Survival Rate and Management of Twins Delivered at 32 Weeks Gestation

Factors Affecting Survival and Management

For monochorionic diamniotic twins without complications, the American College of Obstetricians and Gynecologists recommends delivery between 34-36 weeks of gestation 1, 2
The American College of Obstetricians and Gynecologists suggests that for monochorionic twins with twin-twin transfusion syndrome who have undergone successful fetoscopic laser surgery, delivery is recommended between 34-36 weeks of gestation 4

In TTTS pregnancies complicated by post-treatment single fetal demise, the American College of Obstetricians and Gynecologists recommends full-term delivery (39 weeks) of the surviving co-twin unless other indications for earlier delivery exist 5

The American College of Obstetricians and Gynecologists recommends weekly surveillance for monochorionic twins after laser therapy for TTTS for 6 weeks, followed by every-other-week surveillance 6
Antenatal corticosteroids should be considered for fetal lung maturation, particularly in pregnancies complicated by TTTS and those undergoing invasive interventions, according to the American College of Obstetricians and Gynecologists 5

Failing to determine chorionicity early in pregnancy, which significantly impacts management decisions and outcomes, is a pitfall to avoid, as recommended by the American College of Obstetricians and Gynecologists 7
Not recognizing signs of TTTS or twin anemia-polycythemia sequence (TAPS), which require specialized management, is a pitfall to avoid, according to the American College of Obstetricians and Gynecologists 8
Delaying referral to a specialized fetal care center when indicated for advanced disease stages is a pitfall to avoid, as recommended by the American College of Obstetricians and Gynecologists 2