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When diamniotic twins suddenly become monoamniotic twins: spontaneous septostomy of the dividing membrane
  1. Angela Vidal,
  2. Cristina Nastasia,
  3. Markus Hodel and
  4. Joachim Kohl
  1. Departament of Obstetrics and Gynecology, Cantonal Hospital Lucerne, Luzern, Luzern, Switzerland
  1. Correspondence to Dr Angela Vidal; vidalgutierrez.angelamaria{at}


In twin pregnancies, amnionicity and chorionicity are crucial as they strongly determine prenatal and perinatal management. First trimester ultrasound allows a highly reliable diagnosis of amnionicity and chorionicity, making it an internationally accepted standard in antenatal care. However, in rare cases, amnionicity can change from diamniotic to monoamniotic throughout pregnancy, substantially impacting perinatal management. We report the case of a confirmed monochorionic diamniotic twin pregnancy with a diagnosis of spontaneous septostomy of the dividing membrane (SSDM) at 28 weeks of gestation, resulting in a pseudomonoamniotic pregnancy. Even though SSDM is a rare condition and its sonographic diagnosis might be challenging, it should be considered if, in a known diamniotic pregnancy, there is a sudden failure to visualise the intertwin membrane truly separating both twins.

  • pregnancy
  • materno-fetal medicine
  • radiology

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  • Contributors AV conceived the presented idea and perdormed the literatur research. Treatment was carried out by JK and MH. The manuscript was drafted by AV and CN and crttically reviewed by all authors. The final manuscript was approved by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.