TWIN PREGNANCIES WITH SINGLE FETAL DEATH

Objective. Analysis of the fetal outcome of the surviving twin and the cause of fetal death. Patients. Between January 1979 and December 1992, 43 twin pregnancies with single fetal death were observed: in 11 cases (group I) before 16 weeks of gestation, in 11 cases (group II) between 17 and 24 weeks, and in 21 cases (group III) after 24 weeks of gestation. Results. The pregnancies in group I continued without complication. In groups II and III the incidence of preterm delivery was 50%, of cesarean section 59%, of growth retardation of the surviving twin 22% and perinatal mortality was 13%. Twenty-five (78%) of the surviving twins had a normal postnatal development and one (3%) was handicapped. Conclusion. Loss of one of the twins in the first trimester does not impair the development of the surviving fetus. In the second trimester however this event is associated with increased risk for the survivor as reflected by a high incidence of growth retardation, premature labor and perinatal mortality.