Anatomy of monochorionic diamniotic twin pregnancy #twin #anatomy #pregnancy #twinpregnancy

Monochorionic, diamniotic, twin pregnancy
Monochorionic diamniotic twin pregnancy is a type of twin pregnancy where each twin has its own amniotic sac, but both share one chorion
An MCDA twin pregnancy results from the fertilization of one ovum by one sperm.The resulting zygote forms a blastocyst, which contain two inner cell massesembryoblast and a single outer cell mass .single outer cell mass forms a single chorionic sac and single placenta but two inner cell masses produce two yolk sacs and two amniotic sacs.
Types of Monozygotic Twins
Related to Time of Division After Ovum Fertilization
Chorion Amnion Time to Division Days Frequency
Dichorionic Diamniotic 0-3 25
Monochorionic Diamniotic 4-8 75
Monochorionic Monoamniotic 9-12 1
Monochorionic Monoamniotic 13–15 Rare
conjoined twins
Dichorionic twin pregnancy at 5 weeks and 3 days.
Two round sonolucent sacs with a brightly echogenic rim are clearly visible in the thick decidua.At 6 postmenstrual weeks, a single chorionic sac is seen containing two yolk sacs: the diagnosis of monochorionic twin pregnancy can be done; it is not yet possible to diagnose amnioticity, whether monochorionic or diamniotic
T-sign of the intertwin membrane
a thin inter-twin membrane may be seen but appears very thin without intervening chorion, often taken as less than 2 mm: differentiating from a DCDA pregnancy,#twin #anatomy #pregnancy #twinpregnancy although this assessment becomes increasingly difficult with the progression of pregnancy
Second and third trimesters
Findings noted on a second trimester scan include:
the number of placental masses, thickness of the membrane, and the presence/absence of the twin-peak sign are still viable options for determining chorionicity fetal sex. almost always the same sex
Negative findings: absent twin peak sign: differentiating from a DCDA pregnancy
complication :
Potential complications that can occur with this type of pregnancy include:
problems related to abnormal placental vascular anastomoses
twin to twin transfusion syndrome
twin embolization syndrome
twin reversed arterial perfusion sequence:
demise of one twin: often associated with some adverse outcome for the other twin
placental insertion related problems
increased incidence of velamentous cord insertion 
increased incidence of marginal cord insertion
Vascular anastomoses include 3 types: arterioarterial AA,
enovenous VV and
arteriovenous AV anastomoses.
arterioarterial AA venovenous VV anastomosis are superficial with bidirectional blood flow and directly linking the arteries and veins of two umbilical cords.
while AV anastomoses form at a deep capillary level within shared cotyledons and allow only unidirectional blood flow.
placenta insertion problems : placenta previa
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