Multifetal Flashcards
What is a succenturiate lobe placenta?
an abnormal placenta
an accessory lobe placenta
a non-functioning placenta
all placentas are called this
an accessory lobe placenta
A boy fetus and a girl fetus tells us that the pregnancy is:
monochorionic, monoamniotic
dizygotic
monozygotic
monochorionic, diamniotic
dizygotic
Cleavage of the zygote after day 14 results in:
monochorionic monoamniotic twins
monochorionic diamniotic twins
dichorionic diamniotic twins
conjoined twins
conjoined twins
What is the main factor that causes increased mortality of monoamniotoic twins?
2 vessel cord
cord entanglement
3+ vessel cord
cord entanglement
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
4 days or earlier
If you have 1 chorion and 1 amnion with 2 fetuses sharing a placenta this is considered:
monochorionic monoamniotic
monochorionic diamniotic
dichorionic diamniotic
dizygotic
monochorionic monoamniotic
Monoamniotic Twins are at risk for all of the same complications as monochorionic twins includes:
TRAP
TTTS
TES
Cord entanglement
TTTS
Monochorionic diamniotic means there are ___chorions and ____ amnions.
1, 2
2, 2
2, 1
1, 1
1, 2
Which type of twinning is the most dangerous or high risk?
dizygotic
monochorionic, diamniotic
dichorionic, diamniotic
monochorionic, monoamniotic
monochorionic, monoamniotic
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
elective termination of an embryo, to improve pregnancy outcome/decrease preterm birth
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
TES
TES is a complication that is seen a lot in what other twinning situation?
TTTS
Conjoined Twins
TRAP
Cord entanglement
TTTS
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
pre-term labor
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
Twin-Twin Transfusion Syndrome (TTTS)
What is the percentage rate of death of one twin in monochorionic pregnancy?
10%
20%
25%
30%
20%
What is a succenturiate lobe placenta?
an abnormal placenta
an accessory lobe placenta
a non-functioning placenta
all placentas are called this
an accessory lobe placenta
A boy fetus and a girl fetus tells us that the pregnancy is:
monochorionic, monoamniotic
dizygotic
monozygotic
monochorionic, diamniotic
dizygotic
refers to type of placentation
chorionicity
amnionicity
zygosicity
placenticity
chorionicity
Cleavage of the zygote after day 14 results in:
monochorionic monoamniotic
monochorionic diamniotic
dichorionic diamniotic
conjoined twins
conjoined twins
What is the main factor that causes increased mortality of monoamniotic twins?
2 vessel cord
cord entanglement
3+ vessel cord
cord entanglement
When 2 eggs and 2 sperm join, this is considered what type of zygotism?
Dizygotic
Monozygotic
Trizygotic
Diamniotic
Dizygotic
How many amnions will there be in dizygotic twinning?
1
2
2
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
4 days or earlier
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
embryonic disk
Which of the following is considered fraternal twins?
Dizygotic
Monozygotic
Dizygotic
In monozygotic twinning, if the result is monochorionic, diamniotic what structure has cleaved?
zygote
inner cell mass
embryonic disk
yolk sac
inner cell mass
If you have 1 chorion and 1 amnion with 2 fetuses sharing a placenta this is considered:
monochorionic monoamniotic
monochorionic diamniotic
dichorionic diamniotic
dizygotic
monochorionic monoamniotic
Monochorionic Twins are at risk for all of the same complications as monoamniotic twins EXCEPT:
TRAP
TTTS
TES
Cord entanglement
Cord entanglement
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
Because the blastocyst has already formed
Monochorionic diamniotic means there are ___chorions and ____ amnions.
1, 2
2, 2
2, 1
1, 1
1, 2
If you have a zygote that splits (cleaves) then what type of zygosity results?
Dizygotic
Monozygotic
Monozygotic
One ovum fertilized by one sperm is called:
Monozygotic twinning
Dizygotic twinning
Monozygotic twinning
For spontaneous conception, _______twins are the more common zygosity.
monozygotic
dizygotic
dizygotic
Which type of twinning is the most dangerous or high risk?
dizygotic
monochorionic, diamniotic
dichorionic, diamniotic
monochorionic, monoamniotic
monochorionic, monoamniotic
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
elective termination of an embryo, to improve pregnancy outcome/decrease preterm birth
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
TTTS
In TRAP sequence if the acardiac twin continues to grow, what can this trigger?
pre-term labor
pre-eclampsia
nothing
pre-term labor
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
oligohydramnios, IUGR
In Twin Reversed Arterial Perfusion, the twin that has cardiac activity is considered the ____ twin.
pump
acardiac
pump
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
TES
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
poor prognosis, unable to be detected in time by ultrasound
In which complication does one twin die, but continue to grow by getting its blood supply from the living twin?
TRAP
TTTS
TES
TRAP
In TTTS, which twin might you never see a stomach or bladder?
donor
recipient
donor
In which twinning complication will you have an acardiac twin?
TTTS
TES
TRAP
TRAP
Which twinning complication is there one arterial-arterial and one venous-venous anastomosis present?
TRAP
TTTS
TES
TRAP
TRAP
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
repeated removal of large amounts of amniotic fluid by amniocentesis - to help prevent preterm delivery related to poly
TTTS
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
changes in perfusion to surviving twin due to other twin demise
TES is a complication that is seen a lot in what other twinning situation?
TTTS
Conjoined Twins
TRAP
TTTS
Cord entanglement
TTTS
In Twin Reversed Arterial Perfusion, which twin may demonstrate signs of cardiac failure, hydrops, and polyhydramnios?
acardiac twin
pump twin
pump twin
