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Multifetal Flashcards

1
Q

What is a succenturiate lobe placenta?

an abnormal placenta

an accessory lobe placenta

a non-functioning placenta

all placentas are called this

A

an accessory lobe placenta

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2
Q

A boy fetus and a girl fetus tells us that the pregnancy is:

monochorionic, monoamniotic

dizygotic

monozygotic

monochorionic, diamniotic

A

dizygotic

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3
Q

Cleavage of the zygote after day 14 results in:

monochorionic monoamniotic twins

monochorionic diamniotic twins

dichorionic diamniotic twins

conjoined twins

A

conjoined twins

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4
Q

What is the main factor that causes increased mortality of monoamniotoic twins?

2 vessel cord

cord entanglement

3+ vessel cord

A

cord entanglement

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5
Q

In monozygotic twinning, if there are 2 chorions, 2 amnions, and 2 placenta when did cleavage of the zygote occur?

4 days or earlier

between 4 and 8 days

8 days or more

13 day

A

4 days or earlier

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6
Q

If you have 1 chorion and 1 amnion with 2 fetuses sharing a placenta this is considered:

monochorionic monoamniotic

monochorionic diamniotic

dichorionic diamniotic

dizygotic

A

monochorionic monoamniotic

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7
Q

Monoamniotic Twins are at risk for all of the same complications as monochorionic twins includes:

TRAP

TTTS

TES

Cord entanglement

A

TTTS

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8
Q

Monochorionic diamniotic means there are ___chorions and ____ amnions.

1, 2

2, 2

2, 1

1, 1

A

1, 2

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9
Q

Which type of twinning is the most dangerous or high risk?

dizygotic

monochorionic, diamniotic

dichorionic, diamniotic

monochorionic, monoamniotic

A

monochorionic, monoamniotic

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10
Q

What is selective reduction of embryos and when would it be used?

elective termination of an embryo, to improve pregnancy outcome/decrease preterm birth

elective termination of all embryo, to prevent birth

elective termination of an embryo, to worsen pregnancy outcome/increase preterm birth

A

elective termination of an embryo, to improve pregnancy outcome/decrease preterm birth

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11
Q

Which complication does this describe?

Thromboplastin rich blood from the dead twin travels via placental anastomoses to the live twin.

TTTS

TES

TRAP

Cord entanglement

A

TES

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12
Q

TES is a complication that is seen a lot in what other twinning situation?

TTTS

Conjoined Twins

TRAP

Cord entanglement

A

TTTS

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13
Q

In TRAP sequence, if the acardiac twin continues to grow, what can this trigger?
death of the other twin

pre-term labor

pre-eclampsia

nothing

A

pre-term labor

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14
Q

Which twinning complication has a donor twin and a recipient twin, where the recipient is overloaded?

Twin-Twin Transfusion Syndrome (TTTS)

Twin Reversed Arterial Perfusion Sequence (TRAP)

Twin Embolization Syndrome (TES)

Conjoined Twins

A

Twin-Twin Transfusion Syndrome (TTTS)

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15
Q

What is the percentage rate of death of one twin in monochorionic pregnancy?

10%

20%

25%

30%

A

20%

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16
Q

What is a succenturiate lobe placenta?

an abnormal placenta

an accessory lobe placenta

a non-functioning placenta

all placentas are called this

A

an accessory lobe placenta

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17
Q

A boy fetus and a girl fetus tells us that the pregnancy is:

monochorionic, monoamniotic

dizygotic

monozygotic

monochorionic, diamniotic

A

dizygotic

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18
Q

refers to type of placentation

chorionicity

amnionicity

zygosicity

placenticity

A

chorionicity

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19
Q

Cleavage of the zygote after day 14 results in:

monochorionic monoamniotic

monochorionic diamniotic

dichorionic diamniotic

conjoined twins

A

conjoined twins

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20
Q

What is the main factor that causes increased mortality of monoamniotic twins?

2 vessel cord

cord entanglement

3+ vessel cord

A

cord entanglement

21
Q

When 2 eggs and 2 sperm join, this is considered what type of zygotism?

Dizygotic

Monozygotic

Trizygotic

Diamniotic

22
Q

How many amnions will there be in dizygotic twinning?

1

2

23
Q

In monozygotic twinning, if there are 2 chorions, 2 amnions, and 2 placentas, when did cleavage of the zygote occur?

4 days or earlier

between 4 and 8 days

8 days or more

13 days

A

4 days or earlier

24
Q

In monozygotic twinning, if the result is monochorionic, monoamniotic what structure cleaved?

zygote

inner cell mass of blastocyst

embryonic disk

outer cell mass of blastocyst

A

embryonic disk

25
Q

Which of the following is considered fraternal twins?

Dizygotic

Monozygotic

26
Q

In monozygotic twinning, if the result is monochorionic, diamniotic what structure has cleaved?

zygote

inner cell mass

embryonic disk

yolk sac

A

inner cell mass

27
Q

If you have 1 chorion and 1 amnion with 2 fetuses sharing a placenta this is considered:

monochorionic monoamniotic

monochorionic diamniotic

dichorionic diamniotic

dizygotic

A

monochorionic monoamniotic

28
Q

Monochorionic Twins are at risk for all of the same complications as monoamniotic twins EXCEPT:

TRAP

TTTS
TES

Cord entanglement

A

Cord entanglement

29
Q

If cleavage occurs after 8 days, why will there only be one chorion?

Because the blastocyst failed to form on time

Because the blastocyst has already formed

Because the blastocyst has not yet formed

A

Because the blastocyst has already formed

30
Q

Monochorionic diamniotic means there are ___chorions and ____ amnions.

1, 2

2, 2

2, 1

1, 1

31
Q

If you have a zygote that splits (cleaves) then what type of zygosity results?

Dizygotic

Monozygotic

A

Monozygotic

32
Q

One ovum fertilized by one sperm is called:

Monozygotic twinning

Dizygotic twinning

A

Monozygotic twinning

33
Q

For spontaneous conception, _______twins are the more common zygosity.

monozygotic

dizygotic

34
Q

Which type of twinning is the most dangerous or high risk?

dizygotic

monochorionic, diamniotic

dichorionic, diamniotic

monochorionic, monoamniotic

A

monochorionic, monoamniotic

35
Q

What is selective reduction of embryos and when would it be used?

elective termination of an embryo, to improve pregnancy outcome/decrease preterm birth

elective termination of all embryos, to prevent birth

elective termination of an embryo, to worsen pregnancy outcome/increase preterm birth

A

elective termination of an embryo, to improve pregnancy outcome/decrease preterm birth

36
Q

Your patient on the schedule is down for twins. You begin the scan and see the following things.

Two fetuses, one much larger than the other.
One sac with polyhydramnios, one sac with oligohydramnios.
The fetus in the sac with polyhydramnios appears to have ascites, pleural effusions, and pericardial effusions.
What conclusion can you draw?

TTTS

TRAP

TES

37
Q

In TRAP sequence if the acardiac twin continues to grow, what can this trigger?

pre-term labor

pre-eclampsia

nothing

A

pre-term labor

38
Q

In Twin Twin Transfusion Syndrome, the donor twin will develop anemia and hypovolemia. What will the amniotic fluid volume be like? If you measure the baby, what will the measurements demonstrate?

oligohydramnios, IUGR

polyhydramnios, IUGR

oligohydramnios, large for dates

polyhydramnios, large for dates

A

oligohydramnios, IUGR

39
Q

In Twin Reversed Arterial Perfusion, the twin that has cardiac activity is considered the ____ twin.

pump

acardiac

40
Q

Which complication does this describe?

Thromboplastin rich blood from the dead twin travels via placental anastomoses to the live twin.

TTTS

TES

TRAP

Cord entanglement

41
Q

Why does TES have a good or bad prognosis?

good prognosis, usually detected by ultrasound quickly

poor prognosis, usually detected quickly by ultrasound

good prognosis, unable to be detected in time by ultrasound

poor prognosis, unable to be detected in time by ultrasound

A

poor prognosis, unable to be detected in time by ultrasound

42
Q

In which complication does one twin die, but continue to grow by getting its blood supply from the living twin?

TRAP

TTTS

TES

43
Q

In TTTS, which twin might you never see a stomach or bladder?

donor

recipient

44
Q

In which twinning complication will you have an acardiac twin?

TTTS

TES

TRAP

45
Q

Which twinning complication is there one arterial-arterial and one venous-venous anastomosis present?

TRAP

TTTS

TES

TRAP

46
Q

What is serial amnioreduction? Also select what twinning complication it’s a treatment for? select 2.

repeated removal of large amounts of amniotic fluid by amniocentesis - to help prevent preterm delivery related to poly

TTTS

Answer,
repeated removal of large amounts of amniotic fluid by amniocentesis - to help prevent preterm delivery related to oligo

Answer,
TES

Answer,
repeated removal of small amounts of amniotic fluid by amniocentesis - to help prevent preterm delivery related to poly

A

repeated removal of large amounts of amniotic fluid by amniocentesis - to help prevent preterm delivery related to poly

TTTS

47
Q

With TES, it’s not necessarily an embolus that causes the issue, so what does?

changes in perfusion to demised twin due to other twin survival

changes in perfusion to surviving twin due to other twin demise

A

changes in perfusion to surviving twin due to other twin demise

48
Q

TES is a complication that is seen a lot in what other twinning situation?

TTTS

Conjoined Twins

TRAP

TTTS

Cord entanglement

49
Q

In Twin Reversed Arterial Perfusion, which twin may demonstrate signs of cardiac failure, hydrops, and polyhydramnios?

acardiac twin

pump twin

OBGYN (12 decks)

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