Course Description

Over the past decades there has been a steady increase in the rate of monochorionic twin pregnancies. In contrast to dichorionic twins the monochorionic placenta predisposes to specific complications such as twin-twin transfusion syndrome (TTTS), selective fetal growth restriction (sIUGR) and twin anemia-poycythemia sequence (TAPS), that benefit from early detection and intervention.

At the Center for Advanced Fetal Care at the University of Maryland Medical Center we have cared for complicated twin pregnancies referred to us nationally and internationally. This CME program featuring distinguished faculty from the University of Maryland School of Medicine will provide an overview of the focused evaluation of monochorionic multiple gestation, diagnostic criteria, management options and prenatal and postnatal outcomes following prenatal and postnatal interventions

Target Audience

This educational activity will be of interest to obstetricians, gynecologists, neonatologists, radiologists, maternal fetal medicine specialists and other health care professionals.

Topics will include:

• The Monochorionic Placenta and Its Specific Complications
• Assessing Risks in Monochorionic Twin Pregnancies
• Quintero & Gratacos Staging and Beyond
• Evolution of Fetoscopic Laser Techniques
• Coordinating Fetal Therapy for Complicated Monochorionic Twins
• Outcomes Following Fetoscopic Laser
• The Time After Fetal Therapy: Debate on Monitoring & Delivering
• Cardiac Complications in TTTS Survivors
• NICU Care and Beyond

Learning Objectives

At the conclusion of this course, participants should be able to:

• Review the physiology of twinning and clarify the pathologies that can arise as a result of monochorionic placentation
• Review and clarify the diagnostic and prognostic modalities available today, to identify complications specific to monochorionic pregnancies when they are still amenable to treatment
• Review the prenatal therapies available for complicated monochorionic pregnancies and the post natal outcomes that can be achieved with state of the art treatment

Acknowledgement of Commercial Support

This educational activity is partially supported by an educational grant from Samsung Medison.