İkiz eşinin intrauterin ölümü

Fetuslardan bilinin uterus içinde ikinci veya üçüncü trimesterde öldüğü ikiz gebeliklerde perinatal sonuçları incelemek. Gereç ve yöntem: Ocak 2003-Arahk 2004 tarihleri arasında hastanemizde gerçekleşen 21,593 doğumun kayıtları retrospektif olarak incelendi. Fetuslardan birinin ikinci veya üçüncü trimesterde öldüğü 12 çoğul gebelik olgusu, perinatal so­nuçları açısından incelendi. Bulgular: Toplam 21.593 doğumun 281'i (%1,3) ikiz gebelikti. Bu olgularının l'i'si' (%4,2) ikinci veya üçüncü trimesterde monofetal ölüm ile komplike olan gebeliklerdi. Gebelerin yaş ortalaması 28 (23-42) idi. Monofetal ölümün gerçekleştiği ortalama gestasyonel hafta 22 (18-28) idi ve olgular doğuma kadar ortalama 78 gün £7-?.40) izlendi. Doğumların 7'si (%58) sezaryen ile gerçekleşti. 3 olgu (%25) monokor/onik diamniyotik, 1 olgu (%8) monokoryonik monoamniyotik ve diğer olgular dikoryonik diamniyotikti. Neonatal mortalite hızı %25 idi. Sonuç: Monofetal ölüm ile komplike olmuş ikiz gebeliklerde plasenta yapıları tespit edilmeli, tedavi ve takip seçeneği ona göre belirlenmelidir.

Monofetal death in pregnancy

Objective: To investigate the perinatal findings in twin pregnancies resxilted with the intrauterin death of one fetus in the second or the third trimester. Gereç ve yöntem: A retrospective study was carried out of 21.593 birth recorded in SSK Ege Birth and Women Hospital between Jan 2003 and Dec 2004. Perinatal findings of 12 multiple pregnancies which presented monofetal intrauterin death in tlie second and third trimester were investigated. Results: The average age of the pregnants were 28 (23-42). The mean gestational week which the monofetal death occurred was 22 (18-28) and cases were followed up 7-140 days (mean 78) until birth. Cesarean section rate was 58%. Of these 12, three of the cases were monochorionic and diamniotic and one of then was monochorionic and monoamniotic and the rest were diamniotic and dichorionic. Neonatal mortality rate was found to be 25%. Conclusion: In the case of monofetal death in twin pregnancies, the type of placentation should be analyzed, and follow up and treatment modalities of these cases should be chosen accordingly.

Kaynakça

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2.D’Alton ME, Simpson LL. Syndromes in twins. SeminPerinatol 1995; 19: 375-386.

3.Newman RB, Ellings JM. Antepartum management ofthe multiple gestation: the case for specialized care.Semin Perinatol 1997; 19: 387-403.

4.Peterson IR, Nyholm HCJ. Multiple pregnancies withsingle intrauterine demise: description of twenty-eightpregnancies. Acta Obstet Gynecol Scand 1999; 78: 202-206.

5.Axt R, Mink D, Hendrik J, Ertan K, Vonn Blohm M,Schmidt W. Maternal and neonatal outcome of twinpregnancies complicated by single fetal death. J PrenatMed 1999; 27: 221-227.

6.Fusi L, Gordon H. Twin pregnancy complicated by single intrauterine death: Problems and outcome withconservative management. Br J Obstet Gynaecol 1990;97: 511-516.

7.Lumme R, Saarikoski S. Antepartum death of one twin. Int J Gynaecol Obstet 1987; 5: 331-336.

8.D'Alton ME, Simpson LL. Syndromes in twins. Semin Perinatal 1995; 19: 375-386.

9.Newman KB, Ellings JM. Antepartum management of die multiple gestation: the case for specialized care. Semin Perinatol 1997; 19: 387-403.

10.Peterson IR, Nyholm HCJ. Multiple pregnancies with single intrauterine demise: description of twenty-eight pregnancies. Acta Obstet Gynecol Scand 1999; 78: 202- 206.

11.Axt R, Mink D, Hendrik J, Ertan K, Vonn Blohm M, Schmidt W. Maternal and neonatal outcome of twin pregnancies complicated by single fetal death. J Prenat Med 1999; 27: 221-227.

12.Fusi L, Gordon H. Twin pregnancy complicated by single intrauterine death: Problems and outcome with conservative management. Br J Obstet Gynaecol 1990; 97: 511-516.

13.Baxi LV, Daftary A, Loucopoulos A. Single fetal demise in a twin gestation: Umbilical vein thrombosis. Gynecol Obstet Invest 1998; 46: 266-267.

14.Santema JG, Swaak AM, Wallenburg HC. Expectant management of twin pregnancy with single fetal death. Br. J Obstet Gynaecol 1995; 102: 26-30.

15.Cattanach SA, Wedel M, White S, Young M. Single intrauterine fetal death in a suspected monozygotic twin pregnancy. Aust NZJ Obstet Gynaecol 1990; 30: 137-140.

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