Objective: To compare the rate and type of congenital anomalies in twin pregnancies in relation to chorionicity. Methods: This was a retrospective study from 06/2002 to 10/2008 including 360 monochorionic (MC) and 770 dichorionic (DC) twin pairs with targeted ultrasound examination between 11 and 32 weeks' gestation in a tertiary level setting. Results: The rate of malformations was 8.9% (64/720) in monochorionic and 6.1% (94/1540) in dichorionic twins (p < 0.05). Malformations were isolated in 5.3% (38/720) and 4.7% (72/1540) and complex in 3.6% (26/720) and 1.4% (22/1540) of MC and DC twins (p < 0.005), respectively. The most common anomalies in both twins were cardiovascular anomalies (MC 2.1%, DC 1.5%) and anomalies of the central nervous system (CNS) (MC 1.0%, DC 1.4%). There was an equal prevalence of anomalies of the genitourinary system (MC 1.1%, DC 0.9%), thoraco-abdominal system (MC 0.6%, DC 0.5%), and the extremities (MC 0.6%, DC 0.4%). Conclusion:There was a 1.5 times higher risk for fetal malformations in MC pregnancies. The excess risk was mainly attributed to the higher rate of complex anomalies. While the rate of cardiac abnormalities was higher in MC twins, the rate of CNS abnormalities was lower compared to DC twins.
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