M13: Multiples in Preg & Doppler Flashcards
SEE NORMAL TWINNING FROM OB/GYN 1
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why does chronicity refer to
when is it best determines
of placentas
b/w 10-14 wks
most important predictor of preg outcomes in twins
what signs do we look for
of placentas
lambda - means dichorionic, some of the placental tissue growing up b/w the membranes
T sign - monochorionic…. would have to be Mono/Di to see this
what does a thicker membrane b/w the fetuses suggest
dizygotic twins
most common type of monozygotic twins
monochorionic, diamniotic
whats a structure we can look for when to determine if there are 2 membranes
yolk sac
1 yolk sacs mean 1 membrane
least common type of monozygotic twins
monochorionic, monoamniotic
describe a papyraceous fetus
mummified skeletal remains of a demised twin… would occur later in gestation (if the demise is earlier body would reabsorb it)
when would mono/mono twins be conjoined
where are they most commonly conjoined
prognosis
if the egg splits after day 13
chest (thoracopagus) or abdomen (omphalopagus)
more are still born or die after 1 day of life
the majority of conjoined twins are what gender
female (70%)
what is diprosopus
duplication of anatomy or a single body part
what does TRAP syndrome stand for
other names
twin reversed arterial perfusion
acardiac parabolic twin
acardiac monster
w/ what type of twining does TRAP occur
mono/mono only
w/ TRAP, what type of connections are formed in the placenta
can be artery - artery
vein - vein
describe how TRAP syndrome works
the pump/donor twin pumps deoxygenated blood from the umbilical artery to the placenta… that blood is shunted along the surface of the placenta to the second acardiac twin… the deoxygenated blood enters the acardiac twin through the umbilical artery and leaves deoxygenated through the umbilical vein.
there is reversed flow in the umbilical artery of the acardiac twin
how does TRAP affect the development of the acardiac twin
-only the lower limbs and trunk will develop due to lack of nutrients and 02
-no heart of very abnormal, often no head
… acardiac twin is completely supplied by the donor twin
US appearance of TRAP
lack of separating membrane
inability to separate fetal parts
more than 3 vessel cord
complex anomalies
donor twin is at high risk for developing which condition
hydrous due to volume overload and high cardiac output… also leads to cardiac failure
what is a fetus in fetu
US appearance
a parasitic twin w/in the abdomen of its sibling
teratoma
what is a heterotypic preg
one normal preg
one ectopic
describe superfetation
fertilization of 2 separate ova months apart
on other type of abnormal twinning variation
hydatidiform mole w/ coexisting twin
complications w/ twins
twin to twin transfusion syndrome (TTTS) twin embolization premature delivery congenital anomalies cord accidents
w/ what type of twinning does TTTS occur
what is TTTS
monochorionic only
arteriovenous fistula in the placenta (A-A, V-V, A-V), high mortality rate
