TY - JOUR
T1 - Current antenatal management of monoamniotic twins
T2 - A survey of maternal-fetal medicine specialists
AU - Desai, Neeraj
AU - Lewis, Dawnette
AU - Sunday, Suzanne
AU - Rochelson, Burton
PY - 2012/10
Y1 - 2012/10
N2 - Objective: To assess current management of monoamniotic (MA) twins by US maternal-fetal medicine providers. Methods: We conducted a mailed survey to members of the Society for Maternal-Fetal Medicine regarding fetal surveillance practices and preferred gestational age (GA) for elective delivery with respect to MA twins. Results: Responses from 837 (43%) were received with most (83.9%) recommending elective admission for inpatient monitoring, 53.5% favoring 2628 weeks as earliest GA for admission and 75% performing intermittent fetal monitoring (of these 81% monitored 23 times/day). Respondents in practice less than 10 years were less likely to use outpatient management (p < 0.05). Median GA for elective delivery was 34 weeks but was higher for those who favored outpatient management, admitted >28 weeks, and were private practitioners (p < 0.05). Conclusions: Despite a paucity of evidence, most practitioners admit MA to perform daily intermittent fetal monitoring and deliver at 34 weeks. Antenatal management protocols may also influence timing of delivery. Due to their rarity, a national registry may be a better tool to analyze the outcomes of these pregnancies.
AB - Objective: To assess current management of monoamniotic (MA) twins by US maternal-fetal medicine providers. Methods: We conducted a mailed survey to members of the Society for Maternal-Fetal Medicine regarding fetal surveillance practices and preferred gestational age (GA) for elective delivery with respect to MA twins. Results: Responses from 837 (43%) were received with most (83.9%) recommending elective admission for inpatient monitoring, 53.5% favoring 2628 weeks as earliest GA for admission and 75% performing intermittent fetal monitoring (of these 81% monitored 23 times/day). Respondents in practice less than 10 years were less likely to use outpatient management (p < 0.05). Median GA for elective delivery was 34 weeks but was higher for those who favored outpatient management, admitted >28 weeks, and were private practitioners (p < 0.05). Conclusions: Despite a paucity of evidence, most practitioners admit MA to perform daily intermittent fetal monitoring and deliver at 34 weeks. Antenatal management protocols may also influence timing of delivery. Due to their rarity, a national registry may be a better tool to analyze the outcomes of these pregnancies.
KW - Clinical obstetrics
KW - Monochorionic monoamniotic twin
KW - Multiple gestation
UR - http://www.scopus.com/inward/record.url?scp=84866466063&partnerID=8YFLogxK
U2 - 10.3109/14767058.2012.668979
DO - 10.3109/14767058.2012.668979
M3 - Review article
C2 - 22385411
AN - SCOPUS:84866466063
SN - 1476-7058
VL - 25
SP - 1913
EP - 1916
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 10
ER -