Monoamniotic twin pregnancy: continuous inpatient electronic fetal monitoring—an impossible goal?

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 2; pp. 161.e1 - 161.e6
• Main Authors: Quinn, Kristen H., Cao, Carol Tran, Lacoursiere, D. Yvette, Schrimmer, David
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.2011; Elsevier
• Subjects: Adult; Amnion - diagnostic imaging; Biological and medical sciences; continuous fetal monitoring; Female; Fetal Monitoring - methods; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; monoamniotic twins; Obstetrics and Gynecology; Pregnancy; Retrospective Studies; Twins, Monozygotic; Ultrasonography, Prenatal; continuous fetal monitoring; monoamniotic twins; Surveillance; Gynecology; Monoamniotic twins; Electronics; Fetus; Twin pregnancy; Monozygotic twin; Obstetrics
• ISSN: 0002-9378; 1097-6868; 1097-6868
• DOI: 10.1016/j.ajog.2010.08.044

We sought to determine the effectiveness of continuous fetal monitoring in monoamniotic twins and assess the percentage of successful monitoring across gestation. This was a single-center retrospective cohort analysis of monoamniotic twins. Each subject's entire electronic fetal heart tracing was reviewed. The primary outcome measure was the percentage of time that 0, 1, and 2 fetuses were successfully monitored. To compare the effectiveness of monitoring across gestation, these data were stratified by gestational age (<27, 27-30, and >30 weeks). A total of 10,402 hours of fetal monitoring were reviewed for 17 monoamniotic twin pairs. Successful monitoring of 0, 1, and 2 fetuses occurred 21.2%, 27.1%, and 51.6% of the time, respectively. Successful monitoring of both fetuses was positively correlated with gestational age (<27 weeks 37%; 27-30 weeks 51%; >30 weeks 57%; P < .007). Successful monitoring of both fetuses occurred 51.6% of the time. Continuous monitoring efficiency improved with advancing gestational age.