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Pregnancy outcome of monochorionic twins: does amnionicity matter?

Show simple item record Dias, T. en_US Contro, E. en_US Thilaganathan, B. en_US Khan, H. en_US Zanardini, C. en_US Mahsud-Dornan, S. en_US Bhide, A. en_US 2014-10-29T09:33:08Z 2014-10-29T09:33:08Z 2011 en_US
dc.identifier.citation Twin Research and Human Genetics. 2011; 14(6): pp.586-92. en_US
dc.identifier.issn 1832-4274 (Print) en_US
dc.description Indexed in MEDLINE
dc.description.abstract 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 twinswere 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. en_US
dc.publisher Cambridge University Press en_US
dc.subject Pregnancy, Twin en_US
dc.title Pregnancy outcome of monochorionic twins: does amnionicity matter? en_US
dc.type Article en_US
dc.identifier.department Obstetrics and Gynaecology en_US
dc.creator.corporateauthor International Society for Twin Studies en_US

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