Multiple gestations: timing of indicated late preterm and early-term births in uncomplicated dichorionic, monochorionic, and monoamniotic twins.

In this work we review the indications for late preterm and early-term birth in uncomplicated dichorionic, monochorionic, and monoamniotic twin gestations. Uncomplicated dichorionic twins have optimal outcomes when delivered at 38 weeks' gestation. Monochorionic twins, however, are at greater risk for unexpected stillbirth, and a management plan of late preterm delivery (34-37 weeks) after informed consent is reasonable. Monoamniotic twins are at even greater risk for sudden intrauterine fetal demise, and it is recommended that these expectant mothers be managed by inpatient hospitalization with fetal testing 1-3 times per day and delivery between 32 and 34 weeks' gestation. Recommendations are also provided for the circumstance of single intrauterine fetal demise in a twin gestation.

[1]  C. Koopman‐Esseboom,et al.  Perinatal Outcome of Monoamniotic Twin Pregnancies , 2009, Obstetrics and gynecology.

[2]  M. D'Alton,et al.  Twin Chorionicity and the Risk of Stillbirth , 2008, Obstetrics and gynecology.

[3]  I. Blickstein,et al.  Prospective risk of intrauterine death of monochorionic-diamniotic twins. , 2006, American journal of obstetrics and gynecology.

[4]  N. Fisk,et al.  High Risk of Unexpected Late Fetal Death in Monochorionic Twins Despite Intensive Ultrasound Surveillance: A Cohort Study , 2005, PLoS medicine.

[5]  Morton B. Brown,et al.  The cost of twin pregnancy: maternal and neonatal factors. , 2004, American journal of obstetrics and gynecology.

[6]  T. Garite,et al.  Improved perinatal survival of monoamniotic twins with intensive inpatient monitoring. , 2005, American journal of obstetrics and gynecology.

[7]  M. D'Alton,et al.  Management of Single Fetal Demise in a Multiple Gestation , 2004, Obstetrical & gynecological survey.

[8]  A. Gul,et al.  The outcome of twin pregnancies complicated by single fetal death after 20 weeks of gestation. , 2004, Twin research : the official journal of the International Society for Twin Studies.

[9]  M. D'Alton,et al.  Multicystic encephalomalacia after first-trimester intrauterine fetal death in monochorionic twins. , 2004, American journal of obstetrics and gynecology.

[10]  M. D'Alton,et al.  Prospective risk of fetal death in singleton, twin, and triplet gestations: implications for practice. , 2003, Obstetrics and gynecology.

[11]  Gary Jeng,et al.  Trends in multiple births conceived using assisted reproductive technology, United States, 1997-2000. , 2003, Pediatrics.

[12]  C. Lockwood,et al.  Perinatal outcomes in monoamniotic gestations , 2003, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[13]  D. Mattison,et al.  The Changing Epidemiology of Multiple Births in the United States , 2003, Obstetrics and gynecology.

[14]  K. Costeloe,et al.  Prospective Risk of Stillbirth in Multiple‐Gestation Pregnancies: A Population‐Based Analysis , 2002, Obstetrics and gynecology.

[15]  J. Hitti,et al.  Perinatal mortality and neonatal morbidity rates among twin pairs at different gestational ages: optimal delivery timing at 37 to 38 weeks' gestation. , 2001, American journal of obstetrics and gynecology.

[16]  POD Pharoah,et al.  Consequences of in-utero death in a twin pregnancy , 2000, The Lancet.

[17]  Shunji Suzuki,et al.  Clinical Trial of Induction of Labor versus Expectant Management in Twin Pregnancy , 2000, Gynecologic and Obstetric Investigation.

[18]  L. Schieve,et al.  Live-birth rates and multiple-birth risk using in vitro fertilization. , 1999, JAMA.

[19]  A. Gerson,et al.  Monoamniotic twins: case series and proposal for antenatal management , 1999 .

[20]  J. Tyson,et al.  Outcomes of very low birth weight twins cared for in the National Institute of Child Health and Human Development Neonatal Research Network's intensive care units. , 1998, American journal of obstetrics and gynecology.

[21]  J. Egan,et al.  Monoamniotic twins: improved perinatal survival with accurate prenatal diagnosis and antenatal fetal surveillance. , 1997, American journal of obstetrics and gynecology.

[22]  B. Luke,et al.  Reducing fetal deaths in multiple births: optimal birthweights and gestational ages for infants of twin and triplet births. , 1996, Acta geneticae medicae et gemellologiae.

[23]  R. Yip,et al.  Increasing Trends in Plural Births in the United States , 1995, Obstetrics and gynecology.

[24]  K. Nelson,et al.  Twins, triplets, and cerebral palsy in births in Western Australia in the 1980s. , 1993, BMJ.

[25]  F. Zlatnik,et al.  Monoamniotic Twins: A Retrospective Controlled Study , 1991, Obstetrics and gynecology.

[26]  M. Aronson,et al.  Survival rates of monoamniotic twins do not decrease after 30 weeks' gestation. , 1990, American journal of obstetrics and gynecology.

[27]  Carlson Nj,et al.  Multiple gestation complicated by the death of one fetus. , 1989 .