When diamniotic twins suddenly become monoamniotic twins: spontaneous septostomy of the dividing membrane

In twin pregnancies, amnionicity and chorionicity are crucial as they strongly determine prenatal and perinatal management. First trimester ultrasound allows a highly reliable diagnosis of amnionicity and chorionicity, making it an internationally accepted standard in antenatal care. However, in rare cases, amnionicity can change from diamniotic to monoamniotic throughout pregnancy, substantially impacting perinatal management. We report the case of a confirmed monochorionic diamniotic twin pregnancy with a diagnosis of spontaneous septostomy of the dividing membrane (SSDM) at 28 weeks of gestation, resulting in a pseudomonoamniotic pregnancy. Even though SSDM is a rare condition and its sonographic diagnosis might be challenging, it should be considered if, in a known diamniotic pregnancy, there is a sudden failure to visualise the intertwin membrane truly separating both twins.

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Yolk sac number does not predict reliably amnionicity in monochorionic twin pregnancies: a case of a monochorionic monoamniotic twin pregnancy with two distinct yolk sacs on early first-trimester ultrasound

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.11160 ◽

2012 ◽

Vol 39 (5) ◽

pp. 607-608 ◽

Cited By ~ 11

Author(s):

S. L. Corbett ◽

D. Shmorgun

Keyword(s):

Twin Pregnancy ◽

First Trimester ◽

Yolk Sac ◽

Monochorionic Twin ◽

Twin Pregnancies ◽

First Trimester Ultrasound

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Simpson-Golabi-Behmel-Syndrome in Dichorionic-Diamniotic Twin Pregnancy

Clinics and Practice ◽

10.3390/clinpract11010012 ◽

2021 ◽

Vol 11 (1) ◽

pp. 75-80

Author(s):

Theresa Reischer ◽

Franco Laccone ◽

Gregor J. Kasprian ◽

Gülen Yerlikaya-Schatten

Keyword(s):

Twin Pregnancy ◽

Multiple Pregnancy ◽

Intrauterine Infection ◽

Rare Condition ◽

First Trimester ◽

Cervical Length ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

First Case ◽

Twin Pregnancies

Simpson-Golabi-Behmel syndrome (SGBS) is a rare x-linked overgrowth syndrome with distinct clinical features, which is difficult to diagnose prenatally. We report the diagnosis of SGBS in dichorionic-diamniotic twin pregnancies in the first trimester by ultrasound and genetic testing. The affected fetus developed polyhydramnios and the cervical length of the mother decreased significantly. To save the unaffected twin, a selective feticide of the affected fetus was performed. Finally, the patient underwent preterm caesarean section due to premature rupture of membranes in the dead twin, and also intrauterine infection. While SGBS has been reported, this was the first case in a multiple pregnancy, with possible consequences for the healthy twin. In conclusion, SGBS is a rare condition, which should be considered in the differential diagnosis of prenatal overgrowth syndromes and associated malformation.

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OP11.02: Sensitivity of first trimester ultrasound in detecting fetal structural malformations in twin pregnancies

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.13736 ◽

2014 ◽

Vol 44 (S1) ◽

pp. 93-93

Author(s):

F. D'Antonio ◽

M. Morlando ◽

A. Khalil ◽

A.T. Papageorghiou ◽

B. Thilaganathan ◽

...

Keyword(s):

First Trimester ◽

Twin Pregnancies ◽

First Trimester Ultrasound

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Sensitivity of first-trimester ultrasound in the detection of congenital anomalies in twin pregnancies: population study and systematic review

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/aogs.13017 ◽

2016 ◽

Vol 95 (12) ◽

pp. 1359-1367 ◽

Cited By ~ 10

Author(s):

Francesco D'Antonio ◽

Alessandra Familiari ◽

Basky Thilaganathan ◽

Aris T. Papageorghiou ◽

Lamberto Manzoli ◽

...

Keyword(s):

Systematic Review ◽

Population Study ◽

Congenital Anomalies ◽

First Trimester ◽

Twin Pregnancies ◽

First Trimester Ultrasound

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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 Diagnosis and Therapy ◽

10.1159/000504049 ◽

2020 ◽

Vol 47 (4) ◽

pp. 321-327 ◽

Cited By ~ 1

Author(s):

Ritu Mogra ◽

Rahmah Saaid ◽

Jane Tooher ◽

Lars Pedersen ◽

Greg Kesby ◽

...

Keyword(s):

Intrauterine Growth Restriction ◽

First Trimester ◽

Growth Restriction ◽

Predictive Tools ◽

Intrauterine Growth ◽

Twin Pregnancies ◽

First Trimester Ultrasound

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The Frequency of Ovular Resorption During the First Trimester of Twin Pregnancy

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s000156600000876x ◽

1979 ◽

Vol 28 (4) ◽

pp. 270-272

Author(s):

Lucien Schneider ◽

Roger Bessis ◽

Thérèse Simonnet

Keyword(s):

Twin Pregnancy ◽

First Trimester ◽

Twin Pregnancies

A follow-up of 78 twin pregnancies diagnosed in the first trimester indicated that early ovular resorption occurred in 63% of spontaneous and 64% of Clomiphene-induced gestations, so that singletons were born. No failure was observed in the 12 twin conceptions following administration of gonadotropins or Cyclofenil.

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First-trimester ultrasound determination of chorionicity in twin pregnancy

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.8956 ◽

2011 ◽

Vol 38 (5) ◽

pp. 530-532 ◽

Cited By ~ 55

Author(s):

T. Dias ◽

T. Arcangeli ◽

A. Bhide ◽

R. Napolitano ◽

S. Mahsud-Dornan ◽

...

Keyword(s):

Twin Pregnancy ◽

First Trimester ◽

First Trimester Ultrasound

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Association Between First-Trimester Intrauterine Hematoma and Twin Pregnancy Outcomes: A Retrospective Cohort Study

10.21203/rs.3.rs-75567/v1 ◽

2020 ◽

Author(s):

Wanqing Ji ◽

Jie Zheng ◽

Weidong Li ◽

Fang Guo ◽

Bo Hou ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Odds Ratio ◽

Vaginal Bleeding ◽

Pregnancy Loss ◽

Twin Pregnancy ◽

Adjusted Odds Ratio ◽

First Trimester ◽

Multivariable Logistic Regression Analysis ◽

Vanishing Twin Syndrome ◽

Twin Pregnancies

Abstract Background: In recent years, we have found that first-trimester intrauterine hematoma in twin pregnancy has become increasingly common. The majority of studies on intrauterine hematoma have excluded twin pregnancies, while others did not differentiate between singleton and twin pregnancies. The associations in twin pregnancy are not clear. Therefore, the primary objective of our study was to examine the associations between first-trimester intrauterine hematoma and pregnancy outcomes in twin pregnancy. Material and methods: 1020 twin pregnancies in women who underwent a routine examination from January 2014 to December 2018 were enrolled. According to the presence or absence of intrauterine hematoma, we compared the baseline data and pregnancy outcomes between two groups. Multivariable logistic regression analysis was used to adjust for possible confounding factors. Results: A total of 209 patients (21.3%) developed intrauterine hematoma in the first trimester. First-trimester intrauterine hematoma was significantly associated with increased odds of miscarriage (adjusted odds ratio 14.27, 95% CI 8.25-24.70) and the vanishing twin syndrome (adjusted odds ratio 3.26, 95% CI 1.11-4.61). However, It did not have increased odds of adverse pregnancy outcomes after 20 Weeks of Gestation .In the final regression model analysis, the associations of hematoma with previous miscarriage history, accepted assisted conception, accompanying vaginal bleeding and miscarriage and vanishing twin syndrome were no longer significant. No association was found between hematoma size or the presence of vaginal bleeding and the risk of pregnancy loss or the vanishing twin syndrome before 20 weeks of gestation (P>0.05). Conclusion: In women with twin pregnancies, the presence of intrauterine hematoma in the first trimester was associated with one or both fetal losses before 20 weeks of gestation. However, chorionicity in twins, the conception method, the intrauterine hematoma size and the presence of vaginal bleeding were not independently associated with pregnancy loss.

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Yolk Sacs in Twin Pregnancy

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000000076 ◽

1998 ◽

Vol 47 (3-4) ◽

pp. 177-181 ◽

Cited By ~ 3

Author(s):

W. Malinowski

Keyword(s):

Ectopic Pregnancy ◽

Twin Pregnancy ◽

First Trimester ◽

Yolk Sac ◽

Thin Wall ◽

Multiple Pregnancies ◽

Monochorionic Twin ◽

The Relationship ◽

Twin Pregnancies ◽

Efficient Recognition

AbstractOBJECTIVE. The purpose of this study was to evaluate the relationship between the yolk sacs separated or not separated by septum and chorionicity twin pregnancies scanned early in the first trimester, and the relation between size and morphologic features of the yolk sac and the outcome of twin pregnancies.RESULTS. In all 38 sets of twins two yolk sacs were identified. During the first trimester of a dichorionic twin pregnancy, the yolk sacs were always separated by a septum and not separated (“Eight” sign) in monochorionic twin pregnancy. In five cases, one of yolk sac was abnormally large (> 8mm) and had thin wall. Four of the five mothers spontaneously aborted during the next 2-3 weeks. In one case of monochorionic twin ectopic pregnancy two yolk sacs were seen normally.CONCLUSION. The sonographic identification of yolk sacs in multiple pregnancies allows an early and efficient recognition of presence and chorionicity of twin pregnancy, both in intra – and extrauterine. Identification of abnormal yolk sac or yolk sacs suggests death of one or all embryos.

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