D-dimer levels as a predicting factor for DIC following single twin death: a case report and review of the literature.

BACKGROUND: Intrauterine death of one twin in the second or third trimester occurs in about 1% of all twin pregnancies. The retention in utero of the dead fetus may be associated with maternal disseminated intravascular coagulation.

CASE: We present the case of a diamniotic monochorionic pregnancy with intrauterine death of the first twin at 24 weeks. The pregnancy reached 33 weeks. In our case although all coagulation factors were within normal limits, D-dimer levels were significantly high, without any evidence though of any clotting problems to the mother.

CONCLUSION: The role of D-dimers is practically unknown in multiple pregnancies. It seems that the interpretation of elevated D-dimer levels is still of limited value for prediction or prognosis of thromboembolic complications of multiple pregnancies.