![]() Although their neonatal mortality and morbidity is high, outcomes for survival are better than anticipated. Monochorionic monoamniotic twins remain a group at risk for cord entanglement, congenital malformations, TTS and prematurity. Assessment of amniotic fluid maximum vertical pocket and visualization of bladder should be done at least every two weeks. Head ultrasounds in 59 of 65 survivors showed two (3%) periventricular leukomalacia, five (9%) Grade I-II intraventricular hemorrhage and 52 (88%) normal. The North American Fetal Therapy Network put out the following recommendations for monitoring of uncomplicated monochorionic diamniotic twins: Ultrasound surveillance at least every two weeks starting at 16 weeks. Polar Body Twins Dizygotic (Fraternal) Twins Dizygotic are twins which result from the fertilization of two different eggs with two different sperms. About 1 in 3 have two placentas and 2 in 3 have one placenta. Six of 71 (8%) twins died (four malformations, one TTS and one 26 weeks premature). Monozygotic Twins (dichorionic or monochorionic) (split from one eggs and one sperm). Five twin sets delivered before 31, 19 sets at 31 to 32 and 12 sets at 33 to 34 weeks. Twin-to-twin transfusion syndrome affected three sets of twins. Malformations were diagnosed prenatally (one hypoplastic left heart and one body stalk) and postnatally (one vertebral anomalies-anal atresia-tracheoesophageal fistula-renal defect (VATER) and two lung hypoplasias). Intrauterine growth restriction (IUGR) was diagnosed with a twin-specific nomogram.Ĭord entanglement was observed in 15 pregnancies, but only one twin with entanglement and a true knot, experienced related morbidity. All MCMA twin pregnancies were diagnosed on tertiary centre. Methods: A retrospective cohort analysis of MCMA twins managed at a tertiary obstetric centre from January 2003 until February 2017. These twins are always identical and can be conjoined. Objectives: To determine the frequency of two yolk sacs in MCMA twin pregnancies and the association of yolk sac number with pregnancy outcomes. To report our experience with 36 sets of MoMo twins (1990 to 2005) and to provide updated information for counseling.Ĭhorionicity was determined by placental examination, gestational age and TTS clinically and by sonography. Mono mono, according to Columbia University, means that both twins share the same amniotic sac and the same placenta. ![]() Cord entanglement, malformations, twin-to-twin transfusion syndrome (TTS) and prematurity are responsible for their high perinatal morbidity and mortality. Monochorionic monoamniotic twins (MoMo) occur in one of 10,000 pregnancies. ![]()
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