Monochorionic diamniotic twin pregnancies: natural history and risk stratification.
About 30% of monochorionic twin pregnancies are complicated by twin-to-twin transfusion syndrome (TTTS), isolated discordant growth, twin anemia-polycythemia sequence, congenital defects or intrauterine demise. About 15% will be eligible for invasive fetal therapy, either fetoscopic laser treatment for TTTS or fetoscopic or ultrasound-guided umbilical cord coagulation for a severe congenital defect in one twin or severe discordant growth with imminent demise of the growth-restricted twin. Ultrasound examination in the first and early second trimester can differentiate the monochorionic twins at high risk for adverse outcome from those likely to be uneventful, which may be useful for patient counselling and planning of care.
Lewi
Liesbeth
L
Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Leuven, Belgium. liesbeth.lewi@uzleuven.be
Gucciardo
Leonardo
L
Van Mieghem
Tim
T
de Koninck
Philippe
P
Beck
Veronika
V
Medek
Helga
H
Van Schoubroeck
Dominique
D
Devlieger
Roland
R
De Catte
Luc
L
Deprest
Jan
J
D000653:Amniotic Fluid / Q000000981:diagnostic imaging; D002823:Chorion / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D014430:Twins, Monozygotic; D014463:Ultrasonography