双胎妊娠中单绒毛膜双羊膜囊（MCDA）双胎的管理是围产医学中的难点。由于2个胎儿共用1个胎盘，当MCDA双胎中1个胎儿存在畸形时，临床咨询面临诸多挑战。对于此类复杂双胎，应转至有宫内治疗能力的胎儿医学中心进行咨询、随访及诊治，提供个体化的临床咨询及处理。处理方案应根据MCDA双胎之一畸形的类型、严重程度，以及是否会对另一个胎儿产生影响等进行制定。应遵循最大限度减少对健康胎儿和母体影响的原则，同时充分尊重父母的决定。制定个性化方案，实施从产前到分娩乃至新生儿阶段的序贯化、一体化管理模式。

The management of monochorionic diamniotic（MCDA）twins is a challenge in perinatal medicine. Since the two fetuses share a single placenta，clinical consultation faces numerous challenges when one of the MCDA twins has discordant structural malformations. For such complex twins，referral to a fetal medical center with intrauterine treatment capabilities is necessary for consultation，follow-up and management. Individualized clinical counseling and management should be provided. The management plan should be formulated based on the type and severity of the malformations，as well as the impact on the other fetus. The principle of minimizing the impact on the healthy fetus and the mother should be followed;meanwhile the parents also be fully respected in making decisions. A personalized plan should be made to implement a sequential and integrated management model from the prenatal stage to through delivery and even to the neonatal period.