[1] Other obscure possibilities include multiples sets where monoamniotic twins are part of a larger gestation such as triplets, quadruplets, or more.
[4] Further ultrasounds with high resolution doppler imaging and non-stress tests help to assess the situation and identify potential cord problems.
[1] Cord entanglement and compression generally progress slowly, allowing parents and medical caregivers to make decisions carefully.
[1][4] Regular and aggressive fetal monitoring is recommended for cases of monoamniotic twins to look for cord entanglement beginning after viability.
[10][8] A retrospective study in 2016 argued that there is evidence vaginal delivery can be equally safe and reduce complications for some monoamniotic twins[11] but this finding has not been incorporated into clinical guidelines.