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Chapter 12 - Monochorionic Twin Pregnancy

from Section 1 - Obstetric Aspects of Antenatal Care

Published online by Cambridge University Press:  23 February 2023

By
Nimrah Abbasi  and
Greg Ryan
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 34-year-old primigravida is referred by her primary care provider to your hospital center’s high-risk obstetrics unit after sonographic imaging confirmed viable intrauterine spontaneous monochorionic diamniotic (MCDA) twins with crown–rump lengths (CRL) of 47 mm and 44 mm, consistent for 12+4 weeks’ gestation by CRL of the larger twin. Twin A’s and twin B’s nuchal translucency (NT) measurements are 1.5 mm and 1.0 mm, respectively, with normal-appearing first-trimester fetal morphologies.

Keywords

Sonographic imagingFetal complicationsAntenatal, intrapartum careTwin–twin transfusion syndromeFetoscopic laser coagulationTwin anemia polycythemia sequenceSelective fetal growth restrictionSpontaneous demise of a monochorionic twinDelivery timing
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 158 - 172
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.CrossRefGoogle Scholar
Bamberg, C, Hecher, K. Update on twin-to-twin transfusion syndrome. Best Pract Res Clin Obstet Gynaecol. 2019; 58:55–65.CrossRefGoogle ScholarPubMed
Bennasar, M, Eixarch, E, Martinez, JM, et al. Selective intrauterine growth restriction in monochorionic diamniotic twin pregnancies. Semin Fetal Neonatal Med. 2017;22(6):376–382.CrossRefGoogle ScholarPubMed
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
Hoskins, IA, Combs, CA. Society for Maternal-Fetal Medicine Special Statement: updated checklists for management of monochorionic twin pregnancy. Am J Obstet Gynecol. 2020;223(5):B16–B20.Google Scholar
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
Kilby, MD, Bricker, L. Management of monochorionic twin pregnancy. BJOG 2016;124:e1–e45.Google Scholar
Moldenhauer, JS, Johnson, MP. Diagnosis and management of complicated monochorionic twins. Clin Obstet Gynecol. 2015;58(3):632–642.Google Scholar
NAFTNet (a)Bahtiyar, MO, Emery, SP, Dashe, JS, et al. The North American Fetal Therapy Network consensus statement: prenatal surveillance of uncomplicated monochorionic gestations. Obstet Gynecol. 2015;125(1):118–123.CrossRefGoogle ScholarPubMed
Emery, SP, Bahtiyar, MO, Dashe, JS, et al. The North American Fetal Therapy Network consensus statement: prenatal management of uncomplicated monochorionic gestations. Obstet Gynecol. 2015;125(5):1236–1243.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (NICE) Guideline No. 137: Twin and triplet pregnancy. September 2019.Google Scholar

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