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Chapter 11 - Dichorionic Twin Pregnancy

from Section 1 - Obstetric Aspects of Antenatal Care

Published online by Cambridge University Press:  23 February 2023

By
Noor Amily ,
Amira El-Messidi  and
Karen Fung-Kee-Fung
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A healthy 35-year-old secundigravida with a history of an uncomplicated Cesarean delivery performed four years ago for fetal malpresentation at term is referred by her primary care provider to your general obstetrics clinic at 11+5 weeks’ gestation by menstrual age. The physician provided you with a sonographic dating report confirming a viable intrauterine dichorionic diamniotic twin gestation with a crown–rump length (CRL) of twin A and B at 47 mm and 44 mm, respectively. The patient does not have any obstetric complaints and has been taking routine prenatal vitamins for the past four months. Her social and family histories are unremarkable.

Keywords

Spontaneous dichorionic twin pregnancy, sonographic datingChorionicityZygosity, physiologyMaternal-fetal-neonatal adverse outcomesSelective termination, discordant fetal anomalyNoninvasive prenatal screeningDiagnostic amniocentesis, twin pregnancyAntenatal, intrapartum careDelayed interval deliverySelective fetal growth restrictionDiscordant anomaly, selective fetocide
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 141 - 157
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins – Obstetrics, Society for Maternal-Fetal Medicine. Multifetal gestations: twin, triplet, and higher-order multifetal pregnancies: ACOG Practice Bulletin, No. 231. Obstet Gynecol. 2021;137(6):e145–e162.Google Scholar
Antonakopoulos, N, Pateisky, P, Liu, B, et al. Selective fetal growth restriction in dichorionic twin pregnancies: diagnosis, natural history, and perinatal outcome. J Clin Med. 2020;9(5):1404.CrossRefGoogle ScholarPubMed
Cheung, KW, Seto, MTY, Wang, W, et al. Effect of delayed interval delivery of remaining fetus(es) in multiple pregnancies on survival: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;222(4):306–319.CrossRefGoogle ScholarPubMed
(a) FIGO Working Group on Good Clinical Practice in Maternal-Fetal Medicine. Good clinical practice advice: management of twin pregnancy. Int J Gynaecol Obstet. 2019;144(3):330–337.CrossRefGoogle Scholar
FIGO Working Group on Good Clinical Practice in Maternal-Fetal Medicine. Good clinical practice advice: role of ultrasound in the management of twin pregnancy. Int J Gynaecol Obstet. 2019;144(3):338–339.CrossRefGoogle Scholar
Goodnight, W, Newman, R. Optimal nutrition for improved twin pregnancy outcome. Obstet Gynecol. 2009;114(5):1121–1134.Google Scholar
Khalil, A, Beune, I, Hecher, K, et al. Consensus definition and essential reporting parameters of selective fetal growth restriction in twin pregnancy: a delphi procedure. Ultrasound Obstet Gynecol. 2019;53(1):47–54. [Correction in Ultrasound Obstet Gynecol. 2020 Dec;56(6):967]CrossRefGoogle ScholarPubMed
Khalil, A, Rodgers, M, Baschat, A, et al. ISUOG Practice Guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol. 2016;47(2):247–263. [Correction in Ultrasound Obstet Gynecol. 2018 Jul;52(1):140]Google Scholar
National Institute for Health and Care Excellence (NICE) Guideline No. 137: twin and triplet pregnancy. September 2019.Google Scholar
Palomaki, GE, Chiu, RWK, Pertile, MD, et al. International Society for Prenatal Diagnosis Position Statement: Cell free (cf)DNA screening for Down syndrome in multiple pregnancies. Prenat Diagn. 2020;41(10):1222–1232.CrossRefGoogle ScholarPubMed
(a) Audibert, F, Gagnon, A. No. 262 – prenatal screening for and diagnosis of aneuploidy in twin pregnancies. J Obstet Gynaecol Can. 2017;39(9):e347–e361.Google Scholar
Brown, R, Gagnon, R, Delisle, MF. No. 373 – cervical insufficiency and cervical cerclage. J Obstet Gynaecol Can. 2019;41(2):233–247.CrossRefGoogle ScholarPubMed
Morin, L, Lim, K. No. 260 – ultrasound in twin pregnancies. J Obstet Gynaecol Can. 2017;39(10):e398–e411.CrossRefGoogle ScholarPubMed

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