Vol. 5, Issue 12 (2019)
Study on perinatal outcome of Monochorionic in comparison to dichorionic twin pregnancies
Author(s): Chiman Lal Maida, Hanslata Gehlot
Abstract: Background: The evolution of advanced reproductive techniques over the past three decades has led to an increase in the incidence of twin pregnancy worldwide. Monochorionic (MC) twins have the highest risk of congenital malformations and two to five fold increased risk of perinatal mortality and morbidity and are at substantially increased risk of adverse outcome compared to Dichorionic (DC) twins. Aims and Objective: To compare the neonatal outcomes of monochorionic and dichorionic twin pregnancies Material and Methods: This was a prospective study about all twin pregnancies of known chorionicity at S N Medical College Jodhpur, Rajasthan. Chorionicity was determined on the basis of first-trimester ultrasound assessment of the dividing membrane characteristics and/or routinely postpartum pathological examination of placentas and intertwin membranes. Results: Out of 240 twin pregnancies, 51 (21.2%) were monochorionic and 189 (78.8%) were dichorionic pregnancies. MC twins had a significantly lower birth weight and gestational age compared to DC twins. Pathologic Doppler results were observed more often for MC pregnancies than for DC pregnancies. Perinatal mortality (±20 weeks of gestation) was 11.6% in MC twin pregnancies and 5.0% in DC twin pregnancies. Mortality rate was 16% for DC and 45% for MC twins. Conclusion: Perinatal morbidity and mortality remain high among monochorionic twins. This is likely due to frequent twin-to-twin transfusion syndrome, prematurity, fetal growth restriction and intrauterine fetal death. Improved fetal and neonatal management may result in improved outcomes.
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