EP07.03: Variability of the clinical course of monochorionic twins based on a different architecture of placental bed

Abstract

There are known complications of monochorionic twins: the TTTS (Twin–twin transfusion syndrome), sIUGR (selective intrauterine growth restriction), TAPS (twin anemia polycythemia sequence), TRAP (twin reversed arterial perfusion). The most frequent cases are TTTS, sIUGR and their combinations. The study is based on detailed analysis of the placental vessels and correlated with known clinical course. Therefore the prediction <span style = ''line-height:20.7999992370605px''> of clinical courses of monochorionic twins by ultrasound techniques. We analysed 65 monochorionic biamniotic placentas by use of histological colours. The history of clinical course was known in all cases including ultrasound measurements. Cases of placentas which were not applicable for analysis or cases with unknown clinical courses were excluded. We defined 5 most frequent types of clinical courses of monochorionic twins. The type I – clear TTTS, type II – clear sUIGR, type III – flow type III of sIUGR, type IV and V – combination of TTTS and sIUGR depending on the way of transfusion. TRAP and TAPS placentas were also defined. The knowledge of placental vascular architecture together with known clinical course of monochorionic twins is useful tool for the next management and approach.