691: Inpatient monitoring for monoamniotic twins: perinatal outcomes of continuous versus intermittent electronic fetal monitoring

Abstract

The purpose of this study was to evaluate the impact of inpatient continuous versus intermittent fetal monitoring on perinatal survival of monoamniotic twin pregnancies. This was a multicenter retrospective cohort study of 20 monoamniotic twin gestations over a 12 year period. The risk of intrauterine fetal death and neonatal morbidity was compared among women who received continuous inpatient monitoring versus intermittent inpatient monitoring. Maternal demographic information and neonatal characteristics were abstracted from inpatient hospital charts. Clinical characteristics and perinatal outcomes were compared for women based on intended inpatient continuous fetal monitoring or inpatient intermittent fetal monitoring. Statistical analysis included students t-test, mann-whitney U-test, Chi-square or Fisher's exact test, as appropriate. Fifteen women underwent continuous electronic fetal monitoring (CEFM) and 5 women underwent intermittent electronic fetal monitoring (IEFM). The median gestational age at admission between groups did not differ between groups (CFM 28.9 weeks (IQR 27.4-29.9) versus IM 27.3 weeks (IQR 26-28.7), p=0.43). The median gestational age at delivery was similar between groups (CEFM 33.9 weeks (IQR 32.7-34) versus IEFM 32 weeks (32-34), p= 0.47).The indications for delivery were similar between groups. 58% of the cohort reached a gestational age of 34 weeks. There were no intrauterine fetal deaths in either group. There were no significant differences in birthweight or neonatal morbidity. Continuous fetal monitoring did not improve neonatal survival or perinatal morbidity when compared with inpatient intermittent fetal monitoring.