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Related Experiment Videos

Perinatal outcomes in monoamniotic gestations.

H Roqué1, J Gillen-Goldstein, E Funai

  • 1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Connecticut, Farmington, Connecticut 06030, USA.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|September 10, 2003
PubMed
Summary

Monoamniotic twin gestations face increasing perinatal loss after 32 weeks. Antenatal diagnosis of cord entanglement improves outcomes, suggesting earlier delivery considerations.

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Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • Monoamniotic twins share a single amniotic sac, increasing risks of cord entanglement and adverse outcomes.
  • Previous literature suggested a relatively stable risk of perinatal loss throughout gestation for these pregnancies.

Purpose of the Study:

  • To estimate perinatal mortality and morbidity in monoamniotic twin gestations.
  • To evaluate the predictive value of antenatal cord entanglement diagnosis for obstetric outcomes.

Main Methods:

  • A comprehensive literature review of monoamniotic twin gestations reported between 1990 and 2002.
  • Medline database search limited to English-language articles.

Main Results:

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  • Perinatal loss increased significantly after 32 weeks, reaching 21.9% by 36-38 weeks.
  • Overall perinatal mortality was 23.3%.
  • Antenatal diagnosis of cord entanglement was associated with reduced neonatal intensive care unit days and lower perinatal mortality.

    • Conclusions:

    • Perinatal loss risk rises substantially beyond 32 weeks in monoamniotic twins.
    • Delivery after corticosteroid therapy should be strongly considered around 32 weeks gestation.