I have just been reading an article in the latest Midwives magazine, and came across an article on this.

I have never even heard of it, but found it very interesting. It occurs in twin pregnancies. According to the article it is a 'medicalised term for sharing a placenta.
This happens because a single embryo divides, but if this happens eight or nine days after fertilisation, then they share the same placenta and chorion, and are both in the same amniotic sac.

Monochorionic monoamniotic twins happen in only about 1% of of all twin pregnancies.

If there is a membrane, then the pregnancy will be given the term monochorionic diamniotic.

It is fascinating, and I just wondered if anyone else had heard about it, or know anything about it?

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Student Midwife 2007

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No, haven't heard about it but will definately do a bit of research into it now!!

xx

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Yup, I looked after a woman in my second year who had this, she came in at 32 weeks with niggling, she had, had a bad cough so she thought it was from the coughing that her stomach was irritable. My challenge was to set the CTG to monitor both twins. She was fine until I put her on the monitor, she got more and more tense, and her stomach was rock hard.
I went back and told my mentor something wasn't right, we'd only just obtained her notes and found out she was carrying mono-mono twins.
The consultant portable scanned her, and pointed to these pools of Liquor surrounding one twin, and said we've got to get her delivered immediately (I was in shock, and couldn't understand the urgency).
It turned out they had twin-to-twin transfusion, thus one was transfusing high levels of haemoglobin to the other, which was surrounded in all this Liquor as a result and the one doing the transfusing was IUGR.
Needless to say they were born by emergency c/section 10 minutes later, good result for mum, and the babies are now bounding 2 1/2 year olds full of it!!!
It was a wonderful experience, and good to see swift action on the staffs behalf xx

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What a brilliant experience Tracy,

I am so glad Mum & babies were ok, makes it all worthwhile doesn't it?

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There are two types of twins: monozygote and dizygote. The first one originates from one egg and one sperm like missy told. A dizygote twin are two fertilized eggs like any other normal siblings, only now in one pregnancy. Therefore dizygote twins always have their own placenta, amnion and chorion. Monozygote twins can have all forms:
- seperate chorion (therefore also seperate amnion) (dichorionic diamniotic)
- shared chorion but separate amnion (monochorionic diamniotic) and
- shared amnion (and therefore also shared chorion) (monochorionic monoamniotic).
It's no coincidence one monozygote twin will share its amnion or not, it all depends on the moment the embryo divides. The earlyer this happens, the less the babies share. If the embryo tries to divide after 14 days, you get a siamese twin. TTTS (twin to twin transfusion syndrome) only occurs in monozygote twins.
After the twin is born you often can't tell the difference between monochorionic diamniotic and dichorionic placenta. The pathologist injects some fluid through the veins to see if the veins go from one side of the middle membrane to the other. If so, it's a monochorionic twin.

I just love the twin subject

Oh wow,

Thanks for all that information Jen,

That's really interesting.

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Bless you Mum & Dad x
Student Midwife 2007

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Educational Resources Manager

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Hey great post Jen, I'd have to recheck my books to remember it in such depth I just think mono 1 di 2
haha I'm a simple gal xx

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