title: Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options.
abstract: The aim of this study was to evaluate the effect of selective feticide (SF) compared to expectant management (EM) on perinatal outcome in dichorionic and monochorionic twins discordant for anencephaly. For this purpose, we conducted a systematic review of literature and added ten unpublished cases. As a result, we found that in dichorionic twins, mean gestational age (GA) at birth in the SF group was 38.0 weeks versus 34.9 weeks (P = 0.0002). Mean birth weight was 2922 g in the SF group versus 2474 g (P = 0.03). In monochorionic twins, mean GA at birth was 35.2 weeks versus 32.7 weeks (P = 0.1). Mean birth weight was 2711 g versus 1667 g (P = 0.0001). We conclude that while SF does not reduce perinatal mortality, it does result in significantly longer gestations and higher birth weight, and appears to be the management of choice in dichorionic twins discordant for anencephaly. In monochorionic twins, SF also increases birth weight, but in view of the complexity of this group, no clear recommendations can be made.
authors.affiliation: Prenatal Diagnosis Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, AZ Sint-Augustinus, 2610 Wilrijk, Belgium.
authors.forename: Annelies
authors.initials: A
authors.lastname: Lust
authors.forename: Luc
authors.initials: L
authors.lastname: De Catte
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Lewi
authors.forename: Jan
authors.initials: J
authors.lastname: Deprest
authors.forename: Philippe
authors.initials: P
authors.lastname: Loquet
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
mesh_terms: D000757:Anencephaly / Q000628:therapy*; D004200:Diseases in Twins / Q000628:therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000379:methods*; D011272:Pregnancy, Multiple; D011295:Prenatal Care; D014429:Twins, Dizygotic / Q000502:physiology; D014430:Twins, Monozygotic / Q000502:physiology