Management of pregnancy with dichorionic diamniotic twins complicated by intrauterine death of one of the fetuses (literature review)
DOI:
https://doi.org/10.15574/HW.2024.4(173).6874Keywords:
multiple pregnancy, dichorionic diamniotic twin, single fetal death, high-risk pregnancy, preterm birthAbstract
Over the past decades, the number of multiple pregnancies has increased significantly due to the use of ovulation induction drugs in the treatment of infertility and the development of assisted reproductive technologies. This increases the relevance of the problem of single intrauterine death (SIUD) in the second or third trimester of pregnancy, which is associated with a significant increase in morbidity and mortality for the surviving twin. Complications include preterm birth, fetal growth restriction, and neurological complications in the surviving fetus.
Aim - to review current recommendations for SIUD in dichorionic diamniotic (DCDA) twins to select the most optimal tactics for managing such pregnancies.
For the review, we used Ukrainian and international recommendations on the management of multiple pregnancy, dedicated to the problem of SIUD, available on the electronic resources Pubmed, Semantic Scholar and UpToDate.
To date, there are no agreed guidelines worldwide on the management of multiple pregnancies complicated by SIUD. The opinion on SIUD in DCDA twins is particularly ambiguous, as the fetuses have separate placentas without vascular anastomoses and the prognosis for the surviving twin is more optimistic than in monochorionic twins. Most of the recommendations for SIUD in DCDA twins suggest a wait-and-see approach and prolongation of pregnancy to the fullest possible gestational age.
No conflict of interests was declared by the authors.
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