Twin pregnancy with intrauterine death of one twin

Antepartum death of one twin is an infrequent obstetric complication. It complicates about 6% of twin pregnancies. Death of one twin in second or third trimester is more deleterious with risk for the surviving twin and also risk of disseminated intravascular coagulation to the mother has been reported. Risks are far higher in monochorionic pregnancy than in dichorionic pregnancy. The common foetal circulation between the live and the dead twins may result in foetal cerebral, renal and skin abnormalities. Management depends on the gestational age, chorionicity and the condition of the surviving fetus. High risk obstetric management is required and a careful neonatal and paediatric follow up is advocated