Monoamniotic and Pseudomonoamniotic Twins: Sonographic Diagnosis, Detection of Cord Entanglement, and Obstetric Management

Aisenbrey, Gary A.; Catanzarite, Val; Hurley, Timothy J.; Spiegel, James H.; Schrimmer, David; Mendoza, Art

doi:10.1016/0029-7844(95)00130-j

Cited by 81 publications

(65 citation statements)

References 7 publications

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“…The latter difference is thought to be related not only to placental sharing, but also to the presence of inter-twin placental vascular anastomoses. Monochorionic monoamniotic (MCMA) twins account for approximately 1% of monozygotic twins with a reported incidence ranging from 1:1650 to 1:93734 live births (Aisenbrey et al, 1995;D'Alton & Simpson, 1995;Derom et al, 1988;Colburn & Pasquale, 1982;Simonsen, 1966). MCMA pregnancies are also associated with a very high risk of pregnancy loss (Ezra et al, 2005;Roqué et al, 2003).…”

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confidence: 99%

Pregnancy Outcome of Monochorionic Twins: Does Amnionicity Matter?

et al. 2011

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Objective: To compare the fetal loss rate of monochorionic (MC) twin pregnancies according to their amnionicity. Methods: A retrospective review of all MC pregnancy outcomes in a tertiary centre. Pregnancy outcomes were compared for monochorionic monoamniotic (MCMA) versus monochorionic diamniotic (MCDA) pregnancies. Results: 29 MCMA and 117 MCDA twin pregnancies were identified. The overall fetal loss rate was significantly higher in MCMA (23/52, 44.2%) compared to MCDA pregnancies (28/233, 12%, Chi squared = 30.03, p < .001). Kaplan-Meier analysis showed that fetal survival rate in MCDA twins were significantly higher than in MCMA twins (Log-rank Chi-squared = 27.9, p < .0005). Early pregnancy ultrasound identified the causes for these fetal losses in some MCMA twins. After exclusion of identifiable causes, the difference in fetal survival was not significant in the two groups (Log-rank chi-squared = 0.373, p = .54). Conclusion: The loss rate for MCMA twins is high and occurs mainly due to discordant congenital abnormality, conjoint twins or twin reversed arterial perfusion (TRAP) sequence. Although the fetal loss rate in MCDA is lower than in MCMA pregnancies, the majority of fetal loss in MCDA pregnancies cannot be predicted at the first scan at presentation. The data of this study questions the widespread policy of a difference in the scheduling of elective delivery for MCMA and MCDA twins.

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confidence: 99%

Pregnancy Outcome of Monochorionic Twins: Does Amnionicity Matter?

et al. 2011

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“…Detecting early complications, such as fetal malformations and cord entanglement in monochorionic twin pregnancies by ultrasound and doppler monitoring is important in order to improve prenatal diagnosis 15 . The risk of cord entanglement in monoamniotic twins representing adverse movements in the second trimester, increased to 40-70%.…”

Section: Figure 1 A) Umbilical Cord Entanglement During the Cesareanmentioning

confidence: 99%

Monoamniotic monokoryonik ikiz sirkumvallat plasenta ve konglomere umbilikal kord

Özler¹,

Öztaş²,

Uygur³

et al. 2016

Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi)

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“…There is no consensus regarding optimal fetal surveillance or timing of delivery. Some authors have suggested delivery after fetal lung maturity (Aisenbrey et al, 1995;Rodis et al, 1987). Others have commented that there is no advantage of prophylactic preterm delivery and have claimed that the risk of such delivery outweighs the risk of fetal death (Carr et al, 1990;Tessen & Zlatnic, 1991).…”

Section: Twin Research August 2003mentioning

confidence: 99%