Call to action: long-term neurodevelopment in monochorionic twins.

There is much to celebrate in the increasingly successful management of complicated monochorionic (MC) multiple pregnancy over the last three decades. We know that children born after a multiple pregnancy exhibit differences in neurodevelopment compared to their singleton counterparts and that these differences can be related to chorionicity, complications during pregnancy and fetal number5. It is important to emphasize that evidence derived from uncomplicated MC twin pregnancies cannot be extrapolated to complicated MC twin pregnancies, particularly after fetal interventions, because the nature of the prenatal insults and natural history of each MC twin pregnancy complication is different from the natural history of uncomplicated MC twin pregnancy36,37. Neurodevelopmental impairment in uncomplicated monochorionic pregnancy The prevailing assumption is that the majority of cases of NDI observed in multiple pregnancies are due to increased iatrogenic and spontaneous preterm birth, with the additional contribution of monochorionicity-specific complications in MC pregnancies. [Extracted from the article]