Complications of Monochorionic Diamniotic Twins: Stepwise Approach for Early Identification, Differential Diagnosis, and Clinical Management. Issue 1 (25th January 2021)

• Record Type: Journal Article
• Authors: Micheletti, Talita; Eixarch, Elisenda; Bennasar, Mar; Martinez, Josep María; Gratacos, Eduard
• Editors: Pan, Yang
• Is Part Of: Maternal-fetal medicine. Volume 3:Issue 1(2021)
• Page Start: 42
• Page End: 52
• Publication Date: 2021-01-25
• Subjects: Acute feto-fetal transfusion -- Discordant malformation -- Monochorionic diamniotic twin pregnancy -- Pregnancy, twin -- Selective fetal growth restriction -- Single intrauterine fetal death -- Twin anemia-polycythemia sequence -- Twin-twin transfusion syndrome; Fetal Diseases; Fetus -- physiology; Pregnancy -- physiology; Pregnancy Complications; Electronic journals; Periodical; 618.3005
• DOI: 10.1097/FM9.0000000000000076
• Languages: English
• ISSNs: 2096-6954

Abstract

Abstract : Abstract: One in three monochorionic twins may develop complications during pregnancy. Monochorionic twins, especially monochorionic diamniotic (MCDA), present specific problems caused by the presence of interfetal placental anastomoses. The first critical step in the management of MCDA twins is identification in the first trimester. Secondly, close follow-up every 2 weeks is mandatory to allow early diagnosis and timely treatment of twin-twin transfusion syndrome. Other potentially severe complications include selective fetal growth restriction, twin anemia polycythemia syndrome or single fetal death. Thirdly, a correct differential diagnosis is critical to establish the best therapy. This may represent a clinical challenge since MCDA twin complications often overlap. A simple diagnostic algorithm may be of great help to establish the right diagnosis and management option. In this review we summarize the main steps for the clinical follow-up, differential diagnosis, and targeted management of MCDA twins complications.