Archive des Bibliothèques universitaires de Nantes

Prise en charge des grossesses gémellaires monoamniotiques : étude multicentrique rétrospective observationelle à propos de 221 cas

Par : Cariou de Vergie, Louise

Document archivé le : 30/10/2018

Retrospective multicenter study reviewing obstetric and perinatal outcomes for 221 monoamniotic twin pregnancies. The objective was to evaluate prenatal monitoring strategies and analyze the optimal timing and mode of delivery for monoamniotic twin pregnancies. Overall perinatal mortality was 18.4%. Mean gestational age at birth did not differ significantly between fetuses managed as inpatients and outpatients, nor did the incidence of intrauterine death and perinatal outcomes. After 34 weeks, one third of the women gave birth vaginally. Most outcomes did not differ significantly between vaginal and cesarean deliveries, although the rate of Apgar scores <7 and admission to neonatal intensive care (49.2% vs. 73.3%, P <.0002) were higher in the cesarean group. Outpatient management and continuation of monoamniotic pregnancies beyond 34 weeks are both reasonable options with close surveillance. Although if cesareans seem to be recommended most frequently, vaginal delivery is not strictly contraindicated. 18NANT087M

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