Management of Twin Pregnancies and The Risk of Fetal Death

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Management of Twin Pregnancies and The Risk of Fetal Death

1Natália Garcia Adorno, 1Gabriela Mertz Araújo, 2Ana Clara Ayoroa Freire, 3Ana Cristina Carneiro Mendes,3Larissa Carvalho Viegas, 4Isabeli Gomes de Oliveira, 4Samantha Regina Galo Sanches,4Maria Gabriela S. Guzzi, 4Jheniffer Rodrigues Cação, 5Mayara Azevedo Resende de Lourenzo, 6Érica Guiomar Verdolin dos Santos, 7Vinicius Augusto Trento Galloro, 8Elisa Kelly Soares de Abreu, 9Aline Andressa Ferreira Schröder, 1Giovana Casarini Yamashiro, 11Hamilton Roberto M de O Carriço, 12Gabriela Rodrigues da Mota, 13Pâmela Christinny Fernandes Viêra, 14Rafaianne Santos Veloso, 15Luís Ricardo Santos Rodrigues, 16Vitória Costa Ataídes, 4,17Thiago Augusto Rochetti Bezerra, 18Tatiana da Silva Chaves, 19Aline Cristina Couto da Silva
1Graduated in Medicine. Morgana Potrich College. Mineiros, Goiás, Brazil.
2Medical student. Catholic University of Brasília. Federal District, Brazil.
3Medical student. Morgana Potrich College. Mineiros, Goiás, Brazil.
4Medical student. University of Ribeirão Preto. Guarujá, São Paulo, Brazil.
5Graduated in Medicine. Afya Faculty of Medical Sciences of Paraíba. João Pessoa, Paraíba, Brazil.
6Graduated in Medicine. Federal University of Tocantins. Palmas, Tocantins, Brazil.
7Graduated in Medicine. Albert Einstein Israeli College of Health Sciences. São Paulo, Brazil.
8Graduated in Medicine. Montes Claros State University. Montes Claros, Minas Gerais, Brazil.
9Graduated in Medicine. PUC Goiás. Goiás, Brazil.
10Medical student. Nove de Julho University. São Bernardo do Campo, São Paulo, Brazil.
11Medical student. University of Southern Santa Catarina. Tubarão, Brazil.
12Graduated in Medicine. Federal University of the Southern Frontier. Passo Fundo, Rio Grande do Sul, Brazil.
13Graduated in Medicine. ITPAC Porto Nacional. Tocantins, Brazil.
14Graduated in Medicine. Federal University of Goiás. Goiás, Brazil.
15Graduated in Medicine. UNIFIPMoc. Montes Claros, Minas Gerais, Brazil.
16Graduated in Medicine. Federal University of Pelotas. Pelotas, Rio Grande do Sul, Brazil.
17PhD in Medical Sciences. Ribeirão Preto Medical School. University of São Paulo. Ribeirão Preto, São Paulo, Brazil.
18Graduated in Medicine. Unirg University Center, Gurupi, Tocantins. Medical residency in Gynecology and Obstetrics, Roberto Santos General Hospital, Salvador, Bahia. Postgraduate in General Ultrasound at Schola Fértile, Goiânia, Goiás. Lecturer in Clinical Skills in Gynecology and Obstetrics. Alfredo Nasser College (UNIFAN), Goiânia, Goiás, Brazil.
19Medical student. University of Ribeirão Preto. Guarujá, São Paulo, Brazil.


ABSTRACT:

Introduction: Twin pregnancies can present risks to both mother and fetus. One of the biggest concerns in twin pregnancies is premature birth. 
Objectives: To discuss the management of twin pregnancies in order to avoid fetal death. Material and Methods: The methodology used was a literature review. The research was carried out through an electronic search of scientific articles published between 2010 and 2024.
Discussion: Complications such as premature birth, pre-eclampsia, intrauterine growth restriction and gestational diabetes are more common in twin pregnancies. Reducing these complications requires a well-coordinated, multidisciplinary approach that includes rigorous prenatal monitoring, appropriate medical interventions, nutritional and psychological support for the pregnant woman, as well as specific strategies for birth management.
Conclusion: Twin pregnancies are always special. They are always monitored differently and the risks of them happening are always greater. Health professionals should therefore do their utmost to be aware of all possible complications during twin pregnancies.

 

KEYWORDS:

pregnancy; management of twin pregnancies; premature birth.

 

REFERENCES :

1) ASLAN, Halil et al. The outcome of twin pregnancies complicated by single fetal death after 20 weeks of gestation. Twin Research and Human Genetics, v. 7, n. 1, p. 1-4, 2024.
2) AXT, R. et al. Maternal and neonatal outcome of twin pregnancies complicated by single fetal death. 2019.
3) BATUCA, A., ZANGÃO, O., & CAEIAS, C.. (2022). Alterações do metabolismo numa gravidez gemelar: relato de caso. Revista De Investigação & Inovação Em Saúde, 5(1), 113–123. https://doi.org/10.37914/riis.v5i1.160
4) CARVALHO, Lucília et al. Protocolo de tratamento das complicações relacionadas a gemelaridade monocoriônica. 2024.
5) COELHO, Paula Brandão Ávila et al. Determinantes da morbimortalidade perinatal na gravidez gemelar. 2011. Tese de Doutorado. Instituto Fernandes Figueira.
6) DE FIGUEIREDO ALVES, Ana Paula Pereira et al. Absorção de gemelar na gravidez–relato de caso. Anais da Faculdade de Medicina de Olinda, v. 1, n. 3, p. 34-35, 2019.
7) DE MELO, Ana Beatriz Oliveira et al. Riscos obstétricos em gestações múltiplas: abordagens para reduzir complicações. Brazilian Journal of Implantology and Health Sciences, v. 6, n. 6, p. 257-268, 2024.
8) DE PAIVA PINTO, Bianca et al. Gestação gemelar: frequência de pré-eclâmpsia, diabetes gestacional e prematuridade. Revista Eletrônica Acervo Saúde, v. 15, n. 6, p. e10454-e10454, 2022.
9) DEVEER, Rüya et al. Twin pregnancies with single fetal death: analysis of 38 cases. Fetal and Pediatric Pathology, v. 32, n. 1, p. 71-75, 2013.
10) FRANCISCO, Raimundo Homero de Carvalho Neto; CARVALHO, Herlânio Costa. Restrição de crescimento seletiva em gestação gemelar monocriônica: relato de caso. Rev Med UFC, v. 55, n. 1, p. 57-60, 2015.
11) JAIN, Divya; PUROHIT, R. C. Review of twin pregnancies with single fetal death: management, maternal and fetal outcome. The Journal of Obstetrics and Gynecology of India, v. 64, p. 180-183, 2014.
12) LOUZA, Kamylla Carvalho et al. Avaliação e manejo em emergências obstétricas: hemorragia pós parto. in: saúde da mulher e do recém-nascido: novos paradigmas. Editora Científica Digital, 2024. p. 96-113.
13) MACKIE, F. L. et al. Prognosis of the co‐twin following spontaneous single intrauterine fetal death in twin pregnancies: a systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology, v. 126, n. 5, p. 569-578, 2019.
14) MAGALHÃES, José Antônio A. Medicina fetal. Clinical and Biomedical Research, v. 20, n. 2, 2020.
15) MAHONY, Rhona et al. Fetal death in twins. Acta obstetricia et gynecologica scandinavica, v. 90, n. 11, p. 1274-1280, 2011.
16) PAGE, Jessica M. et al. The risk of stillbirth and infant death by each additional week of expectant management in twin pregnancies. American journal of obstetrics and gynecology, v. 212, n. 5, p. 630. e1-630. e7, 2015.
17) PAIXÃO, Júlia et al. Síndrome de Transfusão Feto-fetal: complicações em gestação gemelar. Caminhos da Clínica, v. 1, n. 01, 2022.
18) PASQUINI, L.; WIMALASUNDERA, R. C.; FISK, N. M. Management of other complications specific to monochorionic twin pregnancies. Best Practice & Research Clinical Obstetrics & Gynaecology, v. 18, n. 4, p. 577-599, 2014.
19) PRÖMPELER, Heinrich J. et al. Twin pregnancies with single fetal death. Acta obstetricia et gynecologica Scandinavica, v. 73, n. 3, p. 205-208, 2014
20) RODRIGUES, Ana Carolina Batista et al. O uso da Ultrassonografia à Beira Leito no manejo das patologias ginecológicas e obstétricas: uma proposta de treinamento. 2024.
21) SAITO, Katsu et al. Perinatal outcome and management of single fetal death in twin pregnancy: a case series and review. 2019.
22) SANTEMA, Job G.; SWAAK, Astrid M.; WALLENBURG, Henk CS. Expectant management of twin pregnancy with single fetal death. BJOG: An International Journal of Obstetrics & Gynaecology, v. 102, n. 1, p. 26-30, 2015.

23) SCHNEIDER, Samanta; SILVA, Jaísa Quedi de Araújo; CUNHA FILHO, Edson. Trabalho de parto prematuro: aspectos gerais e formas de prevenção. Acta méd. (Porto Alegre), p. [4]-[4], 2013.
24) SEBIRE, Neil J. et al. Management of twin pregnancies with fetal trisomies. BJOG: An International Journal of Obstetrics & Gynaecology, v. 104, n. 2, p. 220-222, 2017.
25) SOUZA, Alex Sandro Rolland et al. Indução do trabalho de parto: conceitos e particularidades. Femina, v. 38, n. 4, p. 185-94, 2010.
26) TEIXEIRA, L. et al. Manejo da colestase intra-hepática gestacional Gestational intrahepatic cholestase management. Brazilian Journal of Health Review, v. 4, n. 6, p. 25556-25564, 2021.
27) VAN MIEGHEM, Tim et al. Prenatal management of monoamniotic twin pregnancies. Obstetrics & Gynecology, v. 124, n. 3, p. 498-506, 2014.

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