Document Detail


Perinatal outcome after selective feticide in monochorionic twin pregnancies.
MedLine Citation:
PMID:  23335029     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the incidence and risk factors of adverse perinatal outcome in complicated monochorionic twin pregnancies treated with selective feticide. METHODS: Retrospective analysis of prospectively collected data from a consecutive, national cohort. All monochorionic twin pregnancies treated with selective feticide at the Leiden University Medical Center between 2000 and 2011 were included. Obstetrical and neonatal data were recorded. The primary outcome measure was adverse perinatal outcome, including fetal or neonatal demise or severe neonatal morbidity. RESULTS: Data on perinatal outcome was obtained in all cases (n=131). Overall perinatal survival rate was 67.2% (92/131). Median gestational age at delivery of live born infants was 34 weeks (interquartile range 23-38). Neonatal mortality and morbidity rate in live-born children was 4.3% (4/92) and 12.0 % (11/92), respectively. Severe cerebral injury was detected in 3 children. The overall incidence of adverse perinatal outcome was 41.2% (54/131). Median gestational age at occurrence of preterm prelabor rupture of membranes (PPROM) was in cases with and without adverse perinatal outcome, 19.0 weeks and 32.0 weeks respectively (p=0.017). Live-born children with adverse perinatal outcome were born at a lower median gestational age (29.0 weeks) compared to children without adverse perinatal outcome (38.0 weeks),(p<0.001). CONCLUSIONS: The risk of adverse perinatal outcome after selective feticide is increased and associated with low gestational age at occurrence of PPROM and low gestational age at delivery. Long-term follow-up to assess neurodevelopmental outcome in survivors is required.
Authors:
Em van den Bos; Jmm van Klink; Jm Middeldorp; Fj Klumper; D Oepkes; E Lopriore
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-17
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
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