Investigation of the factors affecting the perinatal outcome of monochorionic diamniotic twins.
OBJECTIVE
To investigate the factors affecting the perinatal outcome in monochorionic diamniotic (MD) twins.


METHODS
We conducted a retrospective study of MD twins treated in our hospital between April 1, 2006 and February 28, 2010. The neonatal outcomes of MD twins conceived by assisted reproductive technology or ovulation induction were compared to the outcomes of those conceived naturally.


RESULTS
In MD twins with twin-to-twin transfusion syndrome (TTTS), fetoscopic laser photocoagulation (FLP) resulted in the survival of at least one twin. In naturally conceived MD twins with two live births, we found that there was a higher discordance rate and the incidence of intrauterine growth retardation was higher in twins born to nulliparous women than multiparous women.


CONCLUSIONS
Further FLP treatment can be performed on twins with TTTS so that prognosis may be improved. Since the risk of discordant growth is significantly greater in twins of nulliparous women, they should be monitored more carefully than multiparous women.
Murakami
Masahiro
M
Division of Maternal Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Kagawa National Children's Hospital, Zentsuji 2603, Zentsuji, Kagawa 765-8501, Japan. rohi3791@yahoo.co.jp
Iwasa
Takeshi
T
Kiyokawa
Machiko
M
Takahashi
Yohei
Y
Morine
Mikio
M
D000328:Adult; D000650:Amnion; D002823:Chorion; D004200:Diseases in Twins / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation / Q000209:etiology* / Q000401:mortality; D005330:Fetofetal Transfusion / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D005332:Fetoscopy; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation; D008297:Male; D010298:Parity; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014430:Twins, Monozygotic