51. Survival rates of monoamniotic twins do not decrease after 30 weeks' gestation
- Author
-
Carr, Stephen R., Aronson, Michael P., and Coustan, Donald R.
- Subjects
Twins -- Physiological aspects ,Amniotic sac -- Abnormalities ,Twins -- Patient outcomes ,Health - Abstract
Monoamniotic twinning (twins that share a common amniotic sac, the membrane that surrounds the fetus) occurs rarely, and when it does, the event is associated with an increased risk of fetal complications and death. One approach to reducing this risk is to induce delivery early in the last trimester of pregnancy, however, few studies have systematically investigated the effectiveness of this method of treatment. To determine whether early delivery improves the survival of monoamniotic twins, a review of medical records was carried out for all women who gave birth at one hospital during a 13-year period (138,232 live births). Twenty-four sets of monoamniotic twins had both fetuses alive at some time prior to 18 weeks' gestation. At 30 weeks' gestation, 15 sets had both fetuses alive, two sets had one dead twin, one set was delivered and both survived, and in the remaining six sets both fetuses died. Among the 17 sets with at least one twin alive at week 30, no death occurred during the remaining gestational period. Both twins survived in 46 percent of the cases, with survival of at least one fetus in 63 percent. Twins had been diagnosed prenatally in only 29 percent of the cases, and monoamniotic twins, in 21 percent. Thus, it appears that the highest mortality occurs between 18 and 30 weeks' gestational age. Any advantage to early delivery must be weighed against the better survival of fetuses delivered later in gestation. There appears to be no support for the practice of early delivery of monoamniotic twins. (Consumer Summary produced by Reliance Medical Information, Inc.)
- Published
- 1990