title: [Monoamnotic twin pregnancy. Multicenter study].
abstract: OBJECTIVE
  The purpose of this study was to evaluate of perinatal mortality and morbidity of monoamniotic twins.
  
  
  METHODS
  This was a multicenter retrospective analysis of 26 monoamniotic twin gestations identified between 1985 and 2004 in a 3 perinatal departments. Of these 26 pregnancies, 11 women were admitted electively for inpatient fetal monitoring. Overall mortality rates, the risk of intrauterine fetal death and neonatal mortality and morbidity, pregnancy complications and fetal anomalies were calculated.
  
  
  RESULTS
  Monoamniotic twin pregnancies were diagnosed reliably prenatally by ultrasound in 22 women and at delivery in 4 cases. Of the 26 gestations, spontaneous fetal losses before 22 weeks of gestation were 4 cases. The overall loss rate and the perinatal mortality rate were 52% and 19.4%, respectively. Twenty-two women had both twins alive at 24 weeks of gestation; 11 women were admitted electively for inpatient fetal monitoring at 26-27 week of gestation. In this group there were 2 neonatal deaths. No intrauterine fetal death occurred in any hospitalized patient. In our series there were 100% incidence of prematurity, 38,5% of umbilical cord entaglement, 23% of TTTS, 3.6% of TRAP and 9.6% fetal congenital anomalies.
  
  
  CONCLUSIONS
  Monoamniotic twins are at extremly risk of pregnancy complications and fetal loss. These pregnancies can be diagnosed reliably by ultrasound in most cases. Electively admitted women for inpatient fetal monitoring could be improved neonatal survival and decreased perinatal morbidity.
authors.affiliation: Zakład Profilaktyki w Ginekologii i Poloinictwie AS w Kielcach.
authors.forename: Witold
authors.initials: W
authors.lastname: Malinowski
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Baś-Budecka
authors.forename: Marek
authors.initials: M
authors.lastname: Bilar
authors.forename: Piotr
authors.initials: P
authors.lastname: Jóźwiak
authors.forename: Ewa
authors.initials: E
authors.lastname: Kuś
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Ronin-Walknowska
mesh_terms: D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000401:mortality*; D004200:Diseases in Twins / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D005313:Fetal Death / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D014427:Twins; D016216:Ultrasonography, Prenatal