Monochorionic–Diamniotic Placentation

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Figer-1

📄 Report Sample Line- Monochorionic–Diamniotic Placentation
single placental mass and a thin intertwin dividing membrane, consistent with monochorionic–diamniotic placentation. The membrane insertion at the placenta demonstrates a T-sign, indicating absence of chorionic tissue between the layers. Each fetus is housed in a separate amniotic sac, with distinct fetal movements and fluid spaces. No signs of twin-to-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), selective intrauterine growth restriction (sIUGR), or amniotic fluid discordance are currently noted. Both fetuses demonstrate concordant growth and normal Doppler waveforms (umbilical artery, MCA, and ductus venosus).


Conclussion: 📋 Findings are consistent with a monochorionic–diamniotic twin pregnancy in the second/third trimester. Fetal growth, amniotic fluid volumes, and Doppler parameters are within normal limits. No evidence of TTTS, TAPS, or sIUGR at this time.
Recommendation: Intensive surveillance with ultrasound every 2 weeks from 16 weeks onwards is recommended due to the increased risk of intertwin complications in monochorionic pregnancies.

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Note: Select English to answer in English, या हिंदी चुनें तो प्रश्नों के उत्तर हिंदी में दीजिए।

1. What defines a monochorionic–diamniotic (MCDA) twin pregnancy? 1. मोनोकोरिओनिक–डायएमनियोटिक (MCDA) ट्विन गर्भावस्था किससे परिभाषित होती है?
A. Two chorions, two amnions
B. Single chorion with two separate amniotic sacs
C. Single chorion and single amniotic sac
D. Two placentas that are always fused

2. Which early ultrasound sign favors monochorionicity (as opposed to dichorionic)? 2. कौन सा प्रारंभिक अल्ट्रासाउंड संकेत मोनोकोरिओनिसिटी को पसंद करता है (डाइकोरिओनिक के विपरीत)?
A. Lambda (twin peak) sign
B. T-sign (thin inter-twin membrane insertion)
C. Thick inter-twin membrane (>2 mm)
D. Two separate placental disks clearly separated

3. Which major complication is characteristically associated with MCDA pregnancies? 3. कौन सी प्रमुख जटिलता MCDA गर्भधारण से खासकर जुड़ी रहती है?
A. Twin-to-twin transfusion syndrome (TTTS)
B. Neural tube defect in both twins
C. Always severe congenital infection
D. Placental abruption is exclusive to MCDA

4. Best time to determine chorionicity by ultrasound? 4. अल्ट्रासाउंड द्वारा कोरियोनिसिटी निर्धारित करने का सर्वोत्तम समय कब है?
A. First trimester (around 11–14 weeks)
B. After 28 weeks
C. At term during labour
D. Chorionicity cannot be determined by ultrasound

5. Compared to dichorionic-diamniotic twins, MCDA pregnancies typically have: 5. डाइकोरिओनिक–डायएमनियोटिक ट्विन्स की तुलना में, MCDA गर्भधारण आमतौर पर क्या दिखाते हैं?
A. Lower risk of complications
B. Higher risk of TTTS and perinatal complications
C. No difference in risks
D. Always need immediate delivery at 28 weeks

6. Typical surveillance schedule for uncomplicated MCDA pregnancies (once determined)? 6. साधारण MCDA गर्भधारण के लिए निगरानी अनुसूची (निर्धारित होने के बाद) क्या है?
A. Routine care same as singleton pregnancy
B. Serial ultrasound every 2 weeks from ~16 weeks to monitor for TTTS and growth discordance
C. Only one scan at 20 weeks is enough
D. Daily Doppler monitoring from 20 weeks

7. First-line fetal therapy for severe TTTS is: 7. गंभीर TTTS के लिए पहले विकल्प की भ्रूणयुग उपचार क्या है?
A. Fetoscopic laser photocoagulation of placental vascular anastomoses
B. Immediate cesarean delivery regardless of gestation
C. Maternal steroids only D. No treatment exists for TTTS

8. Which ultrasound finding argues AGAINST monochorionicity? 8. कौन सा अल्ट्रासाउंड खोज मोनोकोरिओनिसिटी के खिलाफ तर्क देती है?
A. Presence of a thick lambda (twin peak) sign between the fetal membranes
B. Thin inter-twin membrane with T-sign
C. Single placenta with vascular anastomoses on color Doppler
D. Discordant growth between twins

9. Twin anemia-polycythemia sequence (TAPS) in MCDA is best screened with: 9. MCDA में ट्विन एनीमिया-पॉलीसाइथेमिया सीक्वेंस (TAPS) की सही स्क्रीनिंग किससे होती है?
A. Maternal serum AFP only B. Middle cerebral artery peak systolic velocity (MCA-PSV) Doppler in each twin
C. Amniotic fluid volume measurement alone D. Fetal MRI

10. For an uncomplicated MCDA pregnancy, recommended timing of delivery to reduce risk of stillbirth is usually around: 10. एक असम्प्रदायिक MCDA गर्भधारण के लिए, स्ट्रिलबर्थ के जोखिम को कम करने हेतु आमतौर पर प्रसव का अनुशंसित समय कब होता है?
A. 34 weeks B. 37 weeks (often recommended) C. 40 weeks D. Post-term beyond 42 weeks