Biomaterial Database

[Monoamniotic twins: diagnosis and management]. 2009

N Winer, and Y Caroit, and C Le Vaillant, and H-J Philippe

CHU Nantes, Service de gynécologie-obstétrique, 38, boulevard Jean Monnet, 44093 Nantes cedex, France. norbert.winer@chu-nantes.fr

Monoamniotic twin pregnancies are necessarily monochorionic and are defined by the development of two fetuses in a single amniotic cavity. This pregnancy is the result of a division of the egg between the 8th and 13th day after fertilization. The diagnosis can and should be performed during the first trimester of pregnancy. Apart from the small risk of fetal transfusion syndrome, the specificities of these pregnancies are linked to greater risk of perinatal mortality, malformations, prematurity and the persistent risk of entanglement cords until birth. Intensified obstetrical monitoring eventually requiring hospitalization followed by a premature birth around 34 SA is recommended to improve perinatal outcomes with a reduction in prenatal mortality. Reorientation toward a neonatal Level III, the proposal of a systematic course of corticosteroids and elective delivery once lung maturation is achieved are recommended. There is not enough argument to recommend specific delivery mode, although cesarean section is performed by most authors to reduce the funicular risks.

UI	MeSH Term	Description	Entries
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011248	Pregnancy Complications	Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases.	Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D004200	Diseases in Twins	Disorders affecting TWINS, one or both, at any age.	Diseases in Twin,Twin, Diseases in,Twins, Diseases in,in Twin, Diseases,in Twins, Diseases
D005260	Female		Females
D005315	Fetal Diseases	Pathophysiological conditions of the FETUS in the UTERUS. Some fetal diseases may be treated with FETAL THERAPIES.	Embryopathies,Disease, Fetal,Diseases, Fetal,Embryopathy,Fetal Disease
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000650	Amnion	The innermost membranous sac that surrounds and protects the developing embryo which is bathed in the AMNIOTIC FLUID. Amnion cells are secretory EPITHELIAL CELLS and contribute to the amniotic fluid.	Amniotic Membrane,Amnions,Amniotic Membranes,Membrane, Amniotic,Membranes, Amniotic
D016216	Ultrasonography, Prenatal	The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.	Fetal Ultrasonography,Prenatal Diagnosis, Ultrasonic,Ultrasonography, Fetal,Diagnosis, Prenatal Ultrasonic,Diagnosis, Ultrasonic Prenatal,Prenatal Ultrasonic Diagnosis,Prenatal Ultrasonography,Ultrasonic Diagnosis, Prenatal,Ultrasonic Prenatal Diagnosis,Diagnoses, Prenatal Ultrasonic,Diagnoses, Ultrasonic Prenatal,Prenatal Diagnoses, Ultrasonic,Prenatal Ultrasonic Diagnoses,Ultrasonic Diagnoses, Prenatal,Ultrasonic Prenatal Diagnoses
D017410	Practice Guidelines as Topic	Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.	Clinical Guidelines as Topic,Best Practices,Best Practice
D059285	Pregnancy, Twin	The condition of carrying TWINS simultaneously.	Pregnancies, Twin,Twin Pregnancies,Twin Pregnancy