Inpatient versus Outpatient Management of Monoamniotic Twins and Outcomes

Authors:
  • ASAnthony C. Sciscione
    Anthony C. Sciscione
  • GMGaro Megerian
    Garo Megerian
  • JTJorge Tolosa
    Jorge Tolosa
  • GMGeorge Macones
    George Macones
  • AOAnne O'SHea
    Anne O'SHea
  • MPMarjorie A. Pollock
    Marjorie A. Pollock
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Abstract
We sought to evaluate whether early (24 to 28 weeks gestation) hospitalization of monoamniotic twins, with close fetal surveillance, and delivery at 32 to 34 weeks gestation, would significantly improve the perinatal morbidity and mortality compared with an outpatient management strategy. A multicenter, retrospective record review was undertaken. Records of all monoamniotic twins were collected for a 10-year period. Monoamniotic twins were identified using intensive care nursery, ultrasound, and pathology records. Data were collected on inpatient versus outpatient management strategies and the perinatal/maternal outcomes and complications. Twenty-three sets of monoamniotic twins were included in the study. Eleven sets were managed using an inpatient strategy and 12 sets were managed using an outpatient strategy. There were no fetal deaths in the inpatient group and there were three fetal deaths in the outpatient group. Inpatient management of monoamniotic twins should be considered.