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Updated: May 31, 2026

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators
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Published on: March 21, 2018

Fetal death in twins.

Rhona Mahony1, Celia Mulcahy, Fionnuala McAuliffe

  • 1Department of Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin, Dublin, Ireland. rhonamahony@hotmail.com

Acta Obstetricia Et Gynecologica Scandinavica
|July 19, 2011
PubMed
Summary

Monochorionic-diamniotic (MCDA) twin pregnancies have a higher risk of intrauterine fetal death (IUFD) compared to dichorionic-diamniotic (DCDA) twins, especially when complicated by growth issues. However, for normally grown twins, the IUFD risk is low and similar for both types after 34 weeks.

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Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

Published on: September 5, 2011

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Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators
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Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas
09:04

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

Published on: September 5, 2011

Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Reproductive Medicine

Background:

  • Twin pregnancies present unique challenges in fetal development and survival.
  • Chorionicity, the number of placental sacs, significantly influences twin pregnancy outcomes.
  • Intrauterine fetal death (IUFD) is a critical concern in twin gestations, with varying risks based on chorionicity.

Purpose of the Study:

  • To investigate the patterns of intrauterine fetal death (IUFD) in twin pregnancies.
  • To determine the prospective risk of IUFD stratified by chorionicity (monochorionic-diamniotic vs. dichorionic-diamniotic).
  • To analyze the impact of growth restriction and discordance on IUFD risk in different types of twin pregnancies.

Main Methods:

  • Retrospective cohort analysis of 1094 twin pairs delivered between 1997 and 2006 at a national tertiary referral center.
  • IUFD was defined as fetal demise at or after 24 weeks gestation.
  • Chorionicity was confirmed postnatally; intertwin birthweight discordance (≥20%) and growth restriction (<5th centile) were assessed.

Main Results:

  • The incidence of IUFD was significantly higher in monochorionic-diamniotic (MCDA) twins (3.9%) compared to dichorionic-diamniotic (DCDA) twins (1.3%).
  • Twin-twin transfusion syndrome (TTTS) was a major cause of IUFD in MCDA twins before 30 weeks.
  • In pregnancies with abnormal growth, the prospective risk of IUFD was 3.4 for MCDA and 2.0 for DCDA twins; risks were low and similar for normally grown twins after 34 weeks.

Conclusions:

  • Growth restriction or discordance in twin pregnancies significantly increases IUFD risk, particularly in MCDA twins.
  • For normally grown twins, chorionicity does not substantially alter the low risk of IUFD after 34 weeks gestation.
  • These findings highlight the importance of monitoring growth in twin pregnancies, especially MCDA twins, to mitigate IUFD risk.