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Published on: September 5, 2011

Monochorionic monoamniotic twin pregnancies.

Tim Van Mieghem¹, Nimrah Abbasi¹, Shiri Shinar¹

¹Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; Ontario Fetal Centre, Toronto, Ontario, Canada.

American Journal of Obstetrics & Gynecology MFM

|November 3, 2021

Summary

This summary is machine-generated.

Early diagnosis is crucial for monoamniotic twin pregnancies due to high complication rates. Intensified fetal surveillance after viability and delivery between 33-34 weeks can improve outcomes for these rare cases.

Keywords:

cesarean delivery fetal health surveillance multiple pregnancy twin pregnancy ultrasound

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Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators

Published on: March 21, 2018

Area of Science:

Maternal-Fetal Medicine
Perinatology
High-Risk Obstetrics

Background:

Monoamniotic twin pregnancy, characterized by both fetuses sharing a single amniotic sac, is a rare condition.
These pregnancies carry significantly higher risks of complications and fetal demise compared to diamniotic or dichorionic twins.
Survival rates for monoamniotic twins are approximately 70%, with high rates of fetal anomalies and other life-threatening complications.

Purpose of the Study:

To emphasize the critical need for early diagnosis of monoamniotic twin pregnancies.
To highlight the significant risks and complications associated with monoamniotic twins.
To outline recommended management strategies, including screening, surveillance, and delivery timing.

Main Methods:

Review of current literature and clinical guidelines for monoamniotic twin pregnancies.
Emphasis on first-trimester anatomy screening for early detection of fetal anomalies.
Discussion of intensified fetal surveillance protocols post-viability.

Main Results:

Fetal anomalies, such as twin reversed arterial perfusion sequence and conjoined twinning, account for approximately half of fetal deaths.
Other causes of fetal death include twin-twin transfusion syndrome, cord entanglement, and hemodynamic imbalances.
Neonatal morbidity is predominantly linked to prematurity.

Conclusions:

Early and accurate diagnosis of monoamniotic twins is paramount for timely intervention and improved outcomes.
A structured approach involving first-trimester screening, intensified surveillance, and appropriate delivery timing (33-34 weeks) is essential.
Despite advancements, the high incidence of prematurity-related neonatal morbidity necessitates continued focus on optimizing care for these high-risk pregnancies.