Delivery of monochorionic twins in the absence of complications: Analysis of neonatal outcomes and costs

Amy Elizabeth Sullivan, Paul Nathan Hopkins, Hsin Yi Weng, Erick Henry, Jamie Oi Ting Lo, Michael Walter Varner, Michael Sean Esplin

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Objective: We sought to estimate the optimal time to deliver uncomplicated monochorionic-diamnionic (MCDA) twins. Study Design: Data were retrospectively obtained from twin pregnancies from 2000 through 2009. The gestational weekspecific prospective perinatal mortality risk was calculated. A cohort of MCDA twins with nonindicated deliveries was analyzed separately. Neonatal outcomes and costs were compared between MCDA twins with nonindicated deliveries born at specific weeks of gestation, and those born the subsequent week. Results: There were 5894 dichorionic-diamnionic twins and 1704 MCDA twins. After 28 weeks, the gestational weekspecific prospective risk of perinatal mortality did not differ between groups. There were 948 MCDA twins with nonindicated deliveries. Until 37 weeks, the risk of severe neonatal morbidity, perinatal mortality, and hospital costs were greater for fetuses delivered compared to fetuses born in a subsequent week. Conclusion: To optimize neonatal outcome and decrease hospital costs, MCDA twins should not be delivered <37 weeks unless medically indicated.

Original languageEnglish (US)
Pages (from-to)257.e1-257.e7
JournalAmerican journal of obstetrics and gynecology
Volume206
Issue number3
DOIs
StatePublished - Mar 2012

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Keywords

  • delivery
  • monochorionic twins
  • prospective risk

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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