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Analysis of institutional authors

Micheletti TAuthorEixarch E.AuthorBennàsar MAuthorGratacós E.Corresponding Author

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October 11, 2021
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Review
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Complications of Monochorionic Diamniotic Twins: Stepwise Approach for Early Identification, Differential Diagnosis, and Clinical Management

Publicated to:Maternal-Fetal Medicine. 3 (1): 42-52 - 2021-01-01 3(1), DOI: 10.1097/FM9.0000000000000076

Authors: Micheletti, Talita; Eixarch, Elisenda; Bennasar, Mar; Martinez, Josep Maria; Gratacos, Eduard

Affiliations

Center for Biomedical Research on Rare Diseases - Author
Ctr Biomed Res Rare Dis CIBER ER, Madrid 28029, Spain - Author
Inst Invest Biomed August Pi I Sunyer IDIBAP, Barcelona 08036, Spain - Author
Inst Recerca St Joan Deu, Esplugas de Llobregat 08950, Spain - Author
Institut d'Investigacions Biomèdiques August Pi i Sunyer - IDIBAPS - Author
Institut de Recerca Sant Joan de Déu - Author
Univ Barcelona, BCNatal Fetal Med Res Ctr, Hosp Clin, Barcelona 08028, Spain - Author
Univ Barcelona, Hosp St Joan Deu, Barcelona 08028, Spain - Author
Universitat de Barcelona - Author
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Abstract

One in three monochorionic twins may develop complications during pregnancy. Monochorionic twins, especially monochorionic diamniotic (MCDA), present specific problems caused by the presence of interfetal placental anastomoses. The first critical step in the management of MCDA twins is identification in the first trimester. Secondly, close follow-up every 2 weeks is mandatory to allow early diagnosis and timely treatment of twin-Twin transfusion syndrome. Other potentially severe complications include selective fetal growth restriction, twin anemia polycythemia syndrome or single fetal death. Thirdly, a correct differential diagnosis is critical to establish the best therapy. This may represent a clinical challenge since MCDA twin complications often overlap. A simple diagnostic algorithm may be of great help to establish the right diagnosis and management option. In this review we summarize the main steps for the clinical follow-up, differential diagnosis, and targeted management of MCDA twins complications.

Keywords

anemia-polycythemia sequencediscordant malformationendoscopic laser-surgerymonochorionic diamniotic twin pregnancypeak systolic velocityperinatal managementplacental characteristicspregnancyradiofrequency ablationselective fetal growth restrictionserial amnioreductionsingle intrauterine fetal deathtransfusion syndrometwintwin anemia-polycythemia sequencetwin-twin transfusion syndromeumbilical artery dopplerAcute feto-fetal transfusionDiscordant malformationIntrauterine growth restrictionMonochorionic diamniotic twin pregnancyPregnancySelective fetal growth restrictionSingle intrauterine fetal deathTwinTwin anemia-polycythemia sequenceTwin-twin transfusion syndrome

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Maternal-Fetal Medicine, Q4 Agency Scopus (SJR), its regional focus and specialization in Obstetrics and Gynecology, give it significant recognition in a specific niche of scientific knowledge at an international level.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 2.44, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-26, the following number of citations:

  • WoS: 5
  • Scopus: 5

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-26:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 33.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 37 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 0.5.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
  • Additionally, the work has been submitted to a journal classified as Diamond in relation to this type of editorial policy.

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Micheletti Helfer, Talita) and Last Author (Gratacós Solsona, Eduard).

the author responsible for correspondence tasks has been Gratacós Solsona, Eduard.