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Naturally conceived twins with monochorionic placentation have the highest risk of fetal loss

Sperling, L. ; Kiil, C. ; Larsen, L. U. ; Qvist, I. ; Schwartz, M. ; Jörgensen, Connie LU ; Skajaa, K. ; Bang, J. and Tabor, A (2006) In Ultrasound in Obstetrics & Gynecology 28(5). p.644-652
Abstract
Objective The aim of this study was to estimate the rate of fetal loss in dichorionic (DC) and monochorionic (MC) twin pregnancies stratified according to zygosity and method of conception. Methods In a prospective multicenter observational study women with a twin pregnancy bad an ultrasound scan before 14 + 6 weeks' gestation in order to determine chorionicity. The fetal loss rate, the perinatal, neonatal and infant mortality rates and the frequency of very preterm labor were estimated for the different types of twin. Results Among the 495 pregnancies (421 DC and 74 MC) 229 (46%) were conceived naturally and 266 (54%) by assisted reproduction (AR). Outcome data for 945 liveborn babies were obtained. The spontaneous miscarriage rate before... (More)
Objective The aim of this study was to estimate the rate of fetal loss in dichorionic (DC) and monochorionic (MC) twin pregnancies stratified according to zygosity and method of conception. Methods In a prospective multicenter observational study women with a twin pregnancy bad an ultrasound scan before 14 + 6 weeks' gestation in order to determine chorionicity. The fetal loss rate, the perinatal, neonatal and infant mortality rates and the frequency of very preterm labor were estimated for the different types of twin. Results Among the 495 pregnancies (421 DC and 74 MC) 229 (46%) were conceived naturally and 266 (54%) by assisted reproduction (AR). Outcome data for 945 liveborn babies were obtained. The spontaneous miscarriage rate before 24 weeks' gestation was 10.9% (7164) among naturally conceived MC compared to 3.0% (51165) for naturally conceived DC twins (P < 0.05). For twins conceived by AR the corresponding figures were 0% (0/10) and 0.4% (1/256). The odds ratio (OR) for very preterm birth - before 28 weeks'gestation - was 4.2 for MC twins compared to DC twins. The relative risk of fetal loss or death among DC twins was 20% of the risk for MC twins. Conclusion The risk of fetal loss, very preterm delivery and neonatal/infant death is significantly higher among twins with MC compared to DC placentation. Twins conceived by AR have a much lower risk of MC placentation. The risk of losing one or both twins seems higher among naturally conceived twins compared to twins conceived by AR, despite the fact that the maternal age was higher among the mothers of the AR twins. Copyright (c) 2006 ISUOG. Published by John Wiley & Sons, Ltd. (Less)
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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
pregnancy, twin, preterm delivery, perinatal death, fetal loss, multiple pregnancy, ultrasonography, zygosity
in
Ultrasound in Obstetrics & Gynecology
volume
28
issue
5
pages
644 - 652
publisher
John Wiley & Sons Inc.
external identifiers
  • wos:000241596400004
  • scopus:33750366609
ISSN
1469-0705
DOI
10.1002/uog.3820
language
English
LU publication?
yes
id
2370f986-f12a-4581-b4af-084f08219dcc (old id 378572)
date added to LUP
2016-04-01 16:28:44
date last changed
2022-03-22 18:59:10
@article{2370f986-f12a-4581-b4af-084f08219dcc,
  abstract     = {{Objective The aim of this study was to estimate the rate of fetal loss in dichorionic (DC) and monochorionic (MC) twin pregnancies stratified according to zygosity and method of conception. Methods In a prospective multicenter observational study women with a twin pregnancy bad an ultrasound scan before 14 + 6 weeks' gestation in order to determine chorionicity. The fetal loss rate, the perinatal, neonatal and infant mortality rates and the frequency of very preterm labor were estimated for the different types of twin. Results Among the 495 pregnancies (421 DC and 74 MC) 229 (46%) were conceived naturally and 266 (54%) by assisted reproduction (AR). Outcome data for 945 liveborn babies were obtained. The spontaneous miscarriage rate before 24 weeks' gestation was 10.9% (7164) among naturally conceived MC compared to 3.0% (51165) for naturally conceived DC twins (P &lt; 0.05). For twins conceived by AR the corresponding figures were 0% (0/10) and 0.4% (1/256). The odds ratio (OR) for very preterm birth - before 28 weeks'gestation - was 4.2 for MC twins compared to DC twins. The relative risk of fetal loss or death among DC twins was 20% of the risk for MC twins. Conclusion The risk of fetal loss, very preterm delivery and neonatal/infant death is significantly higher among twins with MC compared to DC placentation. Twins conceived by AR have a much lower risk of MC placentation. The risk of losing one or both twins seems higher among naturally conceived twins compared to twins conceived by AR, despite the fact that the maternal age was higher among the mothers of the AR twins. Copyright (c) 2006 ISUOG. Published by John Wiley &amp; Sons, Ltd.}},
  author       = {{Sperling, L. and Kiil, C. and Larsen, L. U. and Qvist, I. and Schwartz, M. and Jörgensen, Connie and Skajaa, K. and Bang, J. and Tabor, A}},
  issn         = {{1469-0705}},
  keywords     = {{pregnancy; twin; preterm delivery; perinatal death; fetal loss; multiple pregnancy; ultrasonography; zygosity}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{644--652}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Ultrasound in Obstetrics & Gynecology}},
  title        = {{Naturally conceived twins with monochorionic placentation have the highest risk of fetal loss}},
  url          = {{http://dx.doi.org/10.1002/uog.3820}},
  doi          = {{10.1002/uog.3820}},
  volume       = {{28}},
  year         = {{2006}},
}