PDF(Pubmed)
Abstract：
BACKGROUND: To investigate the prognosis of the remaining fetus in twin pregnancy after experiencing one fetal demise in the first trimester according to the location of the demised fetus.
METHODS: This was a retrospective study of twin pregnancies with one fetal demise after the first trimester (14 weeks of gestation) delivered between September 2004 and September 2022. The study population was divided into two groups based on the location of the demised fetus as determined by the last recorded ultrasonography results: Group 1 included twin pregnancies where the presenting fetus was demised (n = 36) and Group 2 included twin pregnancies where the non-presenting fetus was demised (n = 44). The obstetric and neonatal outcomes were also reviewed.
RESULTS: A total of 80 pregnant women were included. The median gestational age for the diagnosis of fetal demise was 24.1 weeks. The gestational age of the demised fetus was not different between Groups 1 and 2; however, the gestational age of the remaining fetus at delivery was significantly earlier in Group 1 than it was in Group 2 (33.8 vs. 37.3 weeks, P = .004). The rate of preterm birth before 28 weeks was almost five times higher in Group 1 than in Group 2 (22.2% vs. 4.5%, P = .037). Regression analysis demonstrated significant differences between Groups 1 and 2. Respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity, and jaundice were more common in Group 1 than in Group 2; however, the association was not significant after adjusting for gestational age at delivery.
CONCLUSIONS: When the presenting fetus is demised in a twin pregnancy, the remaining fetus tends to be delivered earlier than when the non-presenting fetus is demised.
METHODS: This was a retrospective study of twin pregnancies with one fetal demise after the first trimester (14 weeks of gestation) delivered between September 2004 and September 2022. The study population was divided into two groups based on the location of the demised fetus as determined by the last recorded ultrasonography results: Group 1 included twin pregnancies where the presenting fetus was demised (n = 36) and Group 2 included twin pregnancies where the non-presenting fetus was demised (n = 44). The obstetric and neonatal outcomes were also reviewed.
RESULTS: A total of 80 pregnant women were included. The median gestational age for the diagnosis of fetal demise was 24.1 weeks. The gestational age of the demised fetus was not different between Groups 1 and 2; however, the gestational age of the remaining fetus at delivery was significantly earlier in Group 1 than it was in Group 2 (33.8 vs. 37.3 weeks, P = .004). The rate of preterm birth before 28 weeks was almost five times higher in Group 1 than in Group 2 (22.2% vs. 4.5%, P = .037). Regression analysis demonstrated significant differences between Groups 1 and 2. Respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity, and jaundice were more common in Group 1 than in Group 2; however, the association was not significant after adjusting for gestational age at delivery.
CONCLUSIONS: When the presenting fetus is demised in a twin pregnancy, the remaining fetus tends to be delivered earlier than when the non-presenting fetus is demised.
摘要：
背景：根据死亡胎儿的位置，在妊娠早期经历一次胎儿死亡后，探讨双胎妊娠剩余胎儿的预后。
方法：这是一项回顾性研究，研究对象是2004年9月至2022年9月期间分娩的头三个月（妊娠14周）后有一个胎儿死亡的双胎妊娠。根据最后记录的超声检查结果确定的死亡胎儿的位置，将研究人群分为两组：第1组包括双胎妊娠，其中存在胎儿死亡（n=36），第2组包括双胎妊娠，其中不存在胎儿死亡（n=44）。还回顾了产科和新生儿的结局。
结果：共包括80名孕妇。诊断胎儿死亡的中位孕龄为24.1周。死亡胎儿的胎龄在第1组和第2组之间没有差异；然而，第1组分娩时剩余胎儿的胎龄明显早于第2组(33.8vs.37.3周，P=.004）。第1组28周之前的早产率几乎是第2组的五倍（22.2％vs.4.5%,P=.037）。回归分析显示第1组和第2组之间存在显著差异。呼吸窘迫综合征,支气管肺发育不良,动脉导管未闭,早产儿视网膜病变,黄疸在第1组比第2组更常见；然而，在校正了分娩时的胎龄后,这种关联并不显著.
结论：当胎儿在双胎妊娠中死亡时，剩余的胎儿往往比未出现的胎儿死亡时更早分娩。
方法：这是一项回顾性研究，研究对象是2004年9月至2022年9月期间分娩的头三个月（妊娠14周）后有一个胎儿死亡的双胎妊娠。根据最后记录的超声检查结果确定的死亡胎儿的位置，将研究人群分为两组：第1组包括双胎妊娠，其中存在胎儿死亡（n=36），第2组包括双胎妊娠，其中不存在胎儿死亡（n=44）。还回顾了产科和新生儿的结局。
结果：共包括80名孕妇。诊断胎儿死亡的中位孕龄为24.1周。死亡胎儿的胎龄在第1组和第2组之间没有差异；然而，第1组分娩时剩余胎儿的胎龄明显早于第2组(33.8vs.37.3周，P=.004）。第1组28周之前的早产率几乎是第2组的五倍（22.2％vs.4.5%,P=.037）。回归分析显示第1组和第2组之间存在显著差异。呼吸窘迫综合征,支气管肺发育不良,动脉导管未闭,早产儿视网膜病变,黄疸在第1组比第2组更常见；然而，在校正了分娩时的胎龄后,这种关联并不显著.
结论：当胎儿在双胎妊娠中死亡时，剩余的胎儿往往比未出现的胎儿死亡时更早分娩。
