Placental examination of dichorionic twins

Histological examination of the placenta in bichorionic multiple pregnancy — is a pathomorphological analysis of two separate or fused placentas that provided the life of each of the twins. In a dichorionic pregnancy, each fetus has its own amniotic membrane and its own chorion (placenta), which makes this study critically important for assessing the health of both children separately.

Research objective: The analysis allows us to determine how each fetus developed, whether blood circulation was adequate for both, and whether there are specific causes of deviations in the development of one or both babies. This study helps to differentiate genetic features from the influence of intrauterine factors (infections, placental insufficiency).

What does the pathologist evaluate:

• Placentation type: confirmation of the bichorial type (presence of a dividing septum consisting of four layers).

• The condition of each placenta: separate assessment of the mass, size and structure of the villi for each fetus.

• Vascular connections (anastomoses): Although they are rare in bichorionic pregnancies, their presence or absence is carefully checked.

• Pathologies of membranes and umbilical cords: assessment of the place of attachment of the umbilical cords (marginal, membranous), which in multiple pregnancies often causes developmental delay in one of the twins.

• Infectious and inflammatory changes: looking for signs of chorioamnionitis, which could affect both babies or just one of them.

Clinical significance: For pediatricians and neonatologists, the results of the study explain the difference in weight or health status of twins at birth. For parents and obstetricians-gynecologists, this is important information for planning subsequent pregnancies, as it allows to exclude or confirm recurring risk factors.

When is it prescribed:

• birth of twins (dichorionic diamniotic twins);

• significant difference in weight and development between fetuses (discordant growth);

• premature birth in multiple pregnancies;

• suspicion of intrauterine infection;

• the presence of complications (preeclampsia, placental abruption).