Perinatal outcome of monoamniotic twin pregnancies
Karien E Hack1, Jan B Derks, Arty H Schaap
1Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht the Netherlands. k.e.a.hack@umcutrecht.nl
Objective:
To study perinatal mortality and neonatal morbidity in a large cohort of monoamniotic twin pregnancies with special emphasis to the gestational age-specific mortality.
Methods:
The study included monoamniotic twin pregnancies delivered in 10 perinatal centers in the Netherlands between January 2000 and December 2007.
Results:
A total of 98 monoamniotic pregnancies were included. The perinatal mortality rate (20 weeks of gestation through 28 days of life) was 19%; after exclusion of fetuses with lethal anomalies, the rate was 17%. After 32 weeks of gestation, only two pregnancies were complicated by perinatal mortality (4%). The incidence of twin-twin transfusion syndrome was 6%. The incidence of congenital heart anomalies and cerebral injury was 4% and 5%, respectively.
Conclusion:
The current incidence of perinatal mortality in monoamniotic twins is considerably lower than in previous decades, but it is still high and occurs throughout pregnancy.
Level Of Evidence:
III.
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