Monochorionic Twin

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Condition	Cause	Recipient	Donor
TTTS → Twin to twin transfusion sydrome	Large vessel anastomosis in placenta	‣	Volume-overload → ‣
Discordant Growth	Uneven split in placenta (Mono), can happen to all twins	May pass away	R pass → lower BP → Stroke or demise
TAPS → Twin anemia polycythemia Sequence	Tiny vessel anastomosis in placenta	Anemia	Polycythemia
TRAP → Twin reversal artery perfusion	One of the fetus has circulation but no pump	Acardia and acrania	Heart Failure

Monochorionic Monoamniotic

Cord entanglement

For All Twins

Prematurity
Discordant Growth
Needing C-Section

![Screenshot 2025-01-22 at 6.10.47 PM.png](<https://prod-files-secure.s3.us-west-2.amazonaws.com/e42703ef-0593-445e-9e12-0601eac56230/01630313-dbde-4df1-a3e1-f942a6840d9a/Screenshot_2025-01-22_at_6.10.47_PM.png>)

Management

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Type	Monitoring Type	Monitoring Starting	Monitoring Frequency	Avg. Delivery Time
DCDA	‣	W28	Q2-4 wk	W38 (Term)
MCDA	‣	W16	Q2 wk	W36-37
MCMA	‣ (in-patient)	W26-28	Daily	W32-35