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Monochorionic Diamniotic Twin Gestations
Introduction
Compared with dichorionic twin gestations, monochorionic twin gestations, whether diamniotic or monoamniotic, have an increased risk of adverse pregnancy outcomes. Ultrasound (US) plays a vital role in prenatal determination of chorionicity and in the management of monochorionic diamniotic twin pregnancies.
Disease
Definition
The term monochorionic refers to a multiple gestation with one placental disk (or chorion), and the term diamniotic describes the presence of two distinct amniotic cavities. In a monochorionic diamniotic twin pregnancy, there is one shared placenta, and each fetus has its own amniotic sac. By definition, monochorionic twin pregnancies are monozygotic.
Prevalence and Epidemiology
Twin gestations accounted for almost 3.4% of live births in the United States in 2014. The frequency of monozygotic twins is constant worldwide at 4 : 1000 births. Approximately two-thirds of monozygotic twin gestations have monochorionic placentation and diamniotic membrane composition. Dizygotic monochorionic diamniotic twin gestations resulting from assisted reproductive technology have been described in case reports.
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