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Prevalence, antenatal management and perinatal outcomes of monochorionic monoamniotic twin pregnancies: a collaborative multicentre study in England, 2000‐2013

Lookup NU author(s): Dr Svetlana Glinyanaya, Professor Judith Rankin, Dr Gareth Waring, Dr Stephen Sturgiss, Dr Therese Hannon

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley, 2019.

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Abstract

OBJECTIVES: To determine the prevalence of monochorionic monoamniotic (MCMA) twin pregnancies and to describe perinatal outcomes and clinical management of these pregnancies.METHODS: This multicentre cohort study used population-based data on MCMA twin pregnancies from 11 Northern Survey of Twin and Multiple Pregnancy (NorSTAMP) maternity units for the prevalence estimation of MCMA twinning. Pregnancy outcomes at <24 weeks' gestation, antenatal parameters and perinatal outcomes (from ≥24 weeks to the first 28 days of life) were analysed using combined data on pregnancies with confirmed MCMA chorionicity from the NorSTAMP and the Southwest Thames Region of London Obstetric Research Collaborative (STORK) multiple pregnancy cohort for 2000-2013.RESULTS: The estimated total prevalence of MCMA twin pregnancies in the North of England was 8.2 per 1000 total twin pregnancies (59/7170), the birth prevalence was 0.08 per 1000 all (singleton and multiple) pregnancies. The rate of a spontaneous or iatrogenic fetal death at <24 weeks' gestation was 31.8% (54/170); the overall perinatal mortality was 14.7% (17/116), ranging from 69.2% at <30 weeks to 4.5% at ≥33 weeks' gestation. MCMA twins who survived in utero beyond 24 weeks were delivered, usually by caesarean section, at a median of 33 weeks of gestation (interquartile range=32-34).CONCLUSIONS: In MCMA twins surviving beyond 24 weeks of gestation, there was a higher survival rate compared to previous decades presumably due to early diagnosis, close surveillance and elective birth around 32-34 weeks of gestation. High perinatal mortality at early gestations was mainly attributed to extreme prematurity due to preterm spontaneous labour. This article is protected by copyright. All rights reserved.


Publication metadata

Author(s): Glinianaia SV, Rankin J, Khalil A, Binder J, Waring G, Sturgiss SN, Thilaganathan B, Hannon T

Publication type: Article

Publication status: Published

Journal: Ultrasound in Obstetrics and Gynecology

Year: 2019

Volume: 53

Issue: 2

Pages: 184-192

Print publication date: 01/02/2019

Online publication date: 13/06/2018

Acceptance date: 05/06/2018

Date deposited: 15/06/2018

ISSN (print): 0960-7692

ISSN (electronic): 1469-0705

Publisher: Wiley

URL: https://doi.org/10.1002/uog.19114

DOI: 10.1002/uog.19114

PubMed id: 29900612


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