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Monochorionic Diamniotic Twins
Anne M. Kennedy, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Monochorionic diamniotic twins (MDT)
          • Synonyms

            • Identical twins
          • Definitions

            • Zygosity refers to type of conception
              • Monozygotic (MZ) or identical twins result from mitotic division of zygote originating from fertilization of 1 ovum by 1 sperm
              • Dizygotic (DZ) or nonidentical twins are result of multiple ovulations, with 2 sperm fertilizing 2 ova
            • 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

          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

                                  1. ISUOG practice guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol. 47(2):247-63, 2016
                                  2. Fichera A et al: Outcome of monochorionic diamniotic twin pregnancies followed at a single center. Prenat Diagn. 35(11):1057-64, 2015
                                  3. 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. ePub, 2015
                                  4. 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. ePub, 2015
                                  5. 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
                                  6. 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
                                  7. Lewi L et al: Growth discordance. Best Pract Res Clin Obstet Gynaecol. 28(2):295-303, 2014
                                  8. Danon D et al: Increased stillbirth in uncomplicated monochorionic twin pregnancies: a systematic review and meta-analysis. Obstet Gynecol. 121(6):1318-26, 2013
                                  9. Lee YM: Delivery of twins. Semin Perinatol. 36(3):195-200, 2012
                                  10. Bornstein E et al: Prematurity in twin pregnancies. Minerva Ginecol. 61(2):113-26, 2009
                                  11. Sfakianaki AK et al: Ultrasound in the evaluation of twin pregnancy. Minerva Ginecol. 61(2):127-39, 2009
                                  12. Cleary-Goldman J et al: Growth abnormalities and multiple gestations. Semin Perinatol. 32(3):206-12, 2008
                                  13. Nikkels PG et al: Pathology of twin placentas with special attention to monochorionic twin placentas. J Clin Pathol. 61(12):1247-53, 2008
                                  14. Bahtiyar MO et al: Prevalence of congenital heart defects in monochorionic/diamniotic twin gestations: a systematic literature review. J Ultrasound Med. 26(11):1491-8, 2007
                                  15. Wee LY et al: Perinatal complications of monochorionic placentation. Curr Opin Obstet Gynecol. 19(6):554-60, 2007
                                  16. Graham GM 3rd et al: Diagnosis and management of obstetrical complications unique to multiple gestations. Semin Perinatol. 29(5):282-95, 2005
                                  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)
                                          • Synonyms

                                            • Identical twins
                                          • Definitions

                                            • Zygosity refers to type of conception
                                              • Monozygotic (MZ) or identical twins result from mitotic division of zygote originating from fertilization of 1 ovum by 1 sperm
                                              • Dizygotic (DZ) or nonidentical twins are result of multiple ovulations, with 2 sperm fertilizing 2 ova
                                            • 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

                                          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

                                                                  1. ISUOG practice guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol. 47(2):247-63, 2016
                                                                  2. Fichera A et al: Outcome of monochorionic diamniotic twin pregnancies followed at a single center. Prenat Diagn. 35(11):1057-64, 2015
                                                                  3. 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. ePub, 2015
                                                                  4. 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. ePub, 2015
                                                                  5. 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
                                                                  6. 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
                                                                  7. Lewi L et al: Growth discordance. Best Pract Res Clin Obstet Gynaecol. 28(2):295-303, 2014
                                                                  8. Danon D et al: Increased stillbirth in uncomplicated monochorionic twin pregnancies: a systematic review and meta-analysis. Obstet Gynecol. 121(6):1318-26, 2013
                                                                  9. Lee YM: Delivery of twins. Semin Perinatol. 36(3):195-200, 2012
                                                                  10. Bornstein E et al: Prematurity in twin pregnancies. Minerva Ginecol. 61(2):113-26, 2009
                                                                  11. Sfakianaki AK et al: Ultrasound in the evaluation of twin pregnancy. Minerva Ginecol. 61(2):127-39, 2009
                                                                  12. Cleary-Goldman J et al: Growth abnormalities and multiple gestations. Semin Perinatol. 32(3):206-12, 2008
                                                                  13. Nikkels PG et al: Pathology of twin placentas with special attention to monochorionic twin placentas. J Clin Pathol. 61(12):1247-53, 2008
                                                                  14. Bahtiyar MO et al: Prevalence of congenital heart defects in monochorionic/diamniotic twin gestations: a systematic literature review. J Ultrasound Med. 26(11):1491-8, 2007
                                                                  15. Wee LY et al: Perinatal complications of monochorionic placentation. Curr Opin Obstet Gynecol. 19(6):554-60, 2007
                                                                  16. Graham GM 3rd et al: Diagnosis and management of obstetrical complications unique to multiple gestations. Semin Perinatol. 29(5):282-95, 2005