title: Multiple gestations: timing of indicated late preterm and early-term births in uncomplicated dichorionic, monochorionic, and monoamniotic twins.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. newmanr@musc.edu
authors.forename: Roger B
authors.initials: RB
authors.lastname: Newman
authors.forename: Elizabeth Ramsey
authors.initials: ER
authors.lastname: Unal
mesh_terms: D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000502:physiology*; D047928:Premature Birth; D050497:Stillbirth; D014429:Twins, Dizygotic; D014430:Twins, Monozygotic