Monochorionic Twins: TTTS, TAPS, and Selective Fetal Growth Restriction
Matthew A Shanahan1,2, Michael W Bebbington3
1Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine.
Clinical Obstetrics and Gynecology
|November 1, 2023
Summary
Monochorionic twin pregnancies present unique risks due to placental differences. Understanding these complications, like twin-to-twin transfusion syndrome, enables effective fetal therapies.
Area of Science:
- Obstetrics and Gynecology
- Perinatology
- Maternal-Fetal Medicine
Background:
- Twin gestations are increasing, necessitating a deeper understanding of associated risks.
- Monochorionic twins share a placenta, leading to specific complications.
- Key complications include twin-to-twin transfusion syndrome, twin anemia-polycythemia sequence, and selective fetal growth restriction.
Purpose of the Study:
- To elucidate the risks inherent in monochorionic twin pregnancies.
- To connect placental differences to specific pregnancy complications.
- To highlight advancements in fetal therapy for these conditions.
Main Methods:
- Review of obstetric literature focusing on twin gestations.
- Analysis of placentation in monochorionic twins.
- Examination of the pathophysiology of twin pregnancy complications.
Main Results:
- Monochorionic placentation is linked to specific adverse outcomes.
- Understanding pathophysiology aids in identifying at-risk pregnancies.
- Fetoscopic laser coagulation is an effective therapy for twin-to-twin transfusion syndrome.
Conclusions:
- Knowledge of monochorionic placentation is crucial for managing twin pregnancies.
- Directed fetal therapy has significantly improved outcomes for certain twin complications.
- Continued research is vital for optimizing care in high-risk twin gestations.
