Abstract
Monochorionic twins (MC) are at increased risk for morbidity. The unique placenta with vascular anastomoses may create imbalance with either acute or chronic hypotension or cardiac insufficiency that will eventually affect the fetal brain. It appears that these characteristics of the MC placenta add to the already higher frequency of brain anomalies observed among MZ twins.TOPS, TAPS, and TTTS require not only inter-twin anastomoses but also two live twins with an unbalanced shunt of blood. The death of the co-twin may prompt a sudden hypotension in the surviving twin with the consequent brain lesions. The more frequently occurring velamentous cord insertion in this kind of pregnancies is related to severe selective intrauterine growth restriction that may cause cerebral compromise. Finally, the preterm birth rate among MC twins is ten times higher than in singletons, and prematurity is a key factor for neurological morbidity as well.In this paper the various aspects of neurological morbidity in MC twins will be discussed.
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