Case Series of Monoamniotic and Pseudomonoamniotic Twin Gestations

Shunji Suzuki

doi:10.1155/2013/369419

Abstract

We retrospectively evaluated a series of 18 monoamniotic and 7 pseudomonoamniotic (secondary to rupture in the membrane dividing monochorionic diamniotic twins) twin gestations managed after 20 weeks' gestation. There were no significant differences in the incidence of neonatal death or umbilical cord entanglement between the monoamniotic and pseudomonoamniotic twin gestations (33 versus 21%, P = 0.94 and 72 versus 43%, P = 0.36). Therefore, the same serious management may be needed for pseudomonoamniotic twin gestations as for monoamniotic twin gestations.

Highlights

Monoamniotic twinning is a rare complication, occurring in less than 1% of monozygosity and is associated with a significant mortality rate [1, 2]
Pseudomonoamniotic twin gestation sometimes has been observed to be complicated by umbilical cord entanglement
Some cases of monochorionic diamniotic twin pregnancy complicated by spontaneous antepartum rupture of the intertwin-dividing membrane without any perinatal episodes have been reported [12, 13]; there have been few investigations comparing the perinatal outcomes in pseudomonoamniotic twins with those in true monoamniotic twins

Summary

Introduction

Monoamniotic twinning is a rare complication, occurring in less than 1% of monozygosity and is associated with a significant mortality rate [1, 2]. The most common cause of perinatal mortality in monoamniotic twins has been reported to be cord entanglement [1, 2]. Cord entanglement has been reported in up to 70% of monoamniotic twins with 50% or more of deaths attributed to this complication [3]. Pseudomonoamniotic twin gestation sometimes has been observed to be complicated by umbilical cord entanglement. Some cases of monochorionic diamniotic twin pregnancy complicated by spontaneous antepartum rupture of the intertwin-dividing membrane (and umbilical cord entanglement) without any perinatal episodes have been reported [12, 13]; there have been few investigations comparing the perinatal outcomes in pseudomonoamniotic twins with those in true monoamniotic twins. In this study, we examined the perinatal outcomes of these pregnancies

Methods

Results

Conclusion