Management and clinical implications of multiple pregnancies: A focus on zygosity, chorionicity, and monochorionic twin complications

• Published in: Sri Lanka journal of obstetrics and gynaecology 2024-04, Vol.46 (1), p.21-31
• Main Authors: McCully, B., Dodampahala, S. H., Menon, A. S., D’Sa, N., Day, E., Ahmed, M., Rahim, M. M.
• Format: Article
• Language: English
• ISSN: 1391-7536; 2279-1655
• DOI: 10.4038/sljog.v46i1.8131

This comprehensive review explores the multifaceted phenomena of twin pregnancies, tracing their historical significance from ancient cultures and mythologies to modern scientific investigations. It delves into the genetic and environmental factors influencing the occurrence of twins, distinguishing between monozygotic (identical) and dizygotic (fraternal) twins and discussing the implications of zygosity and chorionicity on pregnancy management and outcomes1. Highlighting the unique challenges of twin pregnancies, such as increased risks of preterm birth, low birth weight, and specific complications like Twin-Twin Transfusion Syndrome (TTTS), the article emphasises the need for specialised, multidisciplinary care. It presents a case study of a monochorionic diamniotic twin pregnancy, illustrating the complexity of managing such pregnancies, especially in remote settings with limited access to healthcare resources2. The review advocates enhanced prenatal care, early determination of chorionicity, and tailored management strategies to improve outcomes. It concludes by addressing the heightened challenges in remote Australian communities, where socio-economic and logistical barriers further complicate the provision of care, underscoring the necessity of government initiatives and community-based programs to bridge these gaps and ensure equitable healthcare access.