Multifetal Gestation, Malpresentation - Moulton Flashcards
Monozygotic twinning type, w/ cleavage at…
- 0-3 days
- 4-8 days
- 9-12 days
- 13+ days
Most common?
Dichorionic, diamniotic
Monochorionic, diamniotic
Monochorionic, monoamniotic
Conjoined twins
4-8 days (Mono, di)
Most common conjoined twins
Thoracopagus (chest wall)
Dizygotic twins more common in ___ and ____
- Older women
- African Americans
Ultrasound signs of dizygotic vs monozygotic twins (besides 2 heart beats, gender differences)
DIZYGOTIC:
- Thick amnion-chorion septum
- Peak or inverted V sign at base of septum
MONOZYGOTIC:
- Thin dividing membrane
Twin babies are born, and one has no thorax or head. Why?
Called what?
Arterial-arterial anastamoses
- 1 baby transfused backwards, developing body gets oxygen-poor blood, never develops (“ACARDIAC” twin)
Twin-twin transfusion syndrome requires what type of anastamosis? Why baby is small?
Arterial-venous
Donor = small Recipient = big
SAB can lead to ___ in the mom
What happens to the body? (2)
DIC
Under 12 weeks = reabsorbed (vanishing twin syndrome)
Over 12 weeks = fetus papyraceus (shrinks, dehydrates, flattens)
When should monoamniotic twins be delivered?
If no complications?
32 weeks
38 weeks
Which twin presentations CAN be delivered vaginally? (2)
Via C-section? (2)
Vertex-Vertex, Vertex-Breech
Breech-Vertex, Breech-Breech
Most common risk factor of breech presentation
Others? (3)
Diagnosed how?
Prematurity (25% b4 28 wks)
Fetal malformations
Multiple gestations
Uterine malformations
Leopold’s maneuver, ultrasound, pelvic exams
3 types of breech
Most common?
Frank (both legs flexed at hips, extended at knees)
Complete (indian style)
Incomplete (1 leg extended)
External cephalic version (ECV)
Can do in who?
Applying pressure to abdomen to somersault baby into vertex position
36 weeks, not in labor, no contraindications
MOST practices deliver breech babies how?
C-section
Most babies presenting as a BROW will do what?
Convert to FACE (extension) or VERTEX (flexion)
ONLY way a FACE presentation can be delivered vaginally?
Mentum (chin) anterior (MA)
