CC BY-NC-ND 4.0 · Journal of Fetal Medicine 2023; 10(01): 001-008
DOI: 10.1055/s-0043-57002
Research Article

Comparative Study of Perinatal Outcome in Uncomplicated Monochorionic Diamniotic versus Dichorionic Diamniotic Twins at a Specialized Twin Clinic—A Prospective Study

1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
,
Arati Singh
1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
,
Saritha Redishetty
1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
,
Kamala Kavuri
1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
,
Prathibha Reddy
1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
,
Aditi Shah
1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
,
Mounika Kachakayala
1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
,
Geeta Kolar
1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
,
Suseela Vavilala
1   Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
› Author Affiliations

Abstract

Background Monochorionic twins have higher perinatal morbidity and mortality than dichorionic twins. However, there is conflicting data on outcomes of uncomplicated monochorionic twins.

Purpose of the Study The aim of this study is to compare the outcomes of apparently uncomplicated monochorionic twins to dichorionic twins.

Methods This is a prospective study conducted from August 2019 to December 2020 at a specialized twin clinic. All twins, whose chorionicity was determined before 14 weeks with two live fetuses at 24 weeks, were recruited. Complicated monochorionic diamniotic (MCDA) twins with twin-to-twin transfusion syndrome, twin anemia polycythemia syndrome, selective fetal growth restriction before 24 weeks and single or double fetal demise before 24 weeks were excluded. Other exclusion criteria were major congenital and chromosomal abnormalities, higher order multiples, monoamniotic twins, and twins with undetermined chorionicity antenatally. Both the groups were followed till delivery and neonates followed till 28 days. Maternal and neonatal outcomes were studied and compared.

Results One-hundred forty-eight mothers with dichorionic diamniotic (DCDA) and 74 with uncomplicated MCDA were studied. Mean gestational age at delivery was 35 weeks in both the groups. Maternal, fetal, and neonatal morbidities were similar in both, except early onset preeclampsia that was higher in the DCDA group. Prospective risk of stillbirth for DCDA and MCDA after 24 weeks was 1.35 and 4.05%, respectively. Prospective risk of stillbirth for DCDA and MCDA after 30 weeks was 1.49 and 0%, respectively.

Conclusion The maternal and perinatal outcomes in uncomplicated MCDA twins are similar to DCDA twins. Prospective risk of stillbirth after 30 weeks is extremely low. Hence, uncomplicated MCDA twins should not be delivered electively before 36 weeks.



Publication History

Article published online:
16 May 2023

© 2023. Society of Fetal Medicine. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.