Complicated Twin Pregnancies Publications

The following list of publications will help you in your search for more information about complicated monochorionic twin pregnancies, including twin reversed arterial perfusion (TRAP) sequence, twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR) and conjoined twins. Most are written by members of the Fetal Diagnosis and Treatment team at The Children's Hospital of Philadelphia. If you are unable to obtain any of these publications, please let us know, and we will send copies to you.

Journal articles


Heuer GG, Madsen PJ, Flanders TM, Kennedy BC, Storm PB, Taylor JA. Separation of Craniopagus Twins by a Multidisciplinary Team. N Engl J Med. 2019 Jan 24. 380:358-364.


Moldenhauer JS, Johnson MP. Diagnosis and Management of Complicated Monochorionic Twins. Clin Obstet Gynecol. 2015 Sep;58(3):632-42. Read the abstract.


Oliver ER, Coleman BG, Goff DA, Horii SC, Howell LJ, Rychik J, Bebbington MW, Johnson MP. Twin reversed arterial perfusion sequence: a new method of parabiotic twin mass estimation correlated with pump twin compromise. J Ultrasound Med. 2013 Dec;32(12):2115-23. doi: 10.7863/ultra.32.12.2115. Read the abstract.

Hackney DN, Khalek N, Moldenhauer J, Ozcan T. Twin-twin transfusion syndrome presenting as polyhydramnios in both fetuses secondary to spontaneous microseptostomy. AJP Rep. 2013 Oct;3(2):83-6.

Khalek N, Johnson MP, Bebbington MW. Fetoscopic laser therapy for twin-to-twin transfusion syndrome. Semin Pediatr Surg. 2013 Feb;22(1):18-23. Read the abstract.


Bebbington MW, Danzer E, Moldenhauer J, Khalek N, Johnson MP. Radiofrequency ablation vs bipolar umbilical cord coagulation in the management of complicated monochorionic pregnancies. Obstet Gynecol. 2012 Sep;40(3):319-24. Read the abstract.


Rychik J, Tian Z, Bebbington M, Moldenhauer J, Khalek N, Johnson M. Response to “Evaluation of the cardiovascular system in twin-twin transfusion syndrome: It's not about 'scores' but about 'goals'.” [Letter] Ultrasound in Obstetrics & Gynecology 36(5):647-648, Nov. 2010.

Skupski DW, Luks FI, Walker M, Papanna R, Bebbington M, Ryan G, et al. Preoperative predictors of death in twin-to-twin transfusion syndrome treated with laser ablation of placental anastomoses. Am J Obstet Gynecol. 2010 Oct;203(4):388.e1-388.e11. Epub 2010 Aug 9. Cited in PubMed; PMID 20691964. Read the abstract.

Bebbington M, Tiblad E, Huesler-Charles M, Wilson R, Mann S, Johnson M. Outcomes in a cohort of patients with stage 1 twin-to-twin transfusion syndrome (TTTS). Ultrasound Obstet Gynecol. 2010 July; 36(1): 48-51. [Epub ahead of print] Read the abstract.


Wilson RD, Johnson A, Ryan G. Current controversies in prenatal diagnosis 2: Should laser ablation of placental anastomoses be used in all cases of twin to twin transfusion? Prenat Diagn. 2009 Jan;29(1):6-10. No abstract available


Ilagan JG, Wilson RD, Bebbington MW, Johnson MP, Hedrick HL, Kiechty KW, et al. Pregnancy outcomes following bipolar umbilical cord cauterization for selective termination in complicated monochorionic multiple gestations. Fetal Diag and Therapy 2008; 23:153-158. Cited in PubMed; PMID 18042995.


Delisle MF, Brosseuk L, Wilson RD. Amniocentesis for twin pregnancies: Is alpha-fetoprotein useful in confirming that the two sacs were sampled? Fetal Diag and Therapy 2007;22: 221-225. Cited in PubMed; PMID 17228163.

Rychik J, Tian Z, Bebbington M, Xu F, McCann M, Mann S, et al. The twin-twin transfusion syndrome: Spectrum of cardiovascular abnormality and development of a cardiovascular score to assess severity of disease. Am J Obstet Gynecol 2007: 197:392f.e1-392.e8. Cited in PubMed; PMID 17904973. Read the abstract.

Crombleholme TM, Shera D, Lee H, Johnson MP, D'Alson M, Porter F, et al. A prospective, randomized, multicenter trial of amnioreduction vs selective fetoscopic laser photocoagulation for the treatment of severe twin-twin transfusion syndrome. Am J Obstet Gynecol 2007; 197:396.e1-369.e9. Cited in PubMed; PMID 17904975.


von Dadelszen P, Kives S, Delisle MF, Wilson RD, Joy R, et al. The association between early membrane rupture, latency, clinical chorioamnionitis, neonatal infection, and adverse perinatal outcomes in twin pregnancies complicated by preterm prelabour rupture of membranes. Twin Research, Vol 6(4):257-262, August 2003. Cited in PubMed; PMID 14511428.


MacKenzie TC, Crombleholme TM, Johnson MP, Schnaufer L, Flake AW, Hedrick HL, et al. The natural history of prenatally diagnosed conjoined twins. Journal of Pediatric Surgery 37:303-309, 2002. Cited in PubMed; PMID 11877639.


DeLia JE, Kuhlman RS, Clark SA: Fetoscopic laser treatment of twin-twin transfusion syndrome: Expectations and results post learning curve. Fetal Diagn Ther, 13(5), 1998.


Ville Y, Hyett K, et al: Preliminary experience with endoscopic laser surgery for severe twin-twin transfusion syndrome. N Engl J Med, 332:224-227, 1995.

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