title: Prenatal diagnosis and management of monoamniotic twins.
abstract: OBJECTIVE
  The purpose of this article is to investigate the perinatal outcomes of monoamniotic twins under current standards of prenatal management involving intensive fetal surveillance.
  
  
  RESULTS
  The incidence of perinatal mortality in monoamniotic twins has fallen over the last 2 decades. Umbilical cord entanglement has long been considered one of the main causes of poor outcome among monoamniotic twins; however, new evidence shows that it appears to be less important than prematurity and congenital anomalies. If intensive fetal surveillance is provided, the risk of perinatal mortality is acceptably low regardless of setting. In uncomplicated monoamniotic twin pregnancies, delivery at around 33 weeks of gestation might reduce the risk of neonatal adverse events without increasing the risk of perinatal death.
  
  
  CONCLUSIONS
  Perinatal outcome in monoamniotic twins improved if intensive fetal surveillance was performed under either outpatient or inpatient management. Planned delivery in uncomplicated monoamniotic twin pregnancies can be considered at around 33 weeks of gestation.
authors.affiliation: Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ishii
mesh_terms: D002585:Cesarean Section / Q000379:methods*; D036861:Delivery, Obstetric / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D053589:Nuchal Cord / Q000000981:diagnostic imaging* / Q000401:mortality / Q000517:prevention & control; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011295:Prenatal Care / Q000379:methods; D011296:Prenatal Diagnosis; D014430:Twins, Monozygotic; D014463:Ultrasonography