Monoamniotic twin pregnancy – A case report and review of literature.

The incidence of monoamniotic twin pregnancy is estimated at 1 in 25,000 pregnancies. The Perinatal mortality rate in monoamniotic twin pregnancy (MATP) is about 28-70%. Ultrasound assessment should only be performed by skilled practitioners who are able to diagnose zygosity and chorionicity as there is a high mortality and morbidity rate inspite of early diagnosis and intense monitoring. Possible complications include, cord entanglement and knots, Twin-to-twin transfusion syndrome (TTTS) and premature birth. In the absence of TTTS, cord entanglement remains the main issue of concern and therefore current available evidence suggests early delivery by elective caesarean section between 32-34 weeks gestation after administering steroids. Women with monoamniotic twin pregnancy should be counselled regarding the increased risk of a poor perinatal outcome. However careful management throughout pregnancy using a multi-disciplinary team approach can achieve good outcome.