Placenta angio-architecture and origin of monochorial pathology

Abstract

Chorio-angiopagus twins (fetuses sharing one placenta) may exclusively show asymmetry in the distribution of placental territories with high incidence of marginal insertion and sometimes velamentous placenta as well as twin-twin transfusion (acute or chronic) produced by vessel communications (placental anastomosis). A series of fetal phenotypes may result including twin-to-twin transfusion syndrome, selective intrauterine growth restriction, anemia-polycythemia syndrome, and twin reversed arterial perfusion – TRAP- sequence; they may coexist. It is therefore important to study placental angioarchitecture in monochorionic twins in order to understand resulting both outcome and phenotype.