Anatomy of dichorionic and diamniotic twin pregnancy with sonographic features

Anatomy of dichorionic and diamniotic twin pregnancy with sonographic features
definition A dichorionic diamniotic DCDA twin pregnancy is a type of twin pregnancy where each twin has its own chorionic and amniotic sacs. This type occurs most commonly with dizygotic twins, but may also occur with monozygotic twin pregnancies.
cause With a dizygotic pregnancy, two ova are independently fertilised by two sperm leading to two zygotes.

With a monozygotic twin pregnancy, a DCDA pregnancy results from the separation of the zygotes at 1-4 days post fertilisation morula stage.
explanation by using figure
complications
sonographic features
Sonographic assessment of chorionicity is most accurate in the first trimester.

First trimester
Features supporting a DCDA pregnancy:

presence of two gestational sacs with a thick echogenic chorion surrounding each embryo
a thick inter-twin membrane often taken as more than 2 mm
twin peak sign (lambda λ sign)
two yolk sacs may be seen (this, however, does not differentiate a DCDA pregnancy from a monochorionic diamniotic MCDA pregnancy
Second trimester
when there is no placental fusion, two separate placental sites may be seen 4
a finding of two different genders for each twin is a definitive feature for a dizygotic pregnancy which in turn will invariably mean a DCDA pregnancy
If the twins are of the same gender then it is extremely difficult if not impossible to determine if they are monozygotic or dizygotic on ultrasound.
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