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Chapter 29 - New Frontiers in Multiple Pregnancy Management
- By Caroline J. Shaw, Christoph C. Lees
Edited by Leanne Bricker, Julian N. Robinson, Baskaran Thilaganathan, St George's Hospital Medical School, University of London
Book:

Management of Multiple Pregnancies

Published online:

11 October 2022

Print publication:

27 October 2022, pp 318-328
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Summary

Multiple pregnancies, especially those involving monochorionic placentation, have increased risks compared to singleton pregnancies. Better understanding of the angioarchitecture and vascular function of monochorionic placentae will help describe the pathophysiology of disease in monochorionic pregnancies. Research in this area will guide risk stratification, non-invasive diagnosis and treatment strategies in MCDA twins, notably in relation to twin-twin transfusion syndrome (TTTS) and selective growth restriction. Here, we describe MRI and ultrasound advances in placental vascular imaging, including blood oxygenation level dependant (BOLD-MRI), low flow Doppler, and the development of high intensity focused ultrasound (HIFU) as a non-invasive treatment for TTTS and twin reversed arterial perfusion (TRAP) sequence in monochorionic twins.