Kaybolan Ikizlerin Obstetrik Perinatal Sonuçları ile Kaybolan Ikizlerin Herediter Trombofililer ve Gebelik Sonuçları Açısından Değerlendirilmesi

Abstract

In multiple pregnancies, loss of a gestational sac/embryo after detection of the fetuses (with or without cardiac activity) is called vanished twin. In this study, we compared obstetrical/perinatal outcomes of vanished twins diagnosed in our department with singletons, spontaneous twins, twins concieved through assisted reproductive techniques and vanished triplet gestations. Our aim is to detect a possible relationship between vanished twins and placental vascular diseases. We found that vanished twin pregnancies were between singletons and twin gestation in terms of obstetrical outcomes. We compared obstetrical histories of the groups and found that the vanished twin group had significantly higher number of patients with history of 2 or more fetal losses. Besides these, we found that many of the perinatal complications were avioded in the vanished twin cohort. We found that the mutations that can cause hereditary thrombophilias, especially MTHFR polymorphisms, were more common in the vanished twin group. This led us to make another evaluation and obstetrical/perinatal complications were compared between individuals with and without homozygous mutation. In terms of obstetrical outcomes there were no significant difference between two groups. Infants born in the homozygous mutation group had significantly higher rates of developing indirect hyperbilirubinemia. The vanished twin cohort consists of patients whom had early diagnosis for maternal abnormalities of aminoacid metabolism. Early diagnosis led early medical therapeutic interventions and close surveillance available. We suggest that in pregnancies whom vanished twin phenomenon were detected, looking for the underlying pathology and directed medical therapy may prevent most of the complications.