Antenatal management and terms of delivery in monoamniotic twin pregnancy

Background. Monochorionic monoamniotic twin pregnancies (MCMA) have very high rates of antenatal fetal loss (8–42 %). Objective. The aim of the study was to estimate the terms of delivery, complications and pregnancy outcomes in MCMA. Design and methods. A retrospective study of MCMA outcomes was conducted in 18 patients. Delivery was planned by cesarean section after 32 weeks of gestation. Results. The average term of delivery was 34 weeks 1 day. In 16 (88.9 %) cases was performed the elective cesarean section, in 2 (11.1 %) — the emergency. The indication for emergency delivery was in 1 case (5.6 %) the deterioration of fetoplacental hemodynamics and in 1 case (5.6 %) premature rupture of membrane. The average weight of the newborns was 2078 g with an average Apgar score of 7.4/8.3 points. There was a collision of the umbilical cord in 14 (77.8 %) cases. There were no cases of antenatal death in the study group after reaching 24 weeks of gestation. Conclusion. The study indicate a low risk of antenatal loss in MCMA after 24 weeks of gestation, despite the presence of umbilical cord collision in most of the cases, which justifies the planning of delivery after 36 weeks of gestation in uncomplicated course of pregnancy.

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