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KEY FACTS
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Monochorionic diamniotic twins (MDT, MoDi twins)
Synonyms
Identical twins
Definitions
Zygosity refers to type of conception
Dizygotic (DZ) or nonidentical twins are result of multiple ovulations with 2 sperm fertilizing 2 ova
Monozygotic (MZ) or identical twins result from division of single zygote (1 sperm fertilizes 1 ovum)
Chorionicity refers to type of placentation
MZ pregnancies may be monochorionic (MC) or dichorionic (DC) depending on when zygote divides
DZ twins always have DC placentation (although can have "fused" placenta)
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Aviram A et al: Delivery of monochorionic twins - lessons learned from the Twin Birth Study. Am J Obstet Gynecol. 223(6):916.e1-9, 2020
Badr DA et al: Evaluation of the new expert consensus-based definition of selective fetal growth restriction in monochorionic pregnancies. J Matern Fetal Neonatal Med. 1-7, 2020
Marleen S et al: Association between chorionicity and preterm birth in twin pregnancies: a systematic review involving 29,864 twin pregnancies. BJOG. ePub, 2020
Mogra R et al: Prospective validation of first-trimester ultrasound characteristics as predictive tools for twin-twin transfusion syndrome and selective intrauterine growth restriction in monochorionic diamniotic twin pregnancies. Fetal Diagn Ther. 47(4):321-7, 2020
Pandya VM et al: Comparison of crown-rump length discordance and abnormal cord insertions as first-trimester predictors of poor outcome in monochorionic diamniotic twin pregnancies. J Matern Fetal Neonatal Med. 1-5, 2020
Shanahan MA et al: Placental anatomy and function in twin gestations. Obstet Gynecol Clin North Am. 47(1):99-116, 2020
Shi X et al: Prenatal and perinatal outcomes of twin pregnancy discordant for one fetus with nuchal translucency above the 95th percentile. J Matern Fetal Neonatal Med. 1-6, 2020
SMFM Patient Safety and Quality Committee, Society for Maternal-Fetal Medicine. et al: SMFM special statement: updated checklists for management of monochorionic twin pregnancy. Am J Obstet Gynecol. 223(5):B16-20, 2020
Takahashi K et al: Monochorionic diamniotic twins of discordant external genitalia with 45,X/46,XY mosaicism. Mol Genet Genomic Med. e1382, 2020
Jha P et al: US evaluation of twin pregnancies: importance of chorionicity and amnionicity. Radiographics. 39(7):2146-66, 2019
Fishel-Bartal M et al: Can middle cerebral artery peak systolic velocity predict polycythemia in monochorionic diamniotic twins? Evidence from a prospective cohort study. Ultrasound Obstet Gynecol. 48(4):470-5, 2016
ISUOG practice guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol. 47(2):247-63, 2016
Stagnati V et al: Inter-twin discrepancy in middle cerebral artery peak systolic velocity and pregnancy outcome in monochorionic diamniotic twin pregnancies. Ultrasound Obstet Gynecol. 48(1):66-71, 2016
Bahtiyar MO et al: The North American Fetal Therapy Network consensus statement: prenatal surveillance of uncomplicated monochorionic gestations. Obstet Gynecol. 125(1):118-23, 2015
Emery SP et al: The North American Fetal Therapy Network consensus statement: management of complicated monochorionic gestations. Obstet Gynecol. 126(3):575-84, 2015
Emery SP et al: The North American Fetal Therapy Network consensus statement: prenatal management of uncomplicated monochorionic gestations. Obstet Gynecol. 125(5):1236-43, 2015
Fichera A et al: Outcome of monochorionic diamniotic twin pregnancies followed at a single center. Prenat Diagn. 35(11):1057-64, 2015
Allaf MB et al: Does early second-trimester sonography predict adverse perinatal outcomes in monochorionic diamniotic twin pregnancies? J Ultrasound Med. 33(9):1573-8, 2014
American College of Obstetricians and Gynecologists et al: ACOG practice bulletin no. 144: multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. Obstet Gynecol. 123(5):1118-32, 2014
Lewi L et al: Growth discordance. Best Pract Res Clin Obstet Gynaecol. 28(2):295-303, 2014
Danon D et al: Increased stillbirth in uncomplicated monochorionic twin pregnancies: a systematic review and meta-analysis. Obstet Gynecol. 121(6):1318-26, 2013
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Monochorionic diamniotic twins (MDT, MoDi twins)
Synonyms
Identical twins
Definitions
Zygosity refers to type of conception
Dizygotic (DZ) or nonidentical twins are result of multiple ovulations with 2 sperm fertilizing 2 ova
Monozygotic (MZ) or identical twins result from division of single zygote (1 sperm fertilizes 1 ovum)
Chorionicity refers to type of placentation
MZ pregnancies may be monochorionic (MC) or dichorionic (DC) depending on when zygote divides
DZ twins always have DC placentation (although can have "fused" placenta)
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Aviram A et al: Delivery of monochorionic twins - lessons learned from the Twin Birth Study. Am J Obstet Gynecol. 223(6):916.e1-9, 2020
Badr DA et al: Evaluation of the new expert consensus-based definition of selective fetal growth restriction in monochorionic pregnancies. J Matern Fetal Neonatal Med. 1-7, 2020
Marleen S et al: Association between chorionicity and preterm birth in twin pregnancies: a systematic review involving 29,864 twin pregnancies. BJOG. ePub, 2020
Mogra R et al: Prospective validation of first-trimester ultrasound characteristics as predictive tools for twin-twin transfusion syndrome and selective intrauterine growth restriction in monochorionic diamniotic twin pregnancies. Fetal Diagn Ther. 47(4):321-7, 2020
Pandya VM et al: Comparison of crown-rump length discordance and abnormal cord insertions as first-trimester predictors of poor outcome in monochorionic diamniotic twin pregnancies. J Matern Fetal Neonatal Med. 1-5, 2020
Shanahan MA et al: Placental anatomy and function in twin gestations. Obstet Gynecol Clin North Am. 47(1):99-116, 2020
Shi X et al: Prenatal and perinatal outcomes of twin pregnancy discordant for one fetus with nuchal translucency above the 95th percentile. J Matern Fetal Neonatal Med. 1-6, 2020
SMFM Patient Safety and Quality Committee, Society for Maternal-Fetal Medicine. et al: SMFM special statement: updated checklists for management of monochorionic twin pregnancy. Am J Obstet Gynecol. 223(5):B16-20, 2020
Takahashi K et al: Monochorionic diamniotic twins of discordant external genitalia with 45,X/46,XY mosaicism. Mol Genet Genomic Med. e1382, 2020
Jha P et al: US evaluation of twin pregnancies: importance of chorionicity and amnionicity. Radiographics. 39(7):2146-66, 2019
Fishel-Bartal M et al: Can middle cerebral artery peak systolic velocity predict polycythemia in monochorionic diamniotic twins? Evidence from a prospective cohort study. Ultrasound Obstet Gynecol. 48(4):470-5, 2016
ISUOG practice guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol. 47(2):247-63, 2016
Stagnati V et al: Inter-twin discrepancy in middle cerebral artery peak systolic velocity and pregnancy outcome in monochorionic diamniotic twin pregnancies. Ultrasound Obstet Gynecol. 48(1):66-71, 2016
Bahtiyar MO et al: The North American Fetal Therapy Network consensus statement: prenatal surveillance of uncomplicated monochorionic gestations. Obstet Gynecol. 125(1):118-23, 2015
Emery SP et al: The North American Fetal Therapy Network consensus statement: management of complicated monochorionic gestations. Obstet Gynecol. 126(3):575-84, 2015
Emery SP et al: The North American Fetal Therapy Network consensus statement: prenatal management of uncomplicated monochorionic gestations. Obstet Gynecol. 125(5):1236-43, 2015
Fichera A et al: Outcome of monochorionic diamniotic twin pregnancies followed at a single center. Prenat Diagn. 35(11):1057-64, 2015
Allaf MB et al: Does early second-trimester sonography predict adverse perinatal outcomes in monochorionic diamniotic twin pregnancies? J Ultrasound Med. 33(9):1573-8, 2014
American College of Obstetricians and Gynecologists et al: ACOG practice bulletin no. 144: multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. Obstet Gynecol. 123(5):1118-32, 2014
Lewi L et al: Growth discordance. Best Pract Res Clin Obstet Gynaecol. 28(2):295-303, 2014
Danon D et al: Increased stillbirth in uncomplicated monochorionic twin pregnancies: a systematic review and meta-analysis. Obstet Gynecol. 121(6):1318-26, 2013
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