title: Monochorionic diamniotic twin pregnancies: natural history and risk stratification.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Leuven, Belgium. liesbeth.lewi@uzleuven.be
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Lewi
authors.forename: Leonardo
authors.initials: L
authors.lastname: Gucciardo
authors.forename: Tim
authors.initials: T
authors.lastname: Van Mieghem
authors.forename: Philippe
authors.initials: P
authors.lastname: de Koninck
authors.forename: Veronika
authors.initials: V
authors.lastname: Beck
authors.forename: Helga
authors.initials: H
authors.lastname: Medek
authors.forename: Dominique
authors.initials: D
authors.lastname: Van Schoubroeck
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
authors.forename: Luc
authors.initials: L
authors.lastname: De Catte
authors.forename: Jan
authors.initials: J
authors.lastname: Deprest
mesh_terms: 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