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Monoamniotic twins
My wife and I are having twins, and the doctor said they might be ‘monoamniotic.’ He also said there was only a 50 per cent chance of both of the twins making it. Please tell us more about this condition.
The incidence of this type of twinning is approximately four per 1,000 births. Unlike the fraternal type of twinning (dizygotic), this type does not seem to vary depending on mother's age or how many children she has.
Some twins share the same amniotic sac and the same placenta (monochorionic and monoamniotic – 1 in 25,000 to 1 in 60,000 pregnancies) and because of this, cord entanglement and compression become a very high risk. This can lead to an interruption in the blood flow to one or both babies where they may not receive enough nutrients or oxygen.
When there is no membrane between the babies – a monoamniotic twin pregnancy – there is a very high risk of cord entanglement and also twin to twin transfusion syndrome. This represents a very high-risk pregnancy and intensive monitoring and testing of the babies is required. At times, it is safer to deliver such babies early, some as early as they are viable (24 to 28 weeks). Thirty-four weeks is often considered ‘full term’ for monoamniotic twins because the cord risks outweigh the prematurity risks.
If you have been diagnosed with monoamniotic twins, you may find a support group helpful to answer your questions and listen to the stories of others in a similar situation. You may want to visit the Monoamniotic Monochorionic Support Site
Another good resource is the Multiple Births Foundation based at the Institute of Obstretrics & Gynaecology, at Queen Charlotte's and Chelsea Hospital in London. The Foundation was established to support professionals working with multiple birth families, and runs specialist clinics for families. Their website is at www.multiplebirths.org.uk
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