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Study of the natural history of monochorionic twinning
“EuroTwin2Twin”Although most twin
pregnancies end with the birth of two healthy babies, the
pregnancy still poses specific challenges for women, their
children and for their caregivers. This leaflet gives an overview
of problems associated with twin pregnancies and is also an
invitation to participate in the EuroTwin2Twin study.
Why a EuroTwin2Twin study?Only recently, the
distinction between monochorionic and
dichorionic twins is made routinely on early ultrasound
scan. Therefore, a lot of things are still unknown. Most
importantly, it is not known yet if sharing a single placenta
during pregnancy influences the development of the children after
birth. Also, it is unknown to what degree problems like TTTS or
poor growth can be foreseen on early ultrasound scan. Therefore,
with help from the European Commission, a study has been set up
by specialists from fetal medicine centres in different European
countries to answer these questions. Obviously, such a study is
not possible without the participation of parents expecting
twins. Therefore, all women expecting twins and still early in
pregnancy (<14 weeks) are invited to participate. Between 11
and 14 weeks an ultrasound scan will be performed in one of the
participating centres to determine whether the twins are
monochorionic or dichorionic. At the same time,
a risk assessment for Down’s syndrome can be done by
measurement of the baby’s neck, if you would like this. At
16 weeks a scan will be performed to check for early signs growth
problems and TTTS in monochorionic twins only. Both
monochorionic and dichorionic twins are scanned
at 20 weeks to exclude major birth defects and at 26 weeks to
assess the babies’ growth. Your personal doctor will
provide the care during your pregnancy and delivery and will
update us on the further course. After the delivery, the placenta
will be sent for examination to a laboratory specialized in the
examination of twin placentas. During the first 3 days after
birth, an ultrasound scan will be performed of the babies’
head in your local hospital. Between 1 to 2 years of age, you
will be invited for an assessment of the development of the
children in one of the treatment centres.
Women pregnant with twins diagnosed prior
to 14 weeks:
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11-14 weeks: |
-monochorionic or dichorionic |
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-exact gestational age |
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-risk assessment Down’s syndrome if
requested by parents |
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16 weeks: |
only for monochorionic twins |
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-early signs of growth problems &
TTTS |
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20 weeks: |
-exclude major birth defects |
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-early signs growth problems & TTTS |
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26 weeks: |
-growth |
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-exclusion of TTTS |
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At birth: |
-placenta will be sent for examination |
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-ultrasound scan of babies’ head |
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2 years: |
Assessment of the baby’s
development |
The content of this paper has been reviewed and elaborated with
the help of Twin2Twin,
the UK Twin to Twin Transfusion Syndrome Association.
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