Conservative management of twin pregnancies with one dead fetus: is it safe?

Background: Fetal death in one of the twins is unusual and the management issue of such a condition is not straightforward.

Methods: We reviewed the outcomes of nine twin pregnancies with one dead fetus in whom follow-up period exceeded 3 weeks.

Results: The twinning frequency was 8.9 per thousand deliveries and the frequency of subsequent antepartum death of one fetus was found to be 3.8%. The preterm birth rate was 45.5% and the survival rate was 90.1%. The perinatal mortality rate was 12%. Maternal clotting disorder was observed in one patient and treated successfully with heparin.

Conclusions: We suggest that these patients are best managed conservatively unless further hazard to the fetus or mother appears.