If placenta previa or low-lying placenta has been suggested previously, assessment of the location of placental edge can be performed on surveillance examinations. US Duplex Doppler Fetal Middle Cerebral Artery If there is a risk for fetal anemia or if fetal hydrops is noted during evaluation, fetal MCA Doppler can be performed and interpreted using established nomograms. US duplex Doppler fetal MCA is generally not useful for surveillance of uncomplicated DC or multichorionic gestations. US Duplex Doppler Fetal Umbilical Artery If growth restriction or amniotic fluid abnormalities (oligohydramnios) are noted during antepartum surveillance, fetal UA Doppler can be performed. US duplex Doppler fetal UA is generally not useful for surveillance of uncomplicated DC or multichorionic gestations. US Echocardiography Fetal Echocardiography can be performed for surveillance of DC or multichorionic gestations when cardiac defects or secondary cardiac decompensation is suspected or observed. Uncomplicated DC or multichorionic gestations do not need routine fetal echocardiographic follow-up. US Pregnant Uterus Biophysical Profile BPP can be performed in the late second and third trimesters for assessing fetal well-being. To date, there are insufficient data in the literature to suggest that antenatal surveillance of twins with BPP is beneficial in the setting Multiple Gestations of reactive nonstress test or in the absence of associated risk factors [62,63]. US Pregnant Uterus Transabdominal Transabdominal US of the pregnant uterus remains the mainstay for the evaluation of DC or multichorionic gestations. At each US scan, the following should be assessed: fetal biometry, amniotic fluid volume, and key features of fetal anatomy. Due to variability and SDs in measurements, growth assessment, and biometry are usually performed no more frequently than every 2 weeks. It is suggested that the discordance in estimated fetal weights be calculated and documented at each scan.
Multiple Gestations. If placenta previa or low-lying placenta has been suggested previously, assessment of the location of placental edge can be performed on surveillance examinations. US Duplex Doppler Fetal Middle Cerebral Artery If there is a risk for fetal anemia or if fetal hydrops is noted during evaluation, fetal MCA Doppler can be performed and interpreted using established nomograms. US duplex Doppler fetal MCA is generally not useful for surveillance of uncomplicated DC or multichorionic gestations. US Duplex Doppler Fetal Umbilical Artery If growth restriction or amniotic fluid abnormalities (oligohydramnios) are noted during antepartum surveillance, fetal UA Doppler can be performed. US duplex Doppler fetal UA is generally not useful for surveillance of uncomplicated DC or multichorionic gestations. US Echocardiography Fetal Echocardiography can be performed for surveillance of DC or multichorionic gestations when cardiac defects or secondary cardiac decompensation is suspected or observed. Uncomplicated DC or multichorionic gestations do not need routine fetal echocardiographic follow-up. US Pregnant Uterus Biophysical Profile BPP can be performed in the late second and third trimesters for assessing fetal well-being. To date, there are insufficient data in the literature to suggest that antenatal surveillance of twins with BPP is beneficial in the setting Multiple Gestations of reactive nonstress test or in the absence of associated risk factors [62,63]. US Pregnant Uterus Transabdominal Transabdominal US of the pregnant uterus remains the mainstay for the evaluation of DC or multichorionic gestations. At each US scan, the following should be assessed: fetal biometry, amniotic fluid volume, and key features of fetal anatomy. Due to variability and SDs in measurements, growth assessment, and biometry are usually performed no more frequently than every 2 weeks. It is suggested that the discordance in estimated fetal weights be calculated and documented at each scan.