Two cases of antepartum demise of one fetus in a twin pregnancy are reported. Obstetrical management and fetal outcome are discussed with particular respect to changes in maternal coagulation parameters.

A case is reported of a transfusion syndrome in a triplet pregnancy with intrauterine death of two of the fetuses. This is an exceptional occurrence in a triplet pregnancy and raises the problem of the management of multiple pregnancies associated with the death of one or more of the fetuses. The problem of the method of delivery and the complications arising in triplet dizygotic pregnancies is discussed.

During the last 33 years, the perinatal mortality of twins has decreased regularly in our department. When examined by duration of pregnancy, mortality was lowest at 37–38 weeks. Below 38 weeks, fetal loss was paradoxically higher in twins born from multiparae. When delivery occurred beyond 38 weeks, mortality rates were increased, but only differences for primiparous group showed statistical significance. Near-term fetal loss was predominantly due to antepartal intrauterine deaths. Analysis of individual cases indicated that early termination of pregnancy might help prevent near-term stillbirths in twins delivered by primiparae. Efforts should be directed at specific detection of twins threatened by antepartum death.