Perinatal mortality in twin pregnancies: a 3-year analysis in Seine Saint-Denis (France)

Objectives: Our purpose was to evaluate perinatal mortality in twins and to investigate factors associated with this mortality. Study design: A prospective study on the perinatal mortality was performed in the department of Seine-Saint-Denis, Out of all the perinatal deaths, we have retrospectively isolated those arising from twin pregnancies. Results: There were 54 twin pregnancies complicated with perinatal death. The perinatal mortality rate in twin pregnancy was 78.0 per 1000 twin babies delivered. Out of 86 twin deaths, 38 (44.2%) were born before 28 weeks gestation and out of 82 twin perinatal deaths, 37 (45.1%) weighed less than 1000 g. Chorionicity was recorded in 44 twin pairs: 21 (47.7%) were dichorionic and 23 (52.3%) monochorionic. Finally, out of 48 twin sets there were four (8.3%) monoamniotic pregnancies. Conclusions: The present data show that extreme prematurity represents nearly half of perinatal mortality in twins. This study indicates also a significant proportion of monochorionic placentation among twin pregnancies with poor outcome. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.