22 weeks twin pregnancy. Routine antenatal ultrasound.
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Transverse image of the placenta reveals a triangular peak of villi extending from the placenta into the intertwin membrane.
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The twin peak sign indicates the presence of a dichorionic-diamniotic twin gestation. It represents the extension of placental villi into the potential space that is formed from the reflection of opposed amniotic and chorionic layers from each fetus.