On 3/1, Doctor Truong Minh Phuong, Deputy Head of Department A4, Hanoi Obstetrics and Gynecology Hospital, announced the successful and safe delivery in a very rare and challenging twin pregnancy case.

The patient was diagnosed early with a monochorionic monoamniotic twin pregnancy, and initial screenings for abnormalities were conducted. At 18 weeks, she experienced abdominal pain and uterine contractions, presenting with threatened preterm birth and a 2 cm dilated cervix. The medical team immediately intervened to stop the contractions, performed a cervical cerclage to maintain the pregnancy, and managed potential infections. By 26 weeks, one fetus showed abnormalities, indicating a risk of twin-to-twin transfusion syndrome.

"The medical team intensified surveillance of the pregnancy from that point, preparing for intervention should complications arise," the doctor stated.

At 34 weeks, doctors administered lung maturation injections and performed a C-section. Two healthy baby girls were delivered, weighing 1,9 g and 2,1 g, respectively. They cried immediately after birth and were monitored in the Neonatal Department.

A few days later, the two infants were discharged home with their mother.

Doctor Phuong checking on the mother and her two infants before their discharge. *Photo: Hanoi Obstetrics and Gynecology Hospital*

Monochorionic monoamniotic (MCMA) twin pregnancy is a rare obstetric condition, occurring in approximately 1/20,000 pregnancies globally and representing about 1% of all twin pregnancies in Vietnam.

While monochorionic twin pregnancies (shared placenta) are inherently risky, those with a shared amniotic sac (MCMA) present significantly higher dangers. Both fetuses share one amniotic sac and one placenta, increasing risks such as umbilical cord entanglement, twin-to-twin transfusion syndrome, fetal growth restriction, and sudden fetal demise if not closely monitored.

"Most cases of MCMA twin pregnancies are recommended for planned delivery between 32 and 34 weeks, according to medical guidelines," the doctor explained.

Doctors advise expectant mothers with MCMA pregnancies to undergo rigorous monitoring, including 4D ultrasounds, color doppler, and fetal heart rate monitoring, for early detection of any abnormalities. Regular check-ups and ultrasounds enable medical professionals to determine the safest and most appropriate course of management for both mother and babies.

Thuy An