Perinatal mortality in twin pregnancies
is approximately five times higher
than in singleton pregnancies. If
both fetuses die the management is
straightforward: delivery by the most
appropriate means. Death of one
of a twin pair is more challenging.
The sequelae for the surviving
co-twin may be significant, with
risks of demise, premature delivery
with its consequences and the
risk of neurological impairment.
Chorionicity, amnionicity, gestation
and potential causation must all
be considered when determining
appropriate management.