The prenatal fetal deaths in multiple pregnancy are reported in the literature to be 3.6—6.8%. Intrauterine fetal death in twins is 4 times higher than in singletons, and is associated with high neonatal and infant morbidity for the surviving children. A multiple pregnancy complicated by the intrauterine death of a single fetus is classified as a high perinatal risk pregnancy and is associated with a high incidence of pregnancy complications.

OBJECTIVE

To identify the features of the fetoplacental complex in pregnant women with a multiple pregnancy complicated by the intrauterine death of one fetus at different gestational ages.

MATERIAL AND METHODS

The retrospective study analyzed 120 individual charts and 120 case records of pregnant women with multiple pregnancies, 60 of whom had multiple pregnancies complicated by intrauterine death of one fetus, dying before 22 weeks’ gestation in 25 pregnant women and in 35 patients after 22 weeks. Sixty patients with multiple pregnancies had two live births. Primary medical records, laboratory and instrumental studies from maternity charts (Form 096/u), neonatal charts (Form 097/u), and in-patient medical records (Form 003u) were analyzed.

RESULTS

The study identified the features of the fetoplacental complex in pregnant women with a multiple pregnancy complicated by the intrauterine death of one fetus. A leading role was attributed to placental insufficiency, caused by circulatory disorders, involutional-dystrophic changes, and inflammatory processes in the placenta. The morphological changes in the placenta were most pronounced in the antenatal death of one of the fetuses after 22 weeks of gestation.

CONCLUSION

Fetoplacental insufficiency is the cause of one fetal death in multiple gestation, in which fetal-placental circulation disorders prevail over uteroplacental disorders. Early diagnosis and adequate therapy are needed to prevent antenatal fetal death in multiple pregnancy.