Chorionicity is the number of placentae of a pregnancy. This is most accurately determined between weeks 6 and 9 of gestation, sometimes up to week 12. At this time, a thick membrane (two chorions and two amnions) is clearly visible at ultrasound, separating dichorionic twins, which joins the placenta to form a lambda shape. In monochorionic twins, this membrane (two amnions only) is much thinner and joins the placenta to form a “T” shape. Ultrasounds taken later in gestations are less reliable due to the increased crowding of twins in the uterus.
Physical examination of the inter-twin membranes at birth should also be used to determine chorionicity. This will provide confirmation of early ultrasound data and to determination of chorionicity in twins without early ultrasounds information. Dichorionic membranes are thick, opaque and can be pulled apart, whereas monochorionic membranes are thin and semi-transparent.
© A/Prof Mark Umstad and A/Prof Jeff Craig
For a review of the mechanisms and evidence for typical and atypical twinning, please click here