Review: PDF OnlyComplications of Monochorionic Diamniotic Twins Stepwise Approach for Early Identification, Differential Diagnosis, and Clinical ManagementMicheletti, Talita1,2; Eixarch, Elisenda1,2,3; Bennasar, Mar1,2; Martinez, Josep María1,3; Gratacos, Eduard1,2,3,4,*Editor(s): Pan, Yang Author Information 1BCNatal – Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona 08028, Spain 2Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona 08036, Spain 3Centre for Biomedical Research on Rare Diseases (CIBER-ER) Madrid 28029, Spain 4Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat 08950, Spain. Corresponding author: Prof. Eduard Gratacos, BCNatal – Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona 08028, Spain. E-mail: [email protected] Received May 3, 2020 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 Maternal-Fetal Medicine: September 25, 2020 - Volume Latest Articles - Issue - doi: 10.1097/FM9.0000000000000076 Open PAP Metrics Abstract One in three monochorionic twins may develop complications during pregnancy. Monochorionic twins, especially monochorionic diamniotic (MCDA), present specific problems caused by the presence of interfetal placental anastomoses. The first critical step in the management of MCDA twins is identification in the first trimester. Secondly, close follow-up every 2 weeks is mandatory to allow early diagnosis and timely treatment of twin-twin transfusion syndrome. Other potentially severe complications include selective fetal growth restriction, twin anemia polycythemia syndrome or single fetal death. Thirdly, a correct differential diagnosis is critical to establish the best therapy. This may represent a clinical challenge since MCDA twin complications often overlap. A simple diagnostic algorithm may be of great help to establish the right diagnosis and management option. In this review we summarize the main steps for the clinical follow-up, differential diagnosis, and targeted management of MCDA twins complications. © 2020 by Lippincott Williams & Wilkins, Inc.