The incidence, maternal, fetal and neonatal consequences of single intrauterine fetal death in monochorionic twins: A prospective observational UKOSS study
Report maternal, fetal and neonatal complications associated with single intrauterine fetal death (sIUFD) in monochorionic twin pregnancies. UK. 81 monochorionic twin pregnancies with sIUFD after 14 weeks gestation, irrespective of cause. UKOSS reporters submitted data collection forms using data fr...
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| description | Report maternal, fetal and neonatal complications associated with single intrauterine fetal death (sIUFD) in monochorionic twin pregnancies. UK. 81 monochorionic twin pregnancies with sIUFD after 14 weeks gestation, irrespective of cause. UKOSS reporters submitted data collection forms using data from hospital records. Aetiology of sIUFD; surviving co-twin outcomes: perinatal mortality, central nervous system (CNS) imaging, gestation and mode of delivery, neonatal outcomes; post-mortem findings; maternal outcomes. The commonest aetiology was twin-twin transfusion syndrome (38/81, 47%), "spontaneous" sIUFD (22/81, 27%) was second commonest. Death of the co-twin was common (10/70, 14%). Preterm birth ( |
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Katie ; Mackie, Fiona ; Garces, Aurelio Tobías ; Knight, Marian ; Kilby, Mark D ; Sharp, Andrew</creator><contributor>Sharp, Andrew</contributor><creatorcontrib>Morris, R. Katie ; Mackie, Fiona ; Garces, Aurelio Tobías ; Knight, Marian ; Kilby, Mark D ; Sharp, Andrew ; Sharp, Andrew</creatorcontrib><description>Report maternal, fetal and neonatal complications associated with single intrauterine fetal death (sIUFD) in monochorionic twin pregnancies. UK. 81 monochorionic twin pregnancies with sIUFD after 14 weeks gestation, irrespective of cause. UKOSS reporters submitted data collection forms using data from hospital records. Aetiology of sIUFD; surviving co-twin outcomes: perinatal mortality, central nervous system (CNS) imaging, gestation and mode of delivery, neonatal outcomes; post-mortem findings; maternal outcomes. The commonest aetiology was twin-twin transfusion syndrome (38/81, 47%), "spontaneous" sIUFD (22/81, 27%) was second commonest. Death of the co-twin was common (10/70, 14%). Preterm birth (<37 weeks gestation) was the commonest adverse outcome (77%): half were spontaneous and half iatrogenic. Only 46/75 (61%) cases had antenatal CNS imaging, of which 33 cases had known results of which 7/33 (21%) had radiological findings suggestive of neurological damage. Postnatal CNS imaging revealed an additional 7 babies with CNS abnormalities, all born at <36 weeks, including all 4 babies exhibiting abnormal CNS signs. Major maternal morbidity was relatively common, with 6% requiring ITU admission, all related to infection. Monochorionic twin pregnancies with single IUD are complex and require specialist care. Further research is required regarding optimal gestation at delivery of the surviving co-twin, preterm birth prevention, and classifying the cause of death in twin pregnancies. Awareness of the importance of CNS imaging, and follow-up, needs improvement.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0239477</identifier><identifier>PMID: 32956426</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Ablation ; Abnormalities ; Autopsy ; Babies ; Biology and Life Sciences ; Central nervous system ; Childbirth & labor ; Complications ; Complications and side effects ; Data collection ; Death ; Etiology ; Fetal death ; Fetuses ; Gestation ; Health aspects ; Health surveillance ; Hospitals ; Imaging ; Maternal-fetal exchange ; Medical prognosis ; Medicine ; Medicine and Health Sciences ; Metabolism ; Morbidity ; Mortality ; Multiple births ; Neonates ; Neuroimaging ; Newborn babies ; Observational studies ; Obstetrical research ; Obstetrics ; Population studies ; Pregnancy ; Premature birth ; Research and Analysis Methods ; Transfusion ; Twins ; Ultrasonic imaging ; Womens health</subject><ispartof>PloS one, 2020-09, Vol.15 (9), p.e0239477-e0239477</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Morris et al. 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Katie</creatorcontrib><creatorcontrib>Mackie, Fiona</creatorcontrib><creatorcontrib>Garces, Aurelio Tobías</creatorcontrib><creatorcontrib>Knight, Marian</creatorcontrib><creatorcontrib>Kilby, Mark D</creatorcontrib><creatorcontrib>Sharp, Andrew</creatorcontrib><title>The incidence, maternal, fetal and neonatal consequences of single intrauterine fetal death in monochorionic twins: A prospective observational UKOSS study</title><title>PloS one</title><description>Report maternal, fetal and neonatal complications associated with single intrauterine fetal death (sIUFD) in monochorionic twin pregnancies. UK. 81 monochorionic twin pregnancies with sIUFD after 14 weeks gestation, irrespective of cause. UKOSS reporters submitted data collection forms using data from hospital records. Aetiology of sIUFD; surviving co-twin outcomes: perinatal mortality, central nervous system (CNS) imaging, gestation and mode of delivery, neonatal outcomes; post-mortem findings; maternal outcomes. The commonest aetiology was twin-twin transfusion syndrome (38/81, 47%), "spontaneous" sIUFD (22/81, 27%) was second commonest. Death of the co-twin was common (10/70, 14%). Preterm birth (<37 weeks gestation) was the commonest adverse outcome (77%): half were spontaneous and half iatrogenic. Only 46/75 (61%) cases had antenatal CNS imaging, of which 33 cases had known results of which 7/33 (21%) had radiological findings suggestive of neurological damage. Postnatal CNS imaging revealed an additional 7 babies with CNS abnormalities, all born at <36 weeks, including all 4 babies exhibiting abnormal CNS signs. Major maternal morbidity was relatively common, with 6% requiring ITU admission, all related to infection. Monochorionic twin pregnancies with single IUD are complex and require specialist care. Further research is required regarding optimal gestation at delivery of the surviving co-twin, preterm birth prevention, and classifying the cause of death in twin pregnancies. Awareness of the importance of CNS imaging, and follow-up, needs improvement.</description><subject>Ablation</subject><subject>Abnormalities</subject><subject>Autopsy</subject><subject>Babies</subject><subject>Biology and Life Sciences</subject><subject>Central nervous system</subject><subject>Childbirth & labor</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Data collection</subject><subject>Death</subject><subject>Etiology</subject><subject>Fetal death</subject><subject>Fetuses</subject><subject>Gestation</subject><subject>Health aspects</subject><subject>Health surveillance</subject><subject>Hospitals</subject><subject>Imaging</subject><subject>Maternal-fetal exchange</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Metabolism</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Multiple births</subject><subject>Neonates</subject><subject>Neuroimaging</subject><subject>Newborn babies</subject><subject>Observational studies</subject><subject>Obstetrical research</subject><subject>Obstetrics</subject><subject>Population studies</subject><subject>Pregnancy</subject><subject>Premature birth</subject><subject>Research and Analysis Methods</subject><subject>Transfusion</subject><subject>Twins</subject><subject>Ultrasonic imaging</subject><subject>Womens health</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11v0zAUhiMEYqPwD5CwhIRAWotjO07NBVI18TExaRLbuLVOnJPWU2J3sTPYb-HP4tCAVrQLlIsk9vO-Ph8-WfY8p4ucl_nbKz_0DtrF1jtcUMaVKMsH2WGuOJtLRvnDO98H2ZMQrigt-FLKx9kBZ6qQgsnD7OfFBol1xtboDB6RDiKOtkekwQgtAVcTh97B-GO8C3g9jGQgviHBunU7ymMPQ9JZh5OsRoibtEE677zZ-N56Zw2J360L78iKbHsftmiivUHiq4D9DcSEJOXll7PzcxLiUN8-zR410AZ8Nr1n2eXHDxfHn-enZ59OjlencyOlivNGcQVGNWLZ1CVlVdlUteHQVAUrihxYyVHWJYplXipJqZCVTKwRWJcKeAl8lr3Y-W5bH_RU16CZEKJQgnKWiJMdUXu40tvedtDfag9W_17w_VpDH61pUQOXisoCoFFGMIVLLhhNISwZTZ1gVfJ6P502VB3WBsfqtXum-zvObvTa3-iyoEWKKBm8ngx6n5oRou5sMNi2kBo17OJeloVM3Z9lL_9B789uotaQErCu8elcM5rqleQyT-mwkVrcQ6Wnxs6mm4GNTet7gjd7gsRE_BHXMISgT86__j979m2ffXWH3SC0cRN8O4wXKOyDYgeadNtCj83fIudUjzP0pxp6nCE9zRD_BTW0Dsw</recordid><startdate>20200921</startdate><enddate>20200921</enddate><creator>Morris, R. 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Katie</au><au>Mackie, Fiona</au><au>Garces, Aurelio Tobías</au><au>Knight, Marian</au><au>Kilby, Mark D</au><au>Sharp, Andrew</au><au>Sharp, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The incidence, maternal, fetal and neonatal consequences of single intrauterine fetal death in monochorionic twins: A prospective observational UKOSS study</atitle><jtitle>PloS one</jtitle><date>2020-09-21</date><risdate>2020</risdate><volume>15</volume><issue>9</issue><spage>e0239477</spage><epage>e0239477</epage><pages>e0239477-e0239477</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Report maternal, fetal and neonatal complications associated with single intrauterine fetal death (sIUFD) in monochorionic twin pregnancies. UK. 81 monochorionic twin pregnancies with sIUFD after 14 weeks gestation, irrespective of cause. UKOSS reporters submitted data collection forms using data from hospital records. Aetiology of sIUFD; surviving co-twin outcomes: perinatal mortality, central nervous system (CNS) imaging, gestation and mode of delivery, neonatal outcomes; post-mortem findings; maternal outcomes. The commonest aetiology was twin-twin transfusion syndrome (38/81, 47%), "spontaneous" sIUFD (22/81, 27%) was second commonest. Death of the co-twin was common (10/70, 14%). Preterm birth (<37 weeks gestation) was the commonest adverse outcome (77%): half were spontaneous and half iatrogenic. Only 46/75 (61%) cases had antenatal CNS imaging, of which 33 cases had known results of which 7/33 (21%) had radiological findings suggestive of neurological damage. Postnatal CNS imaging revealed an additional 7 babies with CNS abnormalities, all born at <36 weeks, including all 4 babies exhibiting abnormal CNS signs. Major maternal morbidity was relatively common, with 6% requiring ITU admission, all related to infection. Monochorionic twin pregnancies with single IUD are complex and require specialist care. Further research is required regarding optimal gestation at delivery of the surviving co-twin, preterm birth prevention, and classifying the cause of death in twin pregnancies. Awareness of the importance of CNS imaging, and follow-up, needs improvement.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32956426</pmid><doi>10.1371/journal.pone.0239477</doi><tpages>e0239477</tpages><orcidid>https://orcid.org/0000-0003-1247-429X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Ablation Abnormalities Autopsy Babies Biology and Life Sciences Central nervous system Childbirth & labor Complications Complications and side effects Data collection Death Etiology Fetal death Fetuses Gestation Health aspects Health surveillance Hospitals Imaging Maternal-fetal exchange Medical prognosis Medicine Medicine and Health Sciences Metabolism Morbidity Mortality Multiple births Neonates Neuroimaging Newborn babies Observational studies Obstetrical research Obstetrics Population studies Pregnancy Premature birth Research and Analysis Methods Transfusion Twins Ultrasonic imaging Womens health |
| title | The incidence, maternal, fetal and neonatal consequences of single intrauterine fetal death in monochorionic twins: A prospective observational UKOSS study |
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