{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T01:52:07Z","timestamp":1792547527263,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Most of the studies reporting the outcome of the surviving twin after single intra\u2010uterine fetal death (sIUFD) focused on uncomplicated pregnancies or those affected by twin\u2010to\u2010twin transfusion syndrome, while there is a paucity of data for those complicated by twin anemia polycythemia sequence (TAPS). The aim of this systematic review was to report perinatal outcomes in monochorionic diamniotic (MCDA) twin pregnancies complicated by TAPS after sIUFD, according to gestational age at fetal loss and the presence of pregnancy\u2010related comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>MEDLINE, EMBASE, and The Cochrane Library were searched for studies reporting the outcome of monochorionic twin pregnancies complicated by TAPS experiencing single IUFD. The primary outcome was the occurrence of co\u2010twin IUFD. Secondary outcomes were neonatal death (NND), preterm birth (PTB) &lt;34, &lt;32, and &lt;28\u2009weeks of gestation, cerebral abnormalities detected at follow\u2010up prenatal ultrasound, fetal magnetic resonance imaging (MRI) or postnatal imaging (ultrasound or MRI), and adverse neurodevelopmental outcome. Random\u2010effects meta\u2010analysis of proportions was used to analyze the data, and results were reported as pooled proportions or odd ratios (OR) with 95% CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven studies (83 twin pregnancies affected by TAPS, either spontaneous or post\u2010laser, and complicated by single IUFD) were included in the systematic review and 10 (78 pregnancies) in the meta\u2010analysis. Co\u2010twin IUFD occurred in 4.9% (95% CI 1.1\u201311.3) after a single IUFD in pregnancies affected by TAPS, while there was no case of NND. PTB, either spontaneous or iatrogenic, occurred in 80.4% (95% CI 44.3\u201399.5) &lt;34\u2009weeks, and 50.0% (95% CI 16.3\u201383.7) &lt;28\u2009weeks of cases. Intra\u2010uterine transfusion was required in 8.0% (95% CI 0.9\u201338.3). Cerebral anomalies at follow\u2010up ultrasound or fetal MRI were reported in 15.0% (95% CI 8.2\u201378.3) and 11.4% (95% CI 2.4\u201355.7) of cases, while anomalies at post\u2010natal imaging in 9.4% (95% CI 5.6\u201357.6) of cases. It was not possible to perform a meaningful pooled data synthesis on the observed outcomes according to the type and staging of TAPS and according to the donor or recipient twin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The occurrence of co\u2010twin death after single IUFD in pregnancies complicated by TAPS appears low, while cerebral abnormalities detected either pre\u2010 or post\u2010natally occur in 10\u201315% of cases. Further evidence is needed to elucidate the long\u2010term neurological and neurodevelopmental risk of these children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70189","type":"journal-article","created":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T03:13:46Z","timestamp":1778382826000},"page":"1017-1025","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Perinatal outcomes following single intrauterine death in monochorionic twin pregnancies complicated by twin anemia polycythemia sequence: Systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6771-8622","authenticated-orcid":false,"given":"Marina","family":"Piergianni","sequence":"first","affiliation":[{"name":"Center for Fetal Care and High\u2010Risk Pregnancy University of Chieti  Chieti 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Maternal and Child Health and Urological Sciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza Della","family":"Valle","sequence":"additional","affiliation":[{"name":"Center for Fetal Care and High\u2010Risk Pregnancy University of Chieti  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5611-1231","authenticated-orcid":false,"given":"Hiba J.","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, The Fetal Center at Riley Children's and Indiana University Health, Indiana University School of Medicine Riley Children's Hospital  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1308-1474","authenticated-orcid":false,"given":"Alberto","family":"Galindo","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Department of 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