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Prospective risk of late stillbirth in monochorionic twins: a regional cohort study.
MedLine Citation:
PMID:  22302586     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Monochorionic (MC) pregnancies are routinely delivered electively at various late preterm gestations with the aim of avoiding stillbirth at term. The aim of this study is to evaluate the prospective risk of late stillbirth in a large regional cohort of twin pregnancies of known chorionicity. Methods: A retrospective study of all twin pregnancy births between of known chorionicity between 2000 and 2009 from a large regional cohort consisting of 9 hospitals. Prospective risk was calculated per 1000 ongoing fetuses rather than pregnancies as each twin pregnancy has two gestations at risk of stillbirth. Results: A total of 3005 twin pregnancies delivered after 26 weeks' gestation in the STORK collaborative. The total risk of stillbirth after 26 weeks in MC twins (21.7 per 1000 fetuses) was significantly higher (OR 3.26, 95% CI 2.36 to 4.5) than in DC twins (6.7 per 1000 fetuses). The risk of stillbirth in MC twins did not change significantly between 26+ weeks (1.8 per 1000 fetuses) and 36+ weeks (3.4 per 1000 fetuses, OR 1.85, 95% 0.3-13.2). The equivalent figures for DC twins were 0.6 per 1000 fetuses and 2.1 per 1000 fetuses, respectively (OR 3.4, 95% 0.9-13.2). Conclusion: The risk of stillbirth in MC twins does not appear to increase significantly near term. This observation may be due to a policy of routine surveillance and elective delivery from 36 weeks, the data does support a policy of elective birth before 36 weeks' gestation in MC pregnancies. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Tiran Dias; Dimitri Patel Basky Thilaganathan;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-3
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:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-3     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 © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Fetal Medicine Unit, St George's University of London, London, United Kingdom.
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