UKOSS study to assess the incidence, maternal, fetal and neonatal consequences of single intrauterine fetal death in monochorionic twins

A UKOSS study to assess the incidence, maternal, fetal and neonatal consequences of single intrauterine fetal death in monochorionic twins has been published. This study was performed by researchers at the University of Birmingham with the UKOSS team based at NPEU, University of Oxford. The study was funded by a joint bursary from BMFMS and Twins Trust. During the observational period there were 81 monochorionic twin pregnancies with a single twin death reported. The commonest cause was twin-twin transfusion syndrome. Sadly, death of the co-twin was common in 14% and there was a very high rate of preterm birth (<37 weeks) in 77%. Despite there being a high chance of radiological findings suggestive of neurological damage in surviving co-twins antenatally (21%), appropriate CNS imaging antenatally and follow-up in the postnatal period was not always performed.

Monochorionic twin pregnancies with single IUD are complex and require specialist care. Further research is required regarding optimal gestation at delivery of the surviving co-twin, preterm birth prevention, and classifying the cause of death in twin pregnancies. Awareness of the importance of CNS imaging, and follow-up, needs improvement.

Link to published paper - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239477