8 multiple gestations

Question 1

Types of twins, based on placenta/sacs

-what are their complications?

Answer 1

Dizygotic vs monozygotic.

1. Di/di: Lowest pregnancy risk. Possible “vanishing twin” that disappears by end of 1st trimester
2. Mono/di (1 placenta, 2 sacs): twin-twin transfusion
3. mono/mono: cord entanglement, conjoined

Question 2

Twin-twin transfusion

-which baby does better and why

Answer 2

Mono/di twins. The smaller twin will donate its blood supply to the larger baby. The small twin does better b/c of reduced bilirubin load, despite low birth weight.

Question 3

Monozygotic twins: when after conception do they separate?

1. di/di
2. mono/di
3. mono/mono
4. conjoined

Answer 3

1. days 0-3
2. 4-8
3. 9-12
4. >12

Question 4

All twins: increased risk of what important complications and why (3)

Answer 4

1. Preterm labor. for every extra gestation, subtract 4 weeks from due date
2. malpresentation–even if 1 is malpresented, must do C/S
3. PPH (post partum hemorrhage)–uterus was penetrated in multiple locations