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[Multiple pregnancy at 11+0 - 13+6 weeks].

Kypros H Nicolaides1, Piotr Wegrzyn

  • 1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, United Kingdom.Wielka Brytania.

Ginekologia Polska
|July 29, 2006
PubMed
Summary

Monochorionic twins face higher risks than dichorionic twins due to twin-to-twin transfusion syndrome (TTTS). Early ultrasound identification and surveillance are crucial for improving twin pregnancy outcomes.

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Area of Science:

  • Maternal-Fetal Medicine
  • Perinatology
  • Obstetrics

Background:

  • Pregnancy outcomes are primarily determined by chorionicity, not zygosity.
  • Monochorionic twins exhibit significantly higher rates of adverse outcomes, including miscarriage, perinatal death, preterm delivery, fetal growth restriction, and abnormalities, compared to dichorionic twins.
  • Severe early-onset twin-to-twin transfusion syndrome (TTTS) is a major cause of high mortality in monochorionic pregnancies, with fetal demise posing risks to the co-twin.

Purpose of the Study:

  • To emphasize the critical role of chorionicity in determining twin pregnancy outcomes.
  • To highlight the increased risks associated with monochorionic pregnancies, particularly TTTS.
  • To advocate for early identification and management strategies for monochorionic twins.

Main Methods:

  • Sonographic examination for reliable distinction between monochorionic and dichorionic pregnancies.
  • Early ultrasound screening between 11+0 and 13+6 weeks gestation.
  • Close surveillance of identified monochorionic pregnancies.

Main Results:

  • Sonography accurately differentiates between monochorionic and dichorionic pregnancies.
  • Early identification of monochorionic pregnancies allows for timely intervention.
  • Effective management of TTTS in monochorionic twins can reduce fetal loss.

Conclusions:

  • Chorionicity is the key determinant of twin pregnancy outcomes.
  • Early ultrasound detection of monochorionic pregnancies is essential for risk stratification.
  • Targeted surveillance and treatment for TTTS are vital for improving survival rates in monochorionic twins.

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