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In turn, monochorionic\u2010monoamniotic (MCMA) gestations carry greater risks compared with monochorionic\u2010diamniotic (MCDA) gestations. While the true incidence of spontaneous septostomy of the dividing membranes (SSDM) in MCDA twins is unknown, SSDM has been demonstrated to be associated with increased morbidity and mortality, due to functional transition from a MCDA gestation to a MCMA gestation. We report a case of SSDM in a mid\u2010trimester MCDA gestation, review the literature, and describe how to identify and manage this complication.<\/jats:p>","DOI":"10.1002\/jcu.22931","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T03:25:02Z","timestamp":1601522702000},"page":"66-70","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Spontaneous septostomy in a monochorionic\u2010diamniotic twin gestation"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9663-5438","authenticated-orcid":false,"given":"Henry","family":"Adekola","sequence":"first","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine Southern Illinois University School of Medicine  Springfield Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth Ramsey","family":"Unal","sequence":"additional","affiliation":[{"name":"Department of 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