONS
The presence of a fetus with a major anomaly in a twin gestation increases the risk of preterm delivery, low birth weight and perinatal mortality of the normal co-twin.
Maternal and Fetal Unit, Department of Obstetrics and Gynecology, Istanbul SSK Bakirkoy Women's and Children's Hospital, Istanbul, Turkey. ahmetgul@ttnet.net.tr
Ahmet
A
Gul
Altan
A
Cebeci
Halil
H
Aslan
Ibrahim
I
Polat
Ilker
I
Sozen
Yavuz
Y
Ceylan
D001724:Birth Weight; D000013:Congenital Abnormalities / Q000401:mortality*; D016208:Databases, Factual; D004200:Diseases in Twins / Q000401:mortality*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012307:Risk Factors; D015996:Survival Rate; D014427:Twins