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Monochorionic Diamniotic Pregnancy

Twin pregnancy sharing a single placenta but in separate amniotic sacs; carries the risk of twin-to-twin transfusion syndrome.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Monochorionic Diamniotic Pregnancy?

MCDA pregnancy results from splitting of monozygotic twins between days 4 and 8. The twins share a single placenta and chorionic tissue but lie in separate amniotic sacs. The 'T sign' instead of 'lambda sign' on ultrasound and a thin intertwin membrane support the diagnosis of MCDA.

These pregnancies are particularly prone to complications such as twin-to-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), twin anemia-polycythemia sequence (TAPS) and intrauterine fetal demise due to placental vascular anastomoses.

In MCDA pregnancies, biweekly serial ultrasonographic surveillance starts from 16 weeks of gestation. Amniotic fluid, bladder filling, MCA Doppler and growth parameters are carefully monitored; in complications, referral to a perinatology center is essential.

Symptoms

Generally asymptomatic in early pregnancy
Increased maternal weight gain and abdominal enlargement
Acute polyhydramnios when TTTS develops
Maternal respiratory distress
Amniotic fluid imbalance on ultrasonography
Differences in fetal growth
Signs of preterm labor

Risk Factors

IVF and assisted reproductive technologies
Family history of monozygotic twins
Advanced maternal age
Variations in placental anastomoses
Inadequate maternal nutrition
Previous history of MCDA complications

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When monochorionic twin pregnancy is diagnosed, for specialized follow-up
  • Sudden maternal abdominal enlargement and discomfort
  • When amniotic fluid difference is detected on ultrasonography
  • Signs of preterm labor
  • Reduced fetal movements

Treatment Methods

01
Biweekly serial ultrasonography from 16 weeks
02
Amniotic fluid index (DVP), bladder filling and MCA Doppler
03
Fetoscopic laser coagulation according to TTTS stage
04
Surveillance or intervention based on type of sIUGR
05
Corticosteroids and prolonged pulmonary maturation
06
Delivery planning at 34-36 weeks

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.