Angioarchitecture of monochorionic placentas in relation to the twin-twin transfusion syndrome

Article Abstract:

Blood vessel interconnections are commonly found in twin pregnancies that share a placenta, but the number and type appear to differ in cases of twin-twin transfusion. Twin-twin transfusion may cause fetal death rates of 80% to 100%. Many clinicians do not understand that the presence of interconnections between the twins' circulation is not of itself diagnostic of twin-twin transfusion, and therapies to obliterate the interconnection may not take this into account. Ten placentas with twin-twin transfusion diagnosed by overabundance of amniotic fluid in one twin and abnormally low amniotic volume in the other were compared with ten placentas from shared placenta normal twin pregnancies. Placentas were preserved after birth and infused with two different colored dyes via each twin's umbilical artery. Placentas from twin-twin transfusion pregnancies had fewer interconnections and connections were likely to lie deeper within the placenta. It seems likely that increased numbers of interconnections in health twin placentae help ensure that each twin donates and receives equal amounts of blood from the other.

Diseases, Fetofetal transfusion, Diseases in twins

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Neuromorbidity in preterm twins in relation to chorionicity and discordant birth weight

Article Abstract:

In a study to determine the incidence of neurologic morbidity in preterm monochorionic (MC) and dichorionic (DC) twins, it was found that overall incidence of cerebral palsy and minor neurologic disabilities in surviving twins was 4% and 9% respectively. Neurologic morbidity in the preterm MC infants was 7-fold higher than DC infants because of twin-twin transfusion syndrome, discordant birth weight, and cotwin death in utero.

Research and Development in the Physical, Engineering, and Life Sciences, Science & research, Research and Testing Services, Gynecological R&D, Gynecological research, Morbidity

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Placental transport rather than maternal concentration of amino acids regulates fetal growth in monochorionic twins: implications for fetal origin hypothesis

Article Abstract:

Stunted growth in one of the twins in a twin pregnancy seems to occur because of a lack of essential amino acids coming through the placenta. This was the conclusion of a study of 14 twin pregnancies in which the birth weights of the twins differed by 20% or more.

Fetus, Birth weight, Low, Low birth weight, Fetal growth retardation, Amino acid metabolism

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