Monoamniotic twin pregnancy
Correspondence: Amar Bhide. firstname.lastname@example.org
- Monoamniotic twins are believed to account for 1–5% of all monozygotic conceptions, with an estimated annual incidence of 30–150 pregnancies in the UK.
- High perinatal loss rates in monoamniotic twins have been attributed mainly to umbilical cord entanglement, inter-twin transfusion syndrome, discordant fetal abnormality or fetal growth restriction.
- Management of monoamniotic twin pregnancy is aimed at preventing antenatal fetal death and optimising timing of delivery.
- Despite the paucity of robust data on the incidence and causes of perinatal loss, elective delivery at 32–34 weeks of gestation has been proposed.
- Most obstetric units use caesarean birth as the preferred mode of delivery for monoamniotic twins to prevent intrapartum cord complications.
- To understand the aetiology, incidence and diagnosis of monoamnionicity.
- To be able to identify the type and prevalence of complications in monoamniotic twins.
- To be aware of the current evidence on the antenatal management and optimal timing of delivery of monoamniotic twin pregnancy.
- Can we justify elective preterm delivery and its subsequent complications without a robust evidence base demonstrating a reduction in perinatal morbidity and mortality?