Dichorionic Diamniotic Twins Flashcards
What is the most common type of twinning?
Dyzygotic twinning
How frequently does dichorionic twinning occur in spontaneous conceptions?
8/1000 are dizygotic dichorionic twins
Describe ultrasound features characteristic for dichorionic twin gestation.
Lambda/twin peak sign
Thickness of intertwin membranes >= 2 mm
4 layers of membranes (amnion, chorion, chorion and amnion)
When is ultrasound the most accurate at establishing chronicity in multiple gestations?
By 13 6/7 weeks
Maternal risks of pregnancy with dichorionic twins?
Hyperemesis Gestational diabetes Hypertensive disorders Anemia Hemorrhage Cesarean delivery Postpartum depression
Fetal risks of pregnancy with dichorionic twins?
Preterm delivery
IUGR
Stillbirth
Complication of prematurity.
ow do you follow di/di twins throughout gestation?
Fetal growth every 4-6 weeks
Do you follow/perform cervical length screening in twins?
No
What are the options for aneuploidy screening in twins?
NT
NIPT
Diagnostic studies
When do you recommend delivery is an uncomplicated dichorionic twin gestation?
38 weeks of gestation
Indications for cesarean in a di/di twin gestation?
Malpresentation
<32 weeks vtx/nonvertex
Other routine obstetrical indications
What percentage of twins/triplets and quads leads to a vanishing twin?
36% of twins, 53% of triplets, and 65% of quadruplets
What percentage of twins and triplets undergo death of one or more fetuses in the second trimester and third trimester
5% of twins and 17% of triplets
How do you follow a patient following a dichorionic cotwin demise in the first trimester?
Routine obstetric care
How do you manage a patient with twins and history of a prior spontaneous preterm birth?
May consider cervical length screening and prophylactic cerclages
