BIOMAT Database Logo BIOMAT Database Logo

Guideline No. 440: Management of Monochorionic Twin Pregnancies. 2023

Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Perth, Australia & Toronto, ON.

This guideline reviews the evidence-based management of normal and complicated monochorionic twin pregnancies. Women with monochorionic twin or higher order multiple pregnancies. Implementation of these recommendations should improve the management of both complicated and uncomplicated monochorionic (and higher order multiple) twin pregnancies. They will help users monitor monochorionic twin pregnancies appropriately and identify and manage monochorionic twin complications optimally in a timely manner, thereby reducing perinatal morbidity and mortality. These recommendations entail more frequent ultrasound monitoring of monochorionic twins compared to dichorionic twins. Published literature was retrieved through searches of PubMed and the Cochrane Library using appropriate MeSH headings (Twins, Monozygotic; Ultrasonography, Prenatal; Placenta; Fetofetal Transfusion; Fetal Death; Fetal Growth Retardation). Results were restricted to systematic reviews, randomized controlled clinical trials, and observational studies. There were no date limits, but results were limited to English or French language materials. The content and recommendations were drafted and agreed upon by the principal authors. The Board of the SOGC approved the final draft for publication. The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations). Maternal-fetal medicine specialists, obstetricians, radiologists, sonographers, family physicians, nurses, midwives, residents, and other health care providers who care for women with monochorionic twin or higher order multiple pregnancies. Canadian (SOGC) guidelines for the diagnosis, ultrasound surveillance and management of monochorionic twin pregnancy complications, including TTTS, TAPS, sFGR (sIUGR), acardiac (TRAP), monoamniotic twins and intrauterine death of one MC twin. RECOMMENDATIONS.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002170 Canada The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.
D005260 Female Females
D005313 Fetal Death Death of the developing young in utero. BIRTH of a dead FETUS is STILLBIRTH. Fetal Mummification,Fetal Demise,Death, Fetal,Deaths, Fetal,Demise, Fetal,Fetal Deaths,Mummification, Fetal
D005317 Fetal Growth Retardation Failure of a FETUS to attain expected GROWTH. Growth Retardation, Intrauterine,Intrauterine Growth Retardation,Fetal Growth Restriction,Intrauterine Growth Restriction
D005330 Fetofetal Transfusion Passage of blood from one fetus to another via an arteriovenous communication or other shunt, in a monozygotic twin pregnancy. It results in anemia in one twin and polycythemia in the other. (Lee et al., Wintrobe's Clinical Hematology, 9th ed, p737-8) Cross-Transfusion, Intrauterine,Intrauterine Cross-Transfusion,Twin Transfusion,Twin Transfusion Syndrome,Twin-to-Twin Transfusion,Fetal Transfusion Syndrome,Fetofetal Transfusion Syndrome,Twin Twin Transfusion Syndrome,Twin-to-Twin Transfusion Syndrome,Cross Transfusion, Intrauterine,Fetal Transfusion Syndromes,Fetofetal Transfusion Syndromes,Fetofetal Transfusions,Intrauterine Cross Transfusion,Intrauterine Cross-Transfusions,Syndrome, Fetal Transfusion,Syndrome, Fetofetal Transfusion,Syndrome, Twin Transfusion,Syndrome, Twin-to-Twin Transfusion,Transfusion Syndrome, Fetal,Transfusion Syndrome, Fetofetal,Transfusion Syndrome, Twin,Transfusion Syndrome, Twin-to-Twin,Transfusion, Fetofetal,Transfusion, Twin,Transfusion, Twin-to-Twin,Twin Transfusion Syndromes,Twin Transfusions,Twin to Twin Transfusion,Twin to Twin Transfusion Syndrome,Twin-to-Twin Transfusion Syndromes,Twin-to-Twin Transfusions
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014430 Twins, Monozygotic Two off-spring from the same PREGNANCY. They are from a single fertilized OVUM that split into two EMBRYOS. Such twins are usually genetically identical and of the same sex. Twins, Identical,Identical Twin,Identical Twins,Monozygotic Twin,Monozygotic Twins,Twin, Identical,Twin, Monozygotic
D016216 Ultrasonography, Prenatal The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease. Fetal Ultrasonography,Prenatal Diagnosis, Ultrasonic,Ultrasonography, Fetal,Diagnosis, Prenatal Ultrasonic,Diagnosis, Ultrasonic Prenatal,Prenatal Ultrasonic Diagnosis,Prenatal Ultrasonography,Ultrasonic Diagnosis, Prenatal,Ultrasonic Prenatal Diagnosis,Diagnoses, Prenatal Ultrasonic,Diagnoses, Ultrasonic Prenatal,Prenatal Diagnoses, Ultrasonic,Prenatal Ultrasonic Diagnoses,Ultrasonic Diagnoses, Prenatal,Ultrasonic Prenatal Diagnoses
D059285 Pregnancy, Twin The condition of carrying TWINS simultaneously. Pregnancies, Twin,Twin Pregnancies,Twin Pregnancy

Related Publications

Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Management of Monochorionic Twin Pregnancy: Green-top Guideline No. 51.
January 2017, BJOG : an international journal of obstetrics and gynaecology,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Guideline No. 428: Management of Dichorionic Twin Pregnancies.
July 2022, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Management of complicated monochorionic twin pregnancies.
February 2015, Zeitschrift fur Geburtshilfe und Neonatologie,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Monochorionic twin pregnancies.
June 2005, Clinics in perinatology,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Monochorionic monoamniotic twin pregnancies.
March 2022, American journal of obstetrics & gynecology MFM,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Monochorionic monoamniotic twin pregnancies.
November 2022, Best practice & research. Clinical obstetrics & gynaecology,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Monochorionic diamniotic twin pregnancies.
March 2022, American journal of obstetrics & gynecology MFM,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
Management of other complications specific to monochorionic twin pregnancies.
August 2004, Best practice & research. Clinical obstetrics & gynaecology,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
[Monochorionic twin pregnancies : dangerous liasons].
May 2000, Journal de gynecologie, obstetrique et biologie de la reproduction,
Han-Shin Lee, and Nimrah Abbasi, and Tim Van Mieghem, and Elad Mei-Dan, and Franҫois Audibert, and Richard Brown, and Sarah Coad, and Liesbeth Lewi, and Jon Barrett, and Greg Ryan
[Perinatal outcome of monochorionic twin pregnancies].
June 2013, Zhonghua fu chan ke za zhi,
Copied contents to your clipboard!