Nisha Kumari

Nightingale institute of nursing , India

Presentation Title:

Two hearts, One rhythm: Monochorionic diamniotic twins

Abstract

Monochorionic diamniotic (MCDA) twin pregnancies, a rare subset of monozygotic twinning, result from the division of a single fertilised egg, typically between the fourth and eighth day post-conception. These twins share a common chorion but possess separate amniotic sacs, placing them at increased risk of complications due to shared placental circulation and unequal placental sharing. Despite constituting approximately 30% of twin pregnancies, MCDA twins account for the majority of monozygotic twinning cases and are associated with significantly higher perinatal morbidity and mortality rates compared to dichorionic twins. This paper presents a case scenario of a 25-year-old primigravida with a 40-week MCDA twin pregnancy. Diagnosis was confirmed via ultrasound, revealing one fetus in breech and the other in cephalic presentation. Following an elective caesarean section, the patient developed atonic postpartum hemorrhage (PPH), a major risk in multiple pregnancies due to uterine overdistension. Emergency management with a Bakri balloon and gauze packing successfully controlled the bleeding. The patient was closely monitored in a high-dependency unit and recovered without further complications. MCDA pregnancies are known for unique risks, including twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and increased likelihood of structural anomalies. The presence of interfetal vascular anastomoses increases the risk of hemodynamic imbalance and fetal demise. Maternal complications such as anemia, polyhydramnios, and pre-eclampsia are also more prevalent. This case emphasizes the importance of early diagnosis, continuous fetal surveillance, and preparedness for obstetric emergencies. Proper antenatal care and timely interventions can greatly improve maternal and neonatal outcomes in MCDA twin pregnancies. Given the complexity and high-risk nature of such cases, a multidisciplinary approach is essential for optimal perinatal management.

Biography

Ms. Nisha Kumari completed her M.Sc. in Nursing with a specialization in Obstetrics and Gynecology in 2023 from Jamia Hamdard University, Delhi, India. She is currently working as a Lecturer at Nightingale Institute of Nursing, Noida. Ms. Kumari has a strong academic and research background, with publications in UGC-recognized journals. Her areas of interest include maternal health, women's reproductive health, and evidence-based nursing practice. She continues to contribute to the academic community through her teaching and ongoing research activities.

4th International Conference on Midwifery and Women's Healthcare

Nisha Kumari

Presentation Title:

Two hearts, One rhythm: Monochorionic diamniotic twins

Abstract

Biography

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