Document Detail

Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options.
MedLine Citation:
PMID:  18302309     Owner:  NLM     Status:  MEDLINE    
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 For this purpose, we conducted a systematic review of literature and added ten unpublished cases.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.
Annelies Lust; Luc De Catte; Liesbeth Lewi; Jan Deprest; Philippe Loquet; Roland Devlieger
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Review    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  28     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-03     Completed Date:  2008-08-18     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  275-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008 John Wiley & Sons, Ltd.
Prenatal Diagnosis Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, AZ Sint-Augustinus, 2610 Wilrijk, Belgium.
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MeSH Terms
Anencephaly / therapy*
Diseases in Twins / therapy*
Pregnancy Outcome
Pregnancy Reduction, Multifetal / methods*
Pregnancy, Multiple*
Prenatal Care
Twins, Dizygotic* / physiology
Twins, Monozygotic* / physiology

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