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Related Experiment Videos

Diamnionic monochorionic twin gestations: an overview.

E P Gaziano1, J E De Lia, R S Kuhlmann

  • 1Perinatal Center, Abbott Northwestern Hospital, and Department of Obstetrics and Gynecology, Universtiy of Minnesota, Minneapolis 55407, USA.

The Journal of Maternal-Fetal Medicine
|July 21, 2000
PubMed
Summary
This summary is machine-generated.

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Monochorionic (MC) twins face higher risks of mortality and growth issues due to placental factors and twin-twin transfusion syndrome (TTTS). Doppler assessments aid in distinguishing TTTS from placental insufficiency in MC twins.

Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Fetal Medicine

Background:

  • Monochorionic (MC) twins comprise 20-30% of twin gestations but account for a disproportionate share of perinatal mortality and morbidity.
  • Complications in MC twins are often linked to placental morphology, including vascular communications causing twin-twin transfusion syndrome (TTTS) and asymmetric placental sharing.

Purpose of the Study:

  • To investigate the role of placental characteristics and Doppler findings in assessing outcomes for monochorionic twins.
  • To differentiate between twin-twin transfusion syndrome and placental insufficiency using antenatal Doppler assessments.

Main Methods:

  • Review of literature on monochorionic twin complications, placental morphology, and Doppler velocimetry.
  • Analysis of sonographic and clinical criteria used in assessing twin gestations.

Related Experiment Videos

  • Evaluation of Doppler assessment of umbilical and cerebral arteries for fetal blood redistribution (brain-sparing effect).

    • Main Results:

    • Artery-to-vein anastomoses, especially with placental asymmetry, are associated with poorer TTTS outcomes.
    • Doppler assessment of umbilical and cerebral arteries can help distinguish TTTS from placental insufficiency in MC twins.
    • Brain-sparing effects are more common in MC twins, particularly those with growth restriction.

    Conclusions:

    • Placental variables are strongly linked to the polyhydramnios/oligohydramnios sequence in MC twins.
    • Prognosis is poorer for donor twins in TTTS, with higher prenatal mortality.
    • Fetoscopic laser treatment offers a higher survival rate for recipients in TTTS.