Twin Surveillance

The treatment for twins is very different from that of single fetuses. All twins have increased chance of miscarriage, premature birth, stillbirth, in addition to the increased chance of maternal problems like anaemia, high blood pressure, and heavy bleeding after delivery.

During pregnancy, twins are classified as “single placenta twins” or “double placenta twins” based on how many placentas are present. This is a very important categorisation: single placenta twins have special monitoring. In most ‘double placenta twins’ (di chorionic twins), there won’t be any untoward complications and the pregnancy can be safely monitored once in 4 weeks.

However, in ‘single placenta twins’ (mono chorionic twins), there is a 15% chance of certain unique problems called ‘selective fetal growth restriction’, ‘twin to twin transfusion syndrome’, and ‘twin anaemia polycythaemia sequence’. These unique problems are due to the sharing of blood between the two fetuses through the single placenta. Timely identification of any such problems is important to intervene at the appropriate time and optimise the outcome.

The twins monitoring protocol followed at FETOSCAN is at par with the best of fetal medicine centres. All monochorionic twins are meticulously examined for size, liquor, and Doppler differences at each visit, every 2 weeks. Dichorionic twins are monitored for growth issues every 4 weeks.

It is important to know that the categorisation of twins to mono or di chorionic pregnancies is most accurate at the first trimester screening scan rather than late in pregnancy. Therefore, if your twin pregnancy has not been classified as either mono or di chorionic pregnancy after the FTS scan, it is important that you discuss this with your physician.