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Selective Fetal Growth Restriction in Monochorionic Twin Pregnancy: A Review of Current Literature on Diagnostic and Therapeutic Updates

Year: 2026

Type: article

Abstract: Monochorionicity refers to the condition in which twins share a single placenta. Selective fetal growth restriction (sFGR) in monochorionic (MC) twin pregnancy poses significant challenges due to its association with high risks of perinatal mortality and morbidity. Managing sFGR poses a particular challenge, as affected pregnancies require more frequent monitoring compared to uncomplicated singleton or twin pregnancies. Expectant management is typically applied for type I cases, which generally have favorable outcomes. In contrast, more severe cases (type II and III) may require invasive management, such as fetoscopic laser photocoagulation (FLP) or selective termination. However, how to best manage this complicated pregnancy remains debated, as no evidence-based guidance is currently available. This review aims to summarize the underlying pathophysiology, various diagnostic criteria, classification systems, and current management strategies for sFGR. These include the perinatal outcomes associated with expectant and invasive management in sFGR.

Source: Siriraj Medical Journal/San Sirirat

DOI: 10.33192/smj.v78i2.278098

Authors: Fransiscus Octavius Hari Prasetyadi, Cecilia Putri Tedyanto, Vashti Saraswati

Institutions: Universitas Hang Tuah, Universitas Katolik Widya Mandala Surabaya, Universitas Airlangga

Language: English

Topic: Assisted Reproductive Technology and Twin Pregnancy

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7127043747

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