Effectiveness of timing strategies for delivery of monochorionic diamniotic twins

American Journal of Obstetrics and Gynecology
Barrett K RobinsonWilliam A Grobman

Abstract

The purpose of this study was to compare strategies for delivery timing of uncomplicated monochorionic diamniotic twin pregnancies. 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. 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. 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.

References

Mar 1, 1992·Obstetrics and Gynecology·J D SteinfeldM B Senior
Oct 1, 1986·American Journal of Obstetrics and Gynecology·W N Herbert, J F Chapman
Apr 1, 1995·Obstetrics and Gynecology·M O GardnerR L Copper
Oct 23, 1997·British Journal of Obstetrics and Gynaecology·N J SebireK H Nicolaides
Mar 21, 1998·Clinical Obstetrics and Gynecology·J L Kiely
Feb 24, 2001·Archives of Disease in Childhood. Fetal and Neonatal Edition·P O Pharoah
Nov 20, 2002·American Journal of Obstetrics and Gynecology·Naomi E StotlandAaron B Caughey
Feb 13, 2003·Acta Obstetricia Et Gynecologica Scandinavica·Sabah BaghdadiKhalid S Khan
Sep 10, 2003·Obstetrics and Gynecology·William M GilbertBeate Danielsen
Aug 6, 2004·American Journal of Obstetrics and Gynecology·Riitta MarttilaMikko Hallman
Jan 27, 2005·American Journal of Obstetrics and Gynecology·Curtis A ParvinAnn M Gronowski
Jun 24, 2005·PLoS Medicine·Jane Cleary-Goldman, Mary E D'Alton
Nov 2, 2005·American Journal of Obstetrics and Gynecology·Ibrahim BildiriciYoel Sadovsky
Apr 29, 2006·American Journal of Obstetrics and Gynecology·Teresinha SimõesIsaac Blickstein
Aug 15, 2006·BJOG : an International Journal of Obstetrics and Gynaecology·S S C OngM D Kilby
Dec 7, 2006·Clinics in Perinatology·Young Mi LeeMary E D'Alton
Jan 26, 2007·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·R Acosta-RojasUNKNOWN Catalunya and Balears Monochorionic Network
Mar 10, 2007·American Journal of Obstetrics and Gynecology·Jane Cleary-Goldman, Mary E D'Alton
Oct 27, 2007·The Journal of Pediatrics·Kay M TomashekJoann R Petrini
Feb 2, 2008·Obstetrics and Gynecology·Young Mi LeeMary E D'Alton
Jun 6, 2008·American Journal of Obstetrics and Gynecology·Liesbeth LewiJan Deprest
Oct 22, 2008·American Journal of Obstetrics and Gynecology·Jamie A BastekMichal A Elovitz
Dec 17, 2008·The Journal of Pediatrics·Joann R PetriniGabriel J Escobar
Apr 28, 2009·The Journal of Pediatrics·Aaron E Carroll, Stephen M Downs
Nov 11, 2009·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Ana Patrícia DominguesPaulo Moura
Apr 27, 2010·American Journal of Obstetrics and Gynecology·Edward F DonovanUNKNOWN Ohio Perinatal Quality Collaborative
Jun 29, 2010·American Journal of Obstetrics and Gynecology·Nicole A SmithJulian N Robinson
Jul 22, 2011·Obstetrics and Gynecology·Catherine Y SpongGeorge Saade

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Citations

Oct 14, 2014·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Viktor RadzinskyFarid Fatkullin
Feb 4, 2014·American Journal of Obstetrics and Gynecology·Kevin M WymerBeth A Plunkett
Apr 12, 2015·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Elizabeth M StringerJeffrey S A Stringer
Dec 4, 2014·Obstetrics & Gynecology Science·Chae Min LeeSuk Young Kim
Nov 5, 2016·Journal of Perinatal Medicine·Teresinha SimõesIsaac Blickstein
Aug 17, 2021·Geburtshilfe und Frauenheilkunde·Sven KehlMichael Abou-Dakn

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