Surveillance of pregnancy outcome of monochorionic twins at Tu Du Hospital

Abstract

Background: Monochorionic twins are a high risk pregnancy and are associated with special complications that are unique to sharing a placenta and because of the hemodynamic imbalance caused by placental vascular anastomoses. Therefore, the outcome of monochorionic twins is still being researched and reported to looking for the best evidence to perform the optimal interventions.
 Objectives: To describe the outcome of monochorionic twins to determine the proportion of special complications. Moreover, exploring the rate of fetal death in uterus, premature delivery, the successful vaginal birth in complicated monochorionic twins after bipolar cord coagulation.
 Materials and Methods: Case series report of monochorionic twins which was managed pregnancy and delivered at Tu Du hospital between January 2018 and January 2019, comprised 166 cases with 81 complicated monochorionic twin pregnancies.
 Results: The series comprised 85 uncomplicated monochorionic twins (51.2%) and 81 complicated cases (48.8%) with 15% twin-twin transfusion syndrome (TTTS) and 28.3% selective intrauterine growth restriction (sIUGR). Nineteen cases of bipolar cord coagulation perfomed included seven TTTS, eight sIUGR, three cases with serious malformation, and one twin reversed arterial perfusion sequence (TRAP).
 Conclusions: TTTS and sIUGR are complications unique to monochorionic twins and diagnosed in the early stage after 23 week’s gestation. Bipolar cord coagulation is an effective procedure in complicated monochorionic pregnancies to improve pregnancy outcome.