Monochorionic twins represent a type of multiple pregnancy in which two fetuses develop within a single shared placenta. This occurs when one fertilized egg divides at an early stage into two embryos. Monochorionic twin pregnancies are associated with increased risks for both the mother and the fetuses and therefore require specialized medical monitoring and management.
Characteristics and features of monochorionic twins
- Single placenta. Unlike dichorionic twins, where each fetus has its own placenta, monochorionic twins share one placental organ that supplies both fetuses with oxygen and nutrients.
- Increased risks. A shared placenta creates a risk of uneven blood flow distribution between the fetuses, which may lead to serious complications.
- Prevalence. Monochorionic twins account for approximately 20% of all multiple pregnancies.
Risks associated with monochorionic twin pregnancy
Monochorionic twin pregnancy carries several specific risks that require close medical attention:
- Twin-to-twin transfusion syndrome (TTTS). A condition in which blood flow between the fetuses becomes unbalanced, causing one fetus to receive more blood than the other.
- Twin reversed arterial perfusion (TRAP) sequence. A rare complication in which one fetus lacks a functional cardiovascular system and receives blood from the healthy twin, placing both fetuses at risk.
- Unequal fetal growth. Due to shared circulation, fetuses may develop at different rates, increasing the risk of premature birth or severe complications in both fetuses.
- Preterm birth.
Management of monochorionic twin pregnancy in Belarus
Management of monochorionic twin pregnancy in Belarus requires enhanced medical surveillance and frequent examinations to monitor fetal condition and prevent potential complications.
Delivery in monochorionic twin pregnancies is usually planned earlier than in singleton pregnancies to reduce the risk of complications. In uncomplicated cases, delivery is typically recommended at 36–37 weeks of gestation. If TTTS or other serious pathologies develop, delivery may be indicated earlier, depending on fetal condition.
If complications such as twin-to-twin transfusion syndrome or selective fetal growth restriction occur, additional diagnostic procedures and hospitalization may be required for continuous monitoring. In certain cases, treatment options may include:
- Laser coagulation of placental vessels for the treatment of TTTS;
- Medications to prevent preterm labor;
- Intensive inpatient monitoring when the risk of complications is high.
Monochorionic twin pregnancy requires careful and regular medical supervision due to its elevated risk profile. In Belarus, all necessary conditions are in place for managing such pregnancies, from early diagnosis to specialized treatment and monitoring. Adherence to medical recommendations, regular examinations, and timely referral to specialized centers are essential to reduce risks and improve outcomes for both mother and fetuses.
