Perinatal asphyxia in monochorionic versus dichorionic twins: incidence, risk factors and outcome

Fetal Diagn Ther. 2014;35(2):87-91. doi: 10.1159/000356433. Epub 2014 Jan 23.

Abstract

Objective: To estimate the incidence, risk factors, severity and outcome after perinatal asphyxia in monochorionic (MC) versus dichorionic (DC) twins.

Methods: We included all consecutive near-term MC and DC twins with perinatal asphyxia admitted to our neonatal ward between 2004 and 2013 and compared the perinatal characteristics and neonatal outcome between both groups.

Results: The incidence of perinatal asphyxia in MC and DC twin infants was 4.0 (11/272) and 4.0% (8/200; p = 1.00). In contrast to DC twins, asphyxia in MC twins was strongly associated with acute exsanguination and anemia at birth; 64% (7/11) in MC twins and 0% (0/8) in DC twins (p < 0.01). Median hemoglobin level at birth in the MC and DC groups was 11.5 and 18.6 g/dl, respectively (p < 0.01).

Conclusions: Perinatal asphyxia in MC twins is often associated with severe anemia at birth due to acute hemorrhage through the placental vascular anastomoses.

MeSH terms

  • Asphyxia / epidemiology*
  • Asphyxia / etiology
  • Diseases in Twins / epidemiology*
  • Diseases in Twins / etiology
  • Female
  • Fetal Hypoxia / epidemiology*
  • Fetal Hypoxia / etiology
  • Humans
  • Incidence
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy, Twin*
  • Retrospective Studies
  • Risk Factors