Single Intrauterine Demise in Twin Gestation

A prospective management protocol for twin gestations with single intrauterine fetal demise (SIUFD) is described and compared with a previous study from our institution. 402 twin gestations were delivered at our institution between January 1987 and December 1991; 20 had SIUFD. Management protocol consisted of weekly fetal surveillance, biweekly growth assessment, and weekly coagulation profiles. No elective preterm deliveries were performed. The incidence of SIUFD was 5.0% in the study population. The incidence of preterm delivery was 80%. One case of periventricular leukoencephaloma-lacia was diagnosed by ultrasound 24 hr after demise of the co-twin. Two cases of transient maternal coagulopathy occurred.The incidence of preterm delivery was higher than in the previous study. Because sonographic evidence of neurologic injury in a surviving co-twin may be seen within 24 hr of the death of its co-twin, these injuries in the survivor may occur several days before the demise. The rates of maternal coagulopathy and periventricular leukoencephalomalacia were similar to those reported elsewhere.