1. Q9 Twins and Triplets
A woman at 33 weeks gestational age has been diagnosed with monochorionic monoamniotic twin
pregnancy. The pregnancy so far has been uncomplicated. She comes to the emergency department complaining of labor pains. On examination- the cervix is 3 cm dilated. The first twin is cephalic. What is the recommended mode of delivery ?
Offer a caesarean section to women with a monochorionic monoamniotic twin
pregnancy:
- at the time of planned birth (between 32+0 and 33+6 weeks) or
- after any complication is diagnosed in her pregnancy requiring earlier delivery or
- if she is in established preterm labour, and gestational age suggests there is a
reasonable chance of survival of the babies (unless the first twin is close to vaginal
birth and a senior obstetrician advises continuing to vaginal birth).
