This four-page reference guide was made for fast use in the clinic or on the ward and distills practical points on ultrasound patterns, differential risks by chorionicity, recommended surveillance, and family-centered communication.  This quick reference complements evidence-based protocols and published guidelines/reviews. Providers can keep a copy of both the VTS Provider Quick Reference and the Prenatal VTS Patient Checklist in clinical settings. Encourage patients to bring the checklist to visits to guide open discussion about diagnosis, risks, follow-up, and emotional well-being.

Who this is for

• Ob/Gyn, MFM, and midwifery clinicians seeking a quick, clinically oriented aid

• Nurses, sonographers, and bereavement teams coordinating patient education and support pathways

• Neonatology and pediatrics teams planning postnatal assessments after fetal demise in a multiple gestation.

What’s inside

• Antenatal diagnosis: VTS definition, typical ultrasound patterns, chorionicity assessment

• Risk & monitoring cues: what to prioritize for dichorionic vs monochorionic twins (e.g., growth, MCA-PSV Dopplers, neurosonography/F-MRI when indicated)

• Prenatal preparation of disposition and memorialization of fetal remains: clinical documentation, legal and institutional awareness, compassionate communications, and cultural sensitivity

• Postnatal considerations: neonatal assessment, neuroimaging triggers, placental pathology notes

• Family & psychosocial care: language tips, bereavement resources, and follow-up planning

• References to relevant professional guidelines

Why it matters

VTS is often unseen but impactful. Clear, consistent communication and chorionicity-aware monitoring can improve clinical decision-making and help families feel acknowledged and supported during ongoing pregnancy and beyond.