Monoamniotic Twins- A Complex Surgery.

On the first birthday of monoamniotic twins, parents
and doctor re-live the challenges of a rare and difficult delivery

There are many types of complexities associated with certain pregnancies. One such complexity is when the embryo does not split until after the formation of amniotic sac which leads to the formation of monoamniotic twins, wherein the two babies share the same placenta.


As first-time parents, Mr. and Mrs. Gill were thrilled to learn on the first ultrasound that they were expecting twins. But their joy was short-lived when they learnt about the multiple risks involved with monoamniotic twins. They were also informed that this kind of pregnancy is rare and the expectant mothers in these cases are generally advised for termination by most medical facilities.

But Nidhi, the 28 year old twins' mother, was determined to go ahead with her pregnancy, and then she came across an article on 'delivery of monoamniotic twins' by Dr. Khera who had also done one such case earlier. That gave the couple new-found hope and confidence to continue the pregnancy.

Dr. Khera who monitored the pregnancy of Nidhi, mother of twins, advised the parents to be cautious, while highlighting the challenges in such pregnancy. There are chances of cord entanglement between the twins, which can lead to choking; cord compression which could stop the flow of nutrition amongst one twin and twin-to-twin transfusion syndrome (TTTS). Under TTTS, one twin receives majority of nourishment causing the other twin to become severely undernourished.


Nidhi was advised complete bed rest for 80-90 days to reduce the risk during her pregnancy. She underwent emergency caesarean in 33 weeks due to chances of intrauterine growth retardation or intrauterine death or poor growth of foetus inside the womb. The team of Gynaecologists at BLK led by Dr. Khera performed the surgery with utmost care and helped Nidhi successfully deliver two male babies, weighing 1.2 kgs and 1.59 kgs.


Thanks to advancements in medical field coupled with diligent care, routine follow-up and strict supervision by the team of doctors at BLK, the monoamniotic twins pregnancy could have a happy ending. Both the twins are doing extremely well and have just recently enjoyed their first birthday celebrations!


Dr. Poonam Khera
Sr. Consultant
Obstetrics & Gynaecology
BLK Super Speciality Hospital

“Monoamniotic twins are rare, occurring in approximately 1 in 35,000 to 1 in 60,000 pregnancies where serious complications could arise. Having a set of monoamniotic twins can be precarious and unpredictable. To avoid complications, most twins are delivered prematurely, often by C-section.”