Skip to main content
SpringerLink
Log in

Mortality of Twins

  • Chapter
Pathology of Multiple Pregnancy

Abstract

It is tough to be a twin! The risks of disorder, disease, and death are greater for all members of a plural set from the moment of conception to the end of their life span, and encompass physical, psychological, and social threats.1, 2 There seems to be universal agreement on this concept although the reported statistical magnitude and details vary widely. It has been suggested that the frequency of twinning at conception may actually be as high as one in eight, and that for every live-born twin pair, there would appear to be at least six singletons who are actually sole survivors of twin conceptions, and in the remainder, the entire conception is lost, in the majority prior to clinical recognition.3 Mortality of twins is thus a numerically important problem, and is the focus of this chapter. Morbidity of twins is discussed in Chapter 6, and Chapter 7 deals with anomalous development of twins.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Guttmacher AF, Kohl SG. The fetus of multiple gestations. Obstet Gynecol. 1958;12:528–41.

    PubMed  CAS  Google Scholar 

  2. Farr V. Prognosis for the babies, early and late. In: MacGillivray I, Nylander PPS, Comey G, eds. Human Multiple Reproduction. Philadelphia: WB Saunders; 1975:188–211.

    Google Scholar 

  3. Boklage CE. Survival probability of human conceptions from fertilization to term.Int J Fértil. 1990;35:75–94.

    PubMed  CAS  Google Scholar 

  4. Bryan EM. The intrauterine hazards of twins. Arch Dis Child. 1986;61:1044–1045.

    PubMed  CAS  Google Scholar 

  5. Millar C. Second Self: Consequences of the Intrauterine Death of One of Twins. Creswick, Australia: Holistikon Publishing; 1981.

    Google Scholar 

  6. Lewis E, Bryan EM. Management of perinatal loss of a twin. Br Med J. 1988;297:1321–1323.

    CAS  Google Scholar 

  7. Cetrulo CL. The controversy of mode of delivery in twins: the intrapartum management of twin gestation (Part I). Semin Perinatol. 1986;10:39–43.

    PubMed  CAS  Google Scholar 

  8. Papiernik E, Keith LG. The cost effectiveness of pi-eventing preterm delivery in twin pregnancies. Acta Genet Med Gemellol. 1990;39:361–369.

    PubMed  CAS  Google Scholar 

  9. Livingston JE, Poland BJ. A study of spontaneously aborted twins. Teratology. 1980;21:139–148.

    PubMed  CAS  Google Scholar 

  10. Galton F. The history of twins as a criterion of the relative powers of nature and nurture. J Anthropol Inst. G Br Irel 1876;5:391–406.

    Google Scholar 

  11. Benirschke K. The placenta in the litigation process. Am J Obstet Gynecol. 1990;162:1445–1450.

    PubMed  CAS  Google Scholar 

  12. Schindler NR. Importance of the placenta and cord in the defense of neurologically impaired infant claims. Arch Pathol Lab Med. 1991;115:685–687.

    PubMed  CAS  Google Scholar 

  13. Kalousek DK, Fitch N, Paradice BA. Pathology of the Human Embryo and Previable Fetus. An Atlas. New York: Springer-Verlag; 1990:37–60.

    Google Scholar 

  14. Kalousek DK, Baldwin VJ, Dimmick JE, Cimolai N, Andrews A, Paradice B. Embryofetal-perinatal autopsy and placental examination. In: Dimmick JE, Kalousek DK, eds. Developmental Pathology of the Embryo and Fetus. Philadelphia: JB Lippincott; 1992:799–824.

    Google Scholar 

  15. Baldwin VJ, Kalousek DK, Dimmick JE, Apple- garth DA, Hardwick DF. Diagnostic pathologic investigation of the malformed conceptus. Per sped Pediatr Pathol. 1982;7:65–109.

    CAS  Google Scholar 

  16. Keeling JW. The perinatal necropsy. In: Keeling JW, ed. Fetal and Neonatal Pathology. Berlin: Springer-Verlag; 1989:1–43.

    Google Scholar 

  17. Potter EL, Craig JM. Pathology of the Fetus and Infant. 3rd ed. Chicago: Yearbook Medical Publishers; 1975:83–92.

    Google Scholar 

  18. Wiggles worth JS. Performance of the perinatal autopsy. In: Bennington JL, ed. Perinatal Pathology. Major Problems in Pathology. Philadelphia: WB Saunders; 1984;15(3):27–47.

    Google Scholar 

  19. Maherson TA, Valdes-Dapena M. The perinatal autopsy. In: Wigglesworth JS, Singer DB, eds. Textbook of Fetal and Perinatal Pathology. Oxford: Blackwell Scientific; 1991:93–123.

    Google Scholar 

  20. Hellman LM, Kobayashi M, Cromb E. Ultrasonic diagnosis of embryonic malformations. Am J Obstet Gynecol. 1973;115:615–623.

    PubMed  CAS  Google Scholar 

  21. Farquharson DF, Wittmann BK, Hansmann M, Ho Yuen B, Baldwin VJ, Lindahl S. Management of quintuplet pregnancy by selective embryocide. Am J Obstet Gynecol. 1988;158:413–416.

    PubMed  CAS  Google Scholar 

  22. Golbus MS, Cunningham N, Goldberg JD, Anderson R, Filly R, Callen P. Selective termination of multiple gestations. Am J Med Genet. 1988; 31:339–348.

    PubMed  CAS  Google Scholar 

  23. Levi S. Ultrasonic assessment of the high rate of human multiple pregnancy in the first trimester. J Clin Ultrasound. 1976;4:3–5.

    PubMed  CAS  Google Scholar 

  24. Robinson HP, Caines JS. Sonar evidence of early pregnancy failure in patients with twin conceptions. Br J Obstet Gynecol. 1977;84:22–25.

    CAS  Google Scholar 

  25. Schneider L, Bessis R, Simonnet T. The frequency of ovular resorption during the first trimester of twin pregnancy. Acta Genet Med Gemellol. 1979; 28:271–272.

    PubMed  CAS  Google Scholar 

  26. Kurjak A, Latin V. Ultrasound diagnosis of fetal abnormalities in multiple pregnancy. Acta Obstet Gynecol Scand. 1979;58:153–161.

    PubMed  CAS  Google Scholar 

  27. Varma TR. Ultrasound evidence of early pregnancy failure in patients with multiple conceptions. Br J Obstet Gynecol 1979;86:290–292.

    CAS  Google Scholar 

  28. Brown BS. Disappearances of one gestational sac in the first trimester of multiple pregnancies— ultrasonographic findings. J Can Assoc Radiol. 1982;33:273–275.

    PubMed  CAS  Google Scholar 

  29. Landy HJ, Keith L, Keith D. The vanishing twin. Acta Genet Med Gemellol. 1982;31:179–194.

    PubMed  CAS  Google Scholar 

  30. Landy HJ, Weiner S, Corson SL, Batzer FR, Bolognese RJ. The “vanishing twin”; ultrasonographic assessment of fetal disappearance in the first trimester. Am J Obstet Gynecol. 1986;155:14–19.

    PubMed  CAS  Google Scholar 

  31. Saidi MH. First trimester bleeding and the vanishing twin. J Repro Med. 1988;33:831–834.

    CAS  Google Scholar 

  32. Nakamura I, Uno M, Io Y, Ikeshita I, Nonaka K, Miura T. Seasonality in early loss of one fetus among twin pregnancies. Acta Genet Med Gemellol. 1990;39:339–344.

    PubMed  CAS  Google Scholar 

  33. Abrams RH. Double pregnancy: report of a case with 35 days between deliveries. Obstet Gynecol. 1957;9:435–438.

    PubMed  CAS  Google Scholar 

  34. Uchida IA, Freeman VCP, Gedeon M, Goldmaker J. Twinning rate in spontaneous abortions. J Hum Genet. 1983;35:987–993.

    CAS  Google Scholar 

  35. Evans MI, Fletcher JC, Zador IE, Newton BW, Quigg MH, Struyk CD. Selective first-trimester termination in octuplet and quadruplet pregnancies: clinical and ethical issues. Obstet Gynecol. 1988; 71:289–296.

    PubMed  CAS  Google Scholar 

  36. Holder AR, Henifin MS. Selective termination of pregnancy. Hastings Cent Rep. 1988;February/ March:21–22.

    Google Scholar 

  37. Howie PW. Selective reduction in multiple pregnancy. Legal confusion and ethical dilemmas. Br Med J. 1988;297:433–434.

    CAS  Google Scholar 

  38. Hobbins JC. Selective reduction—a perinatal necessity? N Engl J Med. 1988;318:1062–1063.

    PubMed  CAS  Google Scholar 

  39. Editorial. Selective fetal reduction.Lancet. 1988;2:773–775.

    Google Scholar 

  40. Berkowitz RL, Lynch L, Chitkara U, Wilkins IA, Mehalek KE, Alvarez E. Selective reduction of multifetal pregnancies in the first trimester. N Engl J Med. 1988;318:1043–1047.

    PubMed  CAS  Google Scholar 

  41. Evans MI, May M, Drugan A, Fletcher JC, Johnson MP, Sokol RJ. Selective termination: clinical experience and residual risks. Am J Obstet Gynecol. 1990;162:1568–1575.

    PubMed  CAS  Google Scholar 

  42. Wapner RJ, Davis GH, Johnson A, Weinblatt VJ, Fischer RL, Jackson LG, Chervenak FA, Mullough LB. Selective reduction of multifetal pregnancies. Lancet. 1990;1:90–93.

    Google Scholar 

  43. Gonen Y, Blankier J, Casper RF. Transvaginal ultrasound in selective embryo reduction for multiple pregnancy. Obstet Gynecol. 1990;75:720–722.

    PubMed  CAS  Google Scholar 

  44. Lynch L, Berkowitz RL, Chitkara U, Alvarez M. First trimester transabdominal multifetal pregnancy reduction: a report of 85 cases. Obstet Gynecol. 1990;75:735–738.

    PubMed  CAS  Google Scholar 

  45. Tabsh KM A. Transabdominal multifetal pregnancy reduction: report of 40 cases. Obstet Gynecol. 1990;75:739–741.

    PubMed  CAS  Google Scholar 

  46. Porreco RP, Burke MS, Hendrix ML. Multifetal reduction of triplets and pregnancy outcome. Obstet Gynecol. 1991;78:335–339.

    PubMed  CAS  Google Scholar 

  47. Melgar CA, Rosenfeld DL, Rawlinson K, Greenberg M. Perinatal outcome after multifetal reduction to twins compared with non-reduced multiple gestations. Obstet Gynecol 1991;78:763–767.

    PubMed  CAS  Google Scholar 

  48. Itskovitz J, Boldes R, Thaler I, Bronstein M, Erlik Y, Brandes JM. Transvaginal ultrasonography- guided aspiration of gestational sacs for selective abortion in multiple pregnancy. Am J Obstet Gynecol 1989;160:215–217.

    PubMed  CAS  Google Scholar 

  49. Birnholz JC, Dmowski WP, Binor Z, Radwanska E. Selective continuation in gonadotropin-induced multiple pregnancy. Fertil Steril 1987;48:873–876.

    PubMed  CAS  Google Scholar 

  50. Sulak LE, Dodson MG. The vanishing twin: pathologic confirmation of an ultrasound phenomenon. Obstet Gynecol 1986;68:811–815.

    PubMed  CAS  Google Scholar 

  51. Jauniaux E, Elkazen N, Leroy F, Wilkin P, Rodesch F, Hustin J. Clinical and morphological aspects of the vanishing twin phenomenon. Obstet Gynecol 1988;72:577–581.

    PubMed  CAS  Google Scholar 

  52. Yoshida K, Soma H. Outcome of the surviving co-twin of a fetus papyraceous or of a dead fetus. Acta Genet Med Gemellol 1986;35:91–98.

    PubMed  CAS  Google Scholar 

  53. Toor AH, Kidron D, Dische MR. Placental pathology in selectively reduced multiple pregnancies. (Abstract) Pediatr Pathol 1989;9:800.

    Google Scholar 

  54. Chitayat D, Kalousek DK, Millivray BC, Applegarth DA. A co-twin fetus papyraceous as a cause of elevated AFP and acetylcholinesterase in the amniotic fluid of the normal co-twin.Pediatr Pathol 1991;11:487–491.

    PubMed  CAS  Google Scholar 

  55. Stiller RJ, Lockwood CJ, Belanger K, Baumgarten A, Hobbins JC, Mahoney MJ. Amniotic fluid a-fetoprotein concentrations in twin gestations: dependence on placenta membrane anatomy. Obstet Gynecol 1988;158:1088–1092.

    CAS  Google Scholar 

  56. Ottolenghi-Preti GF. Sopra un rarissimo caso di gravidanza gemellare con un feto papiraceo e con inserzione velamentosa del funiculo del feto vivo. Ann Ostet Ginecoeerinat. 1972;93:173–199.

    CAS  Google Scholar 

  57. O’Regan JA, Craig RL. Fetus papyraceous—triplet pregnancy with one normal and two papyraceous fetuses. Am J Obstet Gynecol. 1941;43:343.

    Google Scholar 

  58. Roos FJ, Roter AM, Molina FA. A case of triplets including anomalous twins and a fetus compressus. Am J Obstet Gynecol. 1957;73:1342–1345.

    PubMed  CAS  Google Scholar 

  59. Hommel H, Festge B. Drillingsschwangerschaft mit fetus papyraceus. Zentralbl Gynakol. 1979; 101:845–847.

    PubMed  CAS  Google Scholar 

  60. Kindred JE. Twin pregnancies with one blighted. Am J Obstet Gynecol. 1944;48:642–682.

    Google Scholar 

  61. Baker VV, Doering MC. Fetus papyraceous: an unreported congenital anomaly of the surviving infant. Am J Obstet Gynecol. 1982;143:234–235.

    PubMed  CAS  Google Scholar 

  62. Gilardi G, Giannone E. Ozzervazioni cliniche, morfologiche e patogenetiche su un caso di gravidanza gemellare con transformazione papira- cea di uno dei feti. Arch Ostet Ginecol. 1972; 77:258–263.

    Google Scholar 

  63. Leroy F. Major fetal hazards in multiple pregnancy. Acta Genet Med Gemellol. 1976;25:299–306.

    PubMed  CAS  Google Scholar 

  64. Nance WE. Malformations unique to the twinning process. In: Gedda L, Parisi P, Nance WE, eds. Twin Research 3: Twin Biology and Multiple Pregnancy. Prog Clin Biol Res. 1981;69A:123–133.

    Google Scholar 

  65. Balfour RP. Fetus papyraceous. Obstet Gynecol. 1976;47:507.

    PubMed  CAS  Google Scholar 

  66. Desgranges M-F, De Muylder X, Moutquin J-M, Lazaro-Lopez F, Leduc B. Perinatal profile of twin pregnancies: a retrospective review of 11 years (1969–1979) at Höpital Notre-Dame, Montreal, Canada.Acta Genet Med Gemellol. 1982;31:157–163.

    PubMed  CAS  Google Scholar 

  67. Saier F, Burden L, Cavanagh D. Fetus papyraceous. (An unusual case with congenital anomaly of the surviving fetus.) Obstet Gynecol. 1975; 45:217–220.

    PubMed  CAS  Google Scholar 

  68. Wagner DS, Klein RL, Robinson HB, Novak RW. Placental emboli from a fetus papyraceous. J Pedi- aturg. 1990;25:538–542.

    CAS  Google Scholar 

  69. Mannino FL, Jones KL, Benirschke K. Congenital skin defects and fetus papyraceous. J Pediatr. 1977;91:559–564.

    PubMed  CAS  Google Scholar 

  70. Anderson RL, Golbus MS, Curry CJR, Callen PW, Hastrup WH. Central nervous system damage and other anomalies in surviving fetus following second trimester antenatal death of co-twin.Prenaiagn. 1990;10:513–518.

    CAS  Google Scholar 

  71. Kaplan C. Isolated aortic stenosis with fetus papyraceous: a new vascular disruption anomaly. In: Ryder OA, Byrd ML, eds. One Medicine. Heidelberg: Springer-Verlag; 1984:77–83.

    Google Scholar 

  72. Clark DA. Hydrops fetalis attributable to intrauterine disseminated intravascular coagulation. Clin Pediatr. 1981;20:61–62.

    CAS  Google Scholar 

  73. Redwine FO, Hays PM. Selective birth. Semin Perinatol. 1986;10:73–81.

    PubMed  CAS  Google Scholar 

  74. Aberg A, Mitelman F, Cantz M, Gehler J. Cardiac puncture of fetus with Hurler’s disease avoiding abortion of unaffected co-twin. Lancet. 1978;2: 990–991.

    PubMed  CAS  Google Scholar 

  75. Chitkara U, Berkowitz RL, Wilkins IA, Lynch L, Mehalek KE, Alvarez M. Selective second-trimester termination of the anomalous fetus in twin pregnancies. Obstet Gynecol. 1989;73:690–694.

    PubMed  CAS  Google Scholar 

  76. Lake BD, Young EP, Nicolaides K. Prenatal diagnosis of infantile sialic acid storage disease in a twin pregnancy. J Inherited Metab Dis. 1989;12:152–156.

    PubMed  CAS  Google Scholar 

  77. Antsaklis A, Politis J, Karagiannopoulos C, Kaskarelis D, Karababa P, Panourgias J, Boussiou M, Loukopoulos D. Selective survival of only the healthy fetus following prenatal diagnosis of thalassemia major in binovular twin gestation. Prenaiagn. 1984;4:289–296.

    CAS  Google Scholar 

  78. Rodeck CH. Fetoscopy in the management of twin pregnancies discordant for a severe abnormality. Acta Genet Med Gemellol. 1984;33:57–60.

    PubMed  CAS  Google Scholar 

  79. Daffos F, Capella-Pavlovsky M, Forestier F. Fetal blood sampling during pregnancy with use of a needle guided by ultrasound: a study of606 consecutive cases.Am J Obstet Gynecol. 1985;153:655–660.

    PubMed  CAS  Google Scholar 

  80. Papp Z, Csecsei K, Toth Z, Polgar K, Szeifert GT. Exencephaly in human fetuses. Clin Genet. 1986;30:440–444.

    PubMed  CAS  Google Scholar 

  81. Bollmann R, Schilling H, Prenzlau P, Zienert A, Gust G, Leujak A, Warbanow R, Weihrauch P. Selektive Schwangerschaftsbeendigung durch Sectio parva in der 24. Schwangerschaftswache bei diskordanter Zwillingsgraviditat und Spontangeburt eines gesunden Kindes am Termin. Dtsch Med Wochenschr. 1988;113:383–386.

    PubMed  CAS  Google Scholar 

  82. Still K, Kolatat T, Corbett T, Byrne P. Early third trimester selective feticide of a compromising twin. Fetal Ther. 1989;4:83–87.

    PubMed  CAS  Google Scholar 

  83. Burke MS, Heybome K, Bruno A, Porreco RP. Selective feticide in the second trimester: percutaneous ultrasound guided intracardiac placement of a thrombogenic coil (Abstract). Am J Obstet Gynecol. 1991;164:337.

    Google Scholar 

  84. Baldwin VJ, Wittman BK. Pathology of intrages- tational intervention in twin to twin transfusion syndrome. Pediatr Pathol. 1990;10:79–93.

    PubMed  CAS  Google Scholar 

  85. Benirschke K, Kim CK. Multiple Pregnancy. N Engl J Med. 1973;288:1276–1284, 1329–1336.

    PubMed  CAS  Google Scholar 

  86. Koivisto M, Jouppila P, Kauppila A, Moilanen I, Ylikorkala O. Twin pregnancy neonatal morbidity and mortality. Acta Obstet Gynecol Suppl. 1975; 44:21–29.

    CAS  Google Scholar 

  87. Gedda L. Why can the study of twins be called Gemellology? In: Nance WE, ed. Twin Studies: Biology and Epidemiology. Prog Clin Biol Res. 1978;24B:1–8.

    Google Scholar 

  88. Manlan G, Scott KE. Contribution of twin pregnancy to perinatal mortality and fetal growth retardation; reversal of growth retardation after birth. Can Med Assoc J. 1978; 118:365–368.

    PubMed  CAS  Google Scholar 

  89. Layde PM, Erickson JD, Falek A, Marthy BJ. Congenital malformations in twins. Am J Hum Genet. 1980;32:69–78.

    PubMed  CAS  Google Scholar 

  90. Botting BJ, Davies IM, Maarlane AJ. Recent trends in the incidence of multiple births and associated mortality. Arch Dis Child. 1987;62:941–950.

    PubMed  CAS  Google Scholar 

  91. Fabre E, de Aquero RG, de Agustin JL, Perez-Hiraldo MP, Bescos JL. Perinatal mortality in twin pregnancy: an analysis of birth weight-specific mortality rates and adjusted mortality rates for birth weight distributions. J Perinat Med. 1988; 16:85–91.

    PubMed  CAS  Google Scholar 

  92. Ghai V, Vidyasagar D. Morbidity and mortality factors in twins. An epidemiologic approach. Clin Perinatol. 1988;15:123–140.

    PubMed  CAS  Google Scholar 

  93. Spallacy WN, Handler A, Ferre CD. A case- control study of 1253 twin pregnancies from a 1982–1987 perinatal data base. Obstet Gynecol. 1990;75:168–171.

    Google Scholar 

  94. Kiely JL. The epidemiology of perinatal mortality in multiple births.Bull NY Acad Med. 1990;66: 618–637.

    CAS  Google Scholar 

  95. Sehgal NN. Perinatal mortality in twin pregnancies (implications for clinical management). Postgrad Med. 1980;68:231–234.

    PubMed  CAS  Google Scholar 

  96. Shah SB, Patel DN. Twinning and structural defects. Indian Pediatr. 1984;21:475–478.

    PubMed  Google Scholar 

  97. Wharton B, Edwards JH, Cameron AH. Monoam- niotic twins.J Obstet Gynecol Br Cwlth. 1968; 75:158–163.

    CAS  Google Scholar 

  98. Hartikainen-Sorri A-L, Rantakallio P, Sipila P. Changes in prognosis of twin births over 20 years. Ann Med. 1990;22:131–135.

    PubMed  CAS  Google Scholar 

  99. Magnus P, Arntzen A, Samuelsen SO, Haldorsen T, Bakketeig LS. No correlation in postneonatal deaths for twins. A study of the early mortality of twins based on the Norwegian Medical Birth Registry. Early Hum Dev. 1990;22:89–97.

    PubMed  CAS  Google Scholar 

  100. Myrianthopoulos NC. An epidemiologic survey of twins in a large, prospectively studied population. Am J Hum Genet. 1970;22:611–629.

    PubMed  CAS  Google Scholar 

  101. Myrianthopoulos NC. Congenital malformations in twins: epidemiologic survey. Birth Defects. 1975; 11(8): 1–39.

    CAS  Google Scholar 

  102. Ferguson WF. Perinatal mortality in multiple gestations. (A review of perinatal deaths from 1609 multiple gestations.) Obstet Gynecol. 1963;23: 861–870.

    Google Scholar 

  103. Potter EL. Twin zygosity and placental form in relation to the outcome of pregnancy. Am J Obstet Gynecol. 1963;87:566–577.

    PubMed  CAS  Google Scholar 

  104. Bender S. Twin pregnancy (a review of 472 cases). J Obstet Gynecol Br Cwlth. 1952;59:510–517.

    CAS  Google Scholar 

  105. Bulmer MG. The Biology of Twinning in Man. Oxford: Clarendon Press; 1970:54–60.

    Google Scholar 

  106. Naeye RL, Tafari N, Judge D, Marboe CC. Twins: causes of perinatal death in 12 United States cities and one African city. Am J Obstet Gynecol. 1978;131:267–272.

    PubMed  CAS  Google Scholar 

  107. Baldwin VJ. The placenta. In: Dimmick JE, Kalousek DK, eds. Developmental Pathology of the Embryo and Fetus. Philadelphia: JB Lippincott; 1992:271–319.

    Google Scholar 

  108. Hoffman HJ, Bakketeig LS, Stark CR. Twins and perinatal mortality: a comparison between single and twin births in Minnesota and Norway, 1967–1973. In: Nance WE, ed. Twin Research: Biology and Epidemiology. Prog Clin Biol Res. 1978; 24B: 133–142.

    Google Scholar 

  109. Keith L, Ellis R, Berger GS, Depp R. The Northwestern University Multihospital twin study I. A description of 588 twin pregnancies and associated pregnancy loss, 1971–1975.Am J Obstet Gynecol. 1980;138:781–789.

    PubMed  CAS  Google Scholar 

  110. Marivate M, Norman RJ. Twins. Clin Obstet Gynecol. 1982;9B:723–743.

    Google Scholar 

  111. Fowler MG, Kleinman JC, Kiely JL, Kessel SS. Double jeopardy: twin infant mortality in the United States, 1983 and 1984. Am J Obstet Gynecol. 1991;165:15–22.

    PubMed  CAS  Google Scholar 

  112. Zahálková M. Perinatal and infant mortality in twins. In: Nance WE, ed. Twin Research: Biology and Epidemiology. Prog Clin Biol Res. 1978;24B: 115–120.

    Google Scholar 

  113. Chandra P, Harilal KT. Plural births—mortality and morbidity. In: Nance WE, ed. Twin Research: Biology and Epidemiology. Prog Clin Biol Res. 1978;24B: 109–114.

    Google Scholar 

  114. Osbourne GK, Patel NB. An assessment of perinatal mortality in twin pregnancies in Dundee. Acta Genet Med Gemellol. 1985;34:193–199.

    PubMed  CAS  Google Scholar 

  115. Jakobovits A A, Zubek L. Sex ratio in twin pregnancies (letter). Am J Obstet Gynecol. 1987;156:1360.

    PubMed  CAS  Google Scholar 

  116. Ho SK, Wu PYK. Perinatal factors and neonatal morbidity in twin pregnancy. Am J Obstet Gynecol. 1975;122:979–987.

    PubMed  CAS  Google Scholar 

  117. Khrouf N, Barkallah N, Miled SB, Beehr SB, Gastli H. Les grossesses gemellaires: frequence, developpment foetal et mortalité perinatale. J Gynecol Obstet Biol Reprod (Paris). 1983;12:619–623.

    CAS  Google Scholar 

  118. Kleinman JC, Fowler MG, Kessel SS. Comparison of infant mortality among twins and singletons: United States 1960 and 1983. Am J Epidemiol. 1991;133:133–143.

    PubMed  CAS  Google Scholar 

  119. Howarth GR, Pattinson RG, de Jong G. Total perinatal-related wastage in twin pregnancies. S Afr Med J. 1991;80:31–33.

    PubMed  CAS  Google Scholar 

  120. Hawrylyshyn PA, Barkin M, Bernstein A, Papsin PR. Twin pregnancies—a continuing perinatal challenge.Obstet Gynecol. 1982;59:463–466.

    PubMed  CAS  Google Scholar 

  121. Puissant F, Leroy F. A reappraisal of perinatal mortality factors in twins. Acta Genet Med Gemellol. 1982;31:213–219.

    PubMed  CAS  Google Scholar 

  122. Sekiya S, Hafez ESE. Physiomorphology of twin transfusion syndrome: a study of 86 twin gestations. Obstet Gynecol. 1977;50:288–292.

    PubMed  CAS  Google Scholar 

  123. Gruenwald P. Environmental influences on twins apparent at birth (a preliminary study). Biol Neonate. 1970;15:79–93.

    PubMed  CAS  Google Scholar 

  124. Benirschke K. Twin placenta in perinatal mortality. NY State J Med. 1961;61:1499–1508.

    Google Scholar 

  125. Fujikura T, Froehlich LA. Twin placentation and zygosity. Obstet Gynecol. 1971;37:34–43.

    PubMed  CAS  Google Scholar 

  126. Marthy BJ, Sachs BP, Layde PM, Burton A, Terry JS, Rochat R. The epidemiology of neonatal death in twins.Am J Obstet Gynecol. 1981; 141: 252–256.

    Google Scholar 

  127. Maillivray I. Twins and other multiple deliveries. Clin Obstet Gynecol. 1980;7:581–600.

    Google Scholar 

  128. Bender HG, Werner C. Functional aspects of placental maturation in twin pregnancies. In: Nance WE, ed. Twin Research: Clinical Studies. Prog Clin Biol Res. 1978;24C: 147–150.

    Google Scholar 

  129. Young BK, Suidan J, Antoine C, Silverman F, Lustig I, Wasserman J. Differences in twins: the importance of birth order. Am J Obstet Gynecol. 1985;151:915–921.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, British Columbia’s Children’s Hospital, 4480 Oak Street, V6H 3V4, Vancouver, B.C., Canada

    Virginia J. Baldwin M.D.

Authors
  1. Virginia J. Baldwin M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag New York Inc

About this chapter

Cite this chapter

Baldwin, V.J. (1994). Mortality of Twins. In: Pathology of Multiple Pregnancy. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-9514-0_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-9514-0_5

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4613-9516-4

  • Online ISBN: 978-1-4613-9514-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation