Effectiveness of timing strategies for delivery of monochorionic diamniotic twins

Barrett K. Robinson*, Russell S. Miller, Mary E. D'Alton, William A. Grobman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

OBJECTIVE: The purpose of this study was to compare strategies for delivery timing of uncomplicated monochorionic diamniotic twin pregnancies. STUDY DESIGN: A decision tree compared 9 strategies that included scheduled delivery between 32 and 38 weeks' gestation, with or without confirmation of fetal lung maturity. Outcomes in the model included fetal death, infant death, respiratory distress syndrome, mental retardation, and cerebral palsy. RESULTS: A scheduled delivery at 38 weeks' gestation was the preferred strategy, which resulted in the highest quality adjusted life years under base-case assumptions. Decreased, but comparable, quality adjusted life years estimates resulted from scheduled deliveries at 36 and 37 weeks' gestation, with or without amniocentesis. Sensitivity analyses demonstrated that the optimal gestational age for delivery was always ≥36 weeks' gestation. CONCLUSION: This decision analysis suggests that, for women with uncomplicated monochorionic twins, delivery between 36 and 38 weeks' gestation is the preferred strategy for timing of delivery.

Original languageEnglish (US)
Pages (from-to)53.e1-53.e7
JournalAmerican journal of obstetrics and gynecology
Volume207
Issue number1
DOIs
StatePublished - Jul 2012

Keywords

  • decision analysis
  • monochorionic twins
  • timing of delivery

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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