Combined use of amnioscopy and amniocentesis in the surveillance of twin pregnancy.

Amnioscopy is the simplest and most widely used method for the estimation of slow progessive hypoxic fetal risk during the last four weeks of pregnancy [4]. A questionnaire organized together with WAGNER including 25% of all obstetrics clinics in our country showed that in 1971 85% of them used amnioscopy [5]. In the case of a multiple pregnancy the use of this simple procedure did not appear to be fully satisfactory because there was an uncertainty about the state of the second twin. By combining amnioscopy with amniocentesis it is now possible to supervise both twins with equal certainty. The identification of the second amniotic cavity is made possible by the injection of a dye solution following the aspiration of liquor at the amniocentesis. The reliability of optical examination of the liquor is very high. The antenatal mortality of the fetus supervised by amnioscopic examination is below l per 1,000 [4], and it must be remembered that many of those observed are "at risk". Of course, the combined method is only applicable in those cases in which the Situation of the placenta or placentae permits amniocentesis.