In the DCT pregnancies undergoing ER to dichorionic twins by intrafetal laser the rates of miscarriage and preterm birth <33 weeks were about 5 and 10%, respectively. Although the number of cases presented in this study is too small for definite conclusions to be drawn, it appears
that ER to dichorionic twins by intrafetal laser may be associated with a better outcome than with alternative management options [1] . We have recently reported that in DCT pregnancies expectant management is associated with high rates of both miscarriage (8%) and early preterm
birth (46%), which could, at least in part, be attributed to complications arising from intertwin placental vascular communications and/or unequal sharing of the placenta in the monochorionic pair [1, 9] . The option of ER of the separate fetus by intracardiac injection of KCl is associated with halving of the rate of preterm birth to 23%, but an increase in the rate of miscarriage to 13% because the complications of monochorionic twins persist with the
addition of complications arising from the intra-uterine presence of dead fetoplacental tissue [1, 9, 10] . The option of ER of the monochorionic pair with survival of the separate fetus results in a 14% rate of miscarriage, presumably due to the intra-uterine presence of excessive dead fetoplacental tissue, but a decrease in preterm birth to 8% [1] .
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