6) Multiple Pregnancy Flashcards
1
Q
What is the Definition of “Multiple Pregnancy”?
A
- It’s pregnancy with more than one fetus
2
Q
What are the Causes of Multiple Pregnancy?
A
- Older than 35 Years Old - Due to *Increased Gonadotropin Production
- Previous Multiple Gestation
- Family History of Dizygotic Twins
- Assisted Reproductive Technology (ART)
3
Q
What are the Types of Twins?
A
1) MONOZYGOTIC (Identical)
- Fertilised Oocyte divides into –> 2 embryonic layers
2) DIZYGOTIC (Fraternal)
- Fertilisation of 2 Oocytes, by 2 Mature Spermatozoa
4
Q
What are the Types of Chorionic & Amniotic Division?
A
1) Dichorionic-Diamniotic (DIZYGOTIC Twins)
- Twins have 2 Separate Placentas, but SHARE Amniotic Sac
2) Monochorionic-Diamniotic
- Twins share SAME Placenta, but have own amniotic sac
3) Monochorionic-Monoamniotic
- Twins SHARE BOTH Placenta + Amniotic Sac
5
Q
What are the Clinical Features in Multiple Pregnancy?
A
- Hyperemesis, Fatigue
- Iron Deficiency Anemia
- Increased Heart Rate / Stroke Volume
- Back / Ligament Pain
- Increased Appetite
6
Q
How is Multiple Pregnancy Diagnosed / DDx?
A
- Ultrasound at 1st Trimester
- Assess Fundal Height
- Leopold’s Maneuver
DIFFERENTIAL DIAGNOSIS
- Polyhydraminos
- Fibroids
- Abdominal Cyst
7
Q
What are the Maternal & Fetal COMPLICATIONS of Multiple Pregnancy?
A
MATERNAL
- Placental Abruption, Previa
- C-Section
- Preterm Labor
- Preeclampsia (HELLP Syndrome)
- Gestational Diabetes
- Pulmonary Embolism
FETAL
- Prematurity
- Cord Prolapse
- Congenital Anomalies
- Neural Tube Defects
- Intrauterine Growth Restriction
8
Q
How is Multiple Pregnancy Managed?
A
- Regular Visits - check for twin-twin transfusion
- Vaginal Delivery - ONLY for DIAMNIOTIC Twins with fetus in vertex presentation
- C-Section - For Monochorionic- monoamniotic twins, Breech Presentation
- Induction of Labor - For Dichorionic-diamniotic twins
