Single fetus FDIU in twin pregnancy

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Figure-1

📄 Report Sample Line - Single Fetus FDIU in Twin Pregnancy

shows a twin pregnancy. Twin A demonstrates absent fetal cardiac activity, no fetal movements, and reduced amniotic fluid volume. Fetal biometry of Twin A corresponds to approximately XX weeks of gestation. No structural anomalies are definitively seen. Twin B shows normal cardiac activity and movements, with appropriate biometric parameters for gestational age and normal amniotic fluid volume. The placentation appears [monochorionic/diamniotic OR dichorionic/diamniotic] with [single/separate] placental masses.

Conclusion: 📋 Findings suggestive of Single Intrauterine Fetal Demise (FDIU) in a twin pregnancy. Twin A: FDIU; Twin B: Viable with normal findings.

Recommendation: Serial monitoring of the surviving twin with growth and Doppler studies. Further evaluation for underlying causes if indicated. Consider maternal blood investigations for coagulation profile and infection screening. Referral to a maternal-fetal medicine specialist is advised.

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Note: If you select English, answer all questions in English.
यदि आप हिंदी चुनते हैं, तो सभी प्रश्न हिंदी में हल करें।

1. "Single fetal demise" in a twin pregnancy means: 1. ट्विन प्रेगनेंसी में "सिंगल फेटल डिमाइस" का क्या अर्थ है?
A. Death of one fetus in utero while the other fetus remains alive
B. Death of both fetuses
C. Birth of one fetus only
D. Simultaneous demise of two fetuses

2. The single most important factor determining risk to the surviving twin after single FDIU is: 2. सिंगल FDIU के बाद जीवित जुड़वाँ के जोखिम को निर्धारित करने वाला सबसे महत्वपूर्ण कारक कौन सा है?
A. Chorionicity / placental sharing (monochorionic vs dichorionic)
B. Maternal age
C. Fetal sex of the deceased fetus
D. Time of day when demise occurred

3. In a monochorionic twin pregnancy, single fetal demise can directly cause which complication in the surviving twin? 3. मोनोकोरियोनिक ट्विन गर्भावस्था में, एक भ्रूण की मृत्यु जीवित जुड़वाँ में सीधे किस जटिलता का कारण बन सकती है?
A. Guaranteed normal outcome
B. Only maternal fever
C. Acute hemodynamic shift via placental anastomoses causing ischemic brain injury or organ injury
D. Decreased risk of preterm delivery

4. Immediate evaluation after identifying single FDIU in twins should include: 4. ट्विन्स में सिंगल FDIU की पहचान के बाद तत्काल मूल्यांकन में क्या शामिल होना चाहिए?
A. Confirm chorionicity and perform detailed ultrasound with fetal Dopplers, consider infection screen and counsel parents
B. Immediate cesarean delivery in all cases
C. Start chemotherapy for mother
D. No evaluation required

5. Maternal coagulopathy (DIC) after single fetal demise is: 5. एक भ्रूण मृत्यु के बाद मातृ कोआगुलोपैथी (DIC) क्या है?
A. Very common immediately after any fetal demise
B. Rare but possible, especially with prolonged retention, infection or large dead fetus
C. Impossible
D. Only occurs after delivery

6. Best surveillance plan for the surviving twin when expectant management is chosen includes: 6. प्रत्याशित प्रबंधन चुने जाने पर जीवित जुड़वाँ के लिए सर्वश्रेष्ठ निगरानी योजना में क्या शामिल है?
A. Serial ultrasound for growth, umbilical and middle cerebral artery Dopplers, CTG/NST as indicated; consider fetal MRI if neurological concerns arise
B. Single ultrasound only
C. Immediate planned termination of pregnancy
D. No follow-up required

7. If mother is stable and surviving twin shows normal growth and Dopplers, recommended management is: 7. यदि माँ स्थिर है और जीवित जुड़वाँ में सामान्य वृद्धि और डॉप्लर है, तो अनुशंसित प्रबंधन क्या है?
A. Immediate delivery regardless of gestation
B. Emergency hysterectomy
C. Expectant management with close surveillance and parental counseling
D. No monitoring needed

8. Prognosis for the surviving twin is generally better when the pregnancy is: 8. जीवित जुड़वाँ के लिए पूर्वानुमान सामान्यतः बेहतर होता है जब गर्भावस्था किस प्रकार की होती है?
A. Monochorionic (shared placenta)
B. Dichorionic (separate placentas)
C. Depends only on maternal age
D. Prognosis is identical in all types

9. Indication for earlier delivery of the surviving twin would include: 9. जीवित जुड़वाँ के जल्दी जन्म के लिए संकेत में क्या शामिल होगा?
A. Evidence of fetal distress, abnormal Dopplers, maternal sepsis or coagulopathy
B. Parental preference only without clinical indication
C. Change in maternal hair color
D. Always deliver immediately at any gestation

10. Key counseling point for parents after single FDIU in twins is: 10. ट्विन्स में सिंगल FDIU के बाद माता‑पिता को दिया जाने वाला प्रमुख परामर्श क्या है?
A. There is no risk to the surviving twin and no monitoring needed
B. Explain increased risk of preterm delivery and possible neurological compromise (depending on chorionicity and timing); outline close surveillance plan and neonatal care possibilities
C. Immediate termination is mandatory
D. No obstetric follow‑up until term