title: Inpatient versus outpatient management of monoamniotic twins and outcomes.
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.
authors.affiliation: Christiana Care Health Services, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Newark, Delaware, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: DeFalco
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Sciscione
authors.forename: Garo
authors.initials: G
authors.lastname: Megerian
authors.forename: Jorge
authors.initials: J
authors.lastname: Tolosa
authors.forename: George
authors.initials: G
authors.lastname: Macones
authors.forename: Anne
authors.initials: A
authors.lastname: O'Shea
authors.forename: Marjorie A
authors.initials: MA
authors.lastname: Pollock
mesh_terms: D004200:Diseases in Twins / Q000401:mortality*; D005260:Female; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007297:Inpatients / Q000706:statistics & numerical data; D010045:Outpatients / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011295:Prenatal Care; D012189:Retrospective Studies; D014430:Twins, Monozygotic