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Master Thesis

Prise en charge des grossesses gémellaires monoamniotiques

Abstract : Monoamniotic twin pregnancies represent about one out of 30,000 births. As a result, few studies have been published on this subject with low numbers of addition. We therefore collected data from six centers of type 3 in Ile de France. We can study 71 files of monoamniotic twin pregnancy. Our goal was to evaluate the progress of these pregnancies, the way they were managed, terms of delivery as well as neonatal and maternal fate. In the global population, 11 women (15,4%) showed no complications. We found 22 preterm labor (21%), whose 20 women have giving birth before 32 SA. 28 fetus are dead in utero (19,7%). The vaginal delivery is possible until 36 weeks of amenorrhea. We found 19 attempt of vaginal delivery. Among her, 4 cesarean in emergency has been necessary. But, there are no consequence for the twins. Despite the risk of complications during labor, cesarean section prophylaxis does not improve the health of newborns. Neonatal complications are frequent but mainly related to prematurity rather than other types of complications. The neonatal mortality is 28,8% for the first twins (17 newborns) and 33,3% for the second twins (19 newborns). The neonatal morbidity is 100% for the newborns before 33 SA, is 20,7% for the twins who is born between 33 and 36 SA and is null after this term. As midwives, we must better understand these monoamniotic twin pregnancies enabling us to answer women's questions, and bringing them professional and greater care.
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  • HAL Id : dumas-00563916, version 1


Nina Bernat. Prise en charge des grossesses gémellaires monoamniotiques. Gynécologie et obstétrique. 2010. ⟨dumas-00563916⟩



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