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Complications in monochorionic twin pregnancies.

Philipp Klaritsch1,2

  • 1Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria.

Journal of Perinatal Medicine
|October 12, 2025
PubMed
Summary

Monochorionic twin pregnancies have high complication rates, including twin-to-twin transfusion syndrome and selective fetal growth restriction. Early detection and management are crucial for improving outcomes in these high-risk pregnancies.

Keywords:
TAPSTTTSmonochorionicsFGRtraptwin pregnancy

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Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Twin Gestation Research

Background:

  • Monochorionic placentas are common in identical twins, presenting unique risks.
  • Inter-fetal vascular anastomoses can lead to severe twin pregnancy complications.

Purpose of the Study:

  • To review prenatal detection and management strategies for monochorionic twin pregnancy complications.
  • To highlight risks associated with monochorionic twins, including TTTS, TAPS, TRAP, IUFD, and sFGR.

Main Methods:

  • This is a narrative review.
  • Literature search on prenatal diagnosis and management of monochorionic twin complications.

Main Results:

  • Monochorionic twins face significant risks: TTTS (10%), TAPS (5%), TRAP (2.5%), IUFD (2%), and sFGR (15%).
  • Complications increase the risk of mortality, brain abnormalities, and neurodevelopmental disorders.

Conclusions:

  • Prenatal detection and timely management are vital for improving outcomes in complicated monochorionic twin pregnancies.
  • Understanding these specific risks is essential for specialized obstetric care.