Complications of Monochorionic Diamniotic Twins: Stepwise Approach for Early Identification, Differential Diagnosis, and Clinical Management  

作　　者：Taita Micheletti Elisenda Eixarch Mar Bennasar Josep Maria Martinez Eduard Gratacos 

机构地区：[1]BCNatal-Fetal Medicine Research Center(Hospital Clinic and Hospital Sant Joan de Deu),University of Barcelona,Barcelona 08028,Spain [2]Institut d'Investigacions Biomediques August Pi iSunyer(IDIBAPS),Barcelona 08036,Spain [3]Centre for Biomedical Research on Rare Diseases(CIBER-ER)Madrid 28029,Spain [4]Institut de Recerca Sant Joan de Deu,Esplugues de Llobregat 08950,Spain

出　　处：《Maternal-Fetal Medicine》2021年第1期42-52,共11页母胎医学杂志（英文）

摘　　要：One in three monochorionic twins may develop complications during pregnancy. Monochorionic twins, especially monochorionic diamniotic (MCDA), present specific problems caused by the presence of interfetal placental anastomoses. The first critical step in the management of MCDA twins is identification in the first trimester. Secondly, close follow-up every 2 weeks is mandatory to allow early diagnosis and timely treatment of twin-twin transfusion syndrome. Other potentially severe complications include selective fetal growth restriction, twin anemia polycythemia syndrome or single fetal death. Thirdly, a correct differential diagnosis is critical to establish the best therapy. This may represent a clinical challenge since MCDA twin complications often overlap. A simple diagnostic algorithm may be of great help to establish the right diagnosis and management option. In this review we summarize the main steps for the clinical follow-up, differential diagnosis, and targeted management of MCDA twins complications.

关 键 词：Acute feto-fetal transfusion Discordant malformation Monochorionic diamniotic twin pregnancy Pregnancy TWIN Selective fetal growth restriction Single intrauterine fetal death Twin anemia-polycythemia sequence Twin-twin transfusion syndrome 

分 类 号：R714.23[医药卫生—妇产科学]