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Review

Management of co-twin demise

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Pages 455-461 | Published online: 10 Jan 2014
 

Abstract

The discovery of the death of one twin in utero is an event that will have a huge psychological impact on the parents and can present great difficulties in management for the obstetrician. The parents will have to deal with the loss of one twin while coping with concerns about the safety of the remaining twin. The emotional impact of continuing the pregnancy while the dead twin remains in utero, sometimes for several weeks, will be considerable. The demise of one twin may also result in preterm delivery or significant neurological injury in the survivor. Obstetric management can also be complicated. There is controversy and a lack of good evidence regarding the optimal timing of delivery, as well as uncertainty regarding the correct frequency and type of antenatal surveillance and investigation for the detection of cerebral damage.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

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