With the studies described in this thesis, we were able to investigate cardiovascular compromise in complicated monochorionic twin pregnancy in great detail.All clinicians caring for monochorionic... Show moreWith the studies described in this thesis, we were able to investigate cardiovascular compromise in complicated monochorionic twin pregnancy in great detail.All clinicians caring for monochorionic twins should perform an echocardiogram at mid‑gestation and should carefully examine both neonates at birth. In case of abnormal perioperative fetal Dopplers in twin-twin transfusion syndrome (TTTS), we should be aware of the increased risk of fetal demise or neurodevelopmental impairment. In all surviving TTTS twins, but also in twin pregnancies with selective fetal growth restriction, cardiac abnormalities should be ruled out by follow-up fetal and neonatal echocardiography. Routine long‑term follow-up should be available to all TTTS twins, since TTTS may also have an impact beyond the perinatal phase.Furthermore, both color‑coded Tissue Doppler Imaging (cTDI) and myocardial performance index (MPI) are potentially valuable techniques which can be used in the risk stratification in monochorionic twins. Show less