What are the recommended weekly biophysical profiles for monochorionic twins starting at 32 weeks?

The recommended schedule for biophysical profiles (BPP) in monochorionic twins starting at 32 weeks is to perform them on a weekly basis. This approach is crucial due to the unique risks associated with monochorionic twins, including the potential for twin-to-twin transfusion syndrome (TTTS), growth discordance, and other complications that can arise as the pregnancy progresses.

Weekly monitoring allows for timely detection of any concerning changes in fetal well-being, which is essential for ensuring the best outcomes for both twins. Early identification of issues such as oligohydramnios, abnormal fetal heart patterns, or growth abnormalities can prompt appropriate interventions or delivery to optimize the health of the fetuses.

Scheduling biophysical profiles less frequently, such as every two weeks, every three weeks, or two per week, may not provide adequate monitoring for the potential complications that can arise in monochorionic twins as gestation advances, thereby increasing the risk of adverse outcomes.