JumptonavigationLanguage:EnglishDeutschEspañolFrançaisHrvatskiРусскийMorelanguagesavailableShowfewerlanguagesCoronavirus(COVID-19)resourcesMonoamniotictwins(sharingthesameamnioticsac):dotheydobetterifbornearly?Whatistheissue?Identicaltwinswhosharethesameamnioticsacintheuterusarecalledmonoamniotictwins.Theamnioticsacisthebagofwaters(amnioticfluid)surroundingthebaby.Monoamniotictwinsaredifferentfromthemajorityofidenticaltwins,whoareseparatedfromeachotherintheirownamnioticsac,withtheirownamnioticfluid.Pregnancieswithmonoamniotictwinsarerare–aboutoneinevery10,000pregnanciesisaffected,orabout1percentofallincidencesofidenticaltwins.Monoamniotictwinpregnancieshaverisks–beyondtheriskswhichapplytoalltypesoftwinpregnancy–andtheseincreasedrisksincludethedeathofbothoroneofthetwins.Thehigherrisksaremostlybecausetheumbilicalcordsmaybecomecompressed,whichcanbedangerousbecausethesestopthecordfromgettingoxygentothebaby.Wewantedtofindoutifitisbettertoensureanearlierbirthformonoamniotictwinsthroughinductionorcaesareansection(‘plannedearlybirth’)before34weekspregnancy,ortowaituntillater,about36-38weeks(oruntillabourstartsbyitself),keepingaclosecheckonthepregnancyandthetwinsthroughoutthepregnancy(‘expectantmanagement’).Whyisthisimportant?Monoamniotictwinpregnancieshavehigherrisksthanothertypesoftwinpregnancyandtheseincreasedrisksincludethedeathofbothoroneofthetwins.Itcouldbethatmakingsurethetwinsarebornearly–before34weeks–reducestheriskofcordcompression.However,theeffectsofpretermbirthcanbeserious,too,andtheneedforhospitalcareforsometimeisalmostcertain.Whatevidencedidwefind?Welookedforrandomisedcontrolledtrialscomparingtheoutcomesofplannedearlybirthversusexpectantmanagement(searchdate31March2015).Welookedfortrialsinalllanguages,andwithnodaterestrictions.Wedidnotfindany.Therearecaseseriesstudiesandexpertclinicalopinions,butthesetypesofstudiescannotbereliedupontoprovideaclearanswerunlesstheyincludeverylargenumbersandareproperlyassessedforquality.Whatdoesthismean?Womenandtheirfamiliesshoul