The Green Room: A Podcast from Obstetrics & Gynecology May 2025: Obstetrics
Apr 17, 2025
Joining the discussion is Dr. Lynn L. Simpson, a leading expert in maternal-fetal medicine and chief at Columbia University. She dives into the intricacies of monochorionic twin pregnancies, emphasizing ultrasound's crucial role in early diagnosis. The conversation highlights the challenges of conditions like twin-twin transfusion syndrome and the significance of accurate cervical length assessments. Dr. Simpson also sheds light on the latest practices to manage risks and optimize outcomes, making complex topics accessible and engaging.
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Get Early Ultrasound To Establish Chorionicity
- Obtain a first-trimester ultrasound early whenever twins are suspected to establish chorionicity and accurate dating.
- Ask the sonographer or MFM to clearly state chorionicity so you can plan surveillance and delivery timing.
Prefer NIPT Over Nuchal Translucency For Twins
- Use cell-free DNA (NIPT) in twin pregnancies because it outperforms nuchal translucency for aneuploidy screening.
- Practices still using NT-only screening should consider adopting NIPT for better detection of common aneuploidies.
Zygosity Does Not Replace Chorionicity Assessment
- Zygosity testing can help in specific situations but does not replace ultrasound for determining placentation.
- Most monozygotic twins are monochorionic, so ultrasound remains the primary tool for risk assessment.