Placental Anatomy and Function in Twin Gestations

Obstet Gynecol Clin North Am. 2020 Mar;47(1):99-116. doi: 10.1016/j.ogc.2019.10.010.

Abstract

With an increasing incidence of twin gestations, understanding the inherent risks associated with these pregnancies is essential in modern obstetrics. The unique differences in placentation in twins contribute to the increased risks. Monochorionic twins are susceptible to complications because of their unique placental architecture, including twin-to-twin transfusion syndrome, the twin anemia-polycythemia sequence, selective intrauterine growth restriction, and the twin reversed arterial perfusion sequence. Knowing the clinical correlations of placental anatomy in these gestations helps perinatal pathologists perform a more informed placental evaluation, allowing for better care for the mother and her children.

Keywords: Monochorionic placenta; Selective intrauterine growth restriction; Twin anemia-polycythemia sequence; Twin placenta; Twin reversed arterial perfusion; Twin-to-twin transfusion syndrome.

Publication types

  • Review

MeSH terms

  • Female
  • Fetofetal Transfusion / diagnosis*
  • Humans
  • Placenta / diagnostic imaging*
  • Pregnancy
  • Pregnancy, Twin*
  • Twins, Monozygotic*
  • Ultrasonography, Prenatal / methods