Maternal Characteristics and Perinatal Outcomes in Survivor Twins Following Single Intrauterine Fetal Demise in Monochorionic Twin Pregnancies during The Third Trimester: A Retrospective Observational Study

Abstract Background: Monochorionic twin pregnancies are associated with unique complications, including single intrauterine death (sIUD) of one twin, particularly in the late trimester. This poses significant risks to the surviving co-twin and challenges maternal management. Objective: To evaluate maternal demographic characteristics and perinatal outcomes of the surviving twin following sIUD in monochorionic twin pregnancies during the late trimester at a tertiary care center in Uttar Pradesh. Methods: A retrospective observational study was conducted at a tertiary care center in Uttar Pradesh. Maternal demographic data, obstetric history, and perinatal outcomes of monochorionic twin pregnancies with sIUD in the late trimester were analyzed. Outcomes measured included maternal complications, mode of delivery, neonatal morbidity, and survival rates of the co-twin. Results: The study included 10 cases of monochorionic twin pregnancies with single intrauterine death in the late trimester. Maternal demographic characteristics such as age, parity, and obstetric history were recorded. Perinatal outcomes of the surviving twin, including birth weight, Apgar score, neonatal intensive care unit (NICU) admission, and neurological sequelae, were assessed. Factors influencing perinatal morbidity and mortality were identified. Conclusion: Maternal demographics and perinatal outcomes in surviving co-twins after sIUD in monochorionic twin pregnancies vary based on several clinical factors. Early identification and management can potentially improve neonatal outcomes. Further research and standardized protocols are recommended to optimize care in such high-risk pregnancies.