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Twin twin transfusion syndrome (ttts) complicates up to 15% of identical twins The team for twin deliveries consists of fm residents and staff, ob residents and staff, neonatal intensive care staff, anesthesiologist and two nurses on site in the delivery room. It is due to unequal sharing of blood volume across blood vessel connections in a monochorionic placenta.

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In ttts, unequal blood flow between twins sharing a placenta results in recipient twin (right) having too much amniotic fluid (polyhydramnios), and donor twin (left) with little or no amniotic fluid (oligohydramnios). This report summarizes the assessment of the state of digital twin practices in the department of defense (dod) and the relevant verification, validation, and accreditation (vv&a) body of work, as well as a plan to use commercial virtualization technology in weapon systems and for deployed forces. The society presents updated versions of these 2 checklists reflecting recent changes in practice recommendations.