We retrospectively evaluated a series of 18 monoamniotic and 7 pseudomonoamniotic (secondary to rupture in the membrane dividing monochorionic diamniotic twins) twin gestations managed after 20 weeks' gestation. There were no significant differences in the incidence of neonatal death or umbilical cord entanglement between the monoamniotic and pseudomonoamniotic twin gestations (33 versus 21%, P = 0.94 and 72 versus 43%, P = 0.36). Therefore, the same serious management may be needed for pseudomonoamniotic twin gestations as for monoamniotic twin gestations.