Zumaeta, Alicia MazerGil, Maria MarRodriguez-Fernandez, MiguelCarretero, PilarOchoa, Jose HectorCasanova, Maria CristinaMolina, Francisca Sonia2023-05-032023-05-032022-08-11Mazer Zumaeta, A; Gil, M Mar; Rodríguez-Fernández, M; Carretero, P; Ochoa, J; Casanova, M C; et al. Selective Fetal Growth Restriction in Monochorionic Diamniotic Twins: Diagnosis and Management. Maternal-Fetal Medicine 4(4):p 268-275, October 2022.2096-6954http://hdl.handle.net/10668/19847Selective fetal growth restriction (sFGR) is a severe condition that complicates 10% to 15% of all monochorionic diamniotic (MCDA) twin pregnancies. Pregnancies complicated with sFGR are at high risk of intrauterine demise or adverse perinatal outcome for the twins. Three clinical types have been described according to the umbilical artery (UA) Doppler pattern observed in the smaller twin: type I, when the UA Doppler is normal; type II, when there is persistent absent or reversed end-diastolic blood flow in the UA Doppler; and type III, when there is intermittent absent and/or reversed end-diastolic blood flow in the UA Doppler. Clinical evolution and management options mainly depend on the type of sFGR. Type I is usually associated with a good prognosis and is managed conservatively. There is no consensus on the management of types II and III, but in earlier and more severe presentations, fetal interventions such as selective laser photocoagulation of placental anastomoses or selective fetal cord occlusion of the smaller twin may be considered. This review aims to provide updated information about the diagnosis, evaluation, follow-up, and management of sFGR in MCDA twin pregnancies.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/TwinsMonochorionic diamniotic twinsSelective fetal growth restrictionBirthweight discordanceFetal therapyPlacentaUmbilical artery dopplerEnd-diastolic flowIntermittent absentPregnanciesPhotocoagulationUltrasoundPregnancyFemaleFetal Growth RetardationUmbilical ArteriesFollow-Up StudiesParturitionPrognosisLasersDecision Support Techniquesreviewopen accessArterias umbilicalesEmbarazoEstudios de seguimientoFemeninoPartoPronósticoRayos LáserRetardo del crecimiento fetalTécnicas de apoyo para la decisión10.1097/FM9.00000000000001712641-5895https://doi.org/10.1097/fm9.0000000000000171870909000009