| Contemporary management of monochorionic diamniotic twins: outcomes and delivery recommendations revisited. | |
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MedLine Citation:
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PMID: 20579959 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We sought to investigate outcomes of contemporaneously managed monochorionic diamniotic (MCDA) twins, stratified by pregnancy complication. STUDY DESIGN: Four hundred eighteen MCDA pregnancies from 2001 through 2008 were retrospectively reviewed. RESULTS: There were 236 ongoing pregnancies at 24 weeks' gestation. The likelihood of progressing from 24 weeks to 2 live births was 98.7% in uncomplicated pregnancies, 89.7% with twin-twin transfusion syndrome, and 100% with growth discordance, increasing at 32 weeks to 99.5%, 93.8%, and 100%, respectively. The relative risk (RR) of birth <32 weeks was significantly greater in twin-twin transfusion syndrome (RR, 4.1; 95% confidence interval, 2.7-6.1) and growth discordant (RR, 2.1; 95% confidence interval, 1.8-3.8) pregnancies than in uncomplicated pregnancies (P < .0001). CONCLUSION: This represents one of the largest cohorts of MCDA twins. The risk of third-trimester fetal loss was low. The likelihood of both intrauterine fetal demise and preterm birth were greater in complicated pregnancies. In the absence of a clinical indication for delivery, these data do not support elective preterm delivery for prevention of intrauterine fetal demise in uncomplicated MCDA twins. |
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Authors:
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Nicole A Smith; Louise Wilkins-Haug; Joaquin Santolaya-Forgas; David Acker; Katherine E Economy; Carol B Benson; Julian N Robinson |
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Publication Detail:
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Type: Comparative Study; Journal Article; Twin Study Date: 2010-06-26 |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 203 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-27 Completed Date: 2010-08-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 133.e1-6 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 Mosby, Inc. All rights reserved. |
Affiliation:
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Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA 02115, USA. nasmith@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cohort Studies Delivery, Obstetric / methods* Diseases in Twins / epidemiology, therapy, ultrasonography Female Fetofetal Transfusion / epidemiology, therapy, ultrasonography Gestational Age Humans Incidence Maternal Age Maternal Mortality / trends Obstetric Labor, Premature / epidemiology, therapy Parity Perinatal Mortality / trends Pregnancy Pregnancy Complications / diagnosis, epidemiology*, therapy Pregnancy Outcome / epidemiology* Retrospective Studies Risk Assessment Stillbirth Twins, Monozygotic* Ultrasonography, Prenatal Young Adult |
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