Monoamniotic twin pregnancies can be diagnosed reliably by ultrasound alone in most cases. Frequent antenatal testing may show signs of cord compression that may prompt delivery but will not prevent sudden fetal death. Fetal death can occur at greater than 32 weeks' gestation despite intensive fetal surveillance. Elective preterm delivery could be considered to eliminate the uncertain risk of fetal death.

We sought to evaluate whether early (24 to 28 weeks gestation) hospitalization of monoamniotic twins, with close fetal surveillance, and delivery at 32 to 34 weeks gestation, would significantly improve the perinatal morbidity and mortality compared with an outpatient management strategy. A multicenter, retrospective record review was undertaken. Records of all monoamniotic twins were collected for a 10-year period. Monoamniotic twins were identified using intensive care nursery, ultrasound, and pathology records. Data were collected on inpatient versus outpatient management strategies and the perinatal/maternal outcomes and complications. Twenty-three sets of monoamniotic twins were included in the study. Eleven sets were managed using an inpatient strategy and 12 sets were managed using an outpatient strategy. There were no fetal deaths in the inpatient group and there were three fetal deaths in the outpatient group. Inpatient management of monoamniotic twins should be considered.

If a patient with transposition of the great arteries who underwent the Mustard procedure is hemodynamically stable before pregnancy, good maternal and fetal outcome can be expected.

No abstract

Haloperidol overdose during pregnancy causes a maternal extrapyramidal reaction, temporary fetal akinesia, and prolonged fetal neuromuscular depression.