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Year Three - Reproductive System > Multiple Gestation > Flashcards

Multiple Gestation Flashcards

1
Q

What is a multiple pregnancy?

A

It refers to a pregnancy with more than one fetus

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2
Q

What are monozygotic twins?

A

Identical twins

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3
Q

When does a monozygotic pregnancy occur?

A

When a zygote divides after fertilisation

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4
Q

What are dizygotic twins?

A

Non-identical

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5
Q

When does a dizygotic pregnancy occur?

A

When more than one egg is released during one menstrual cycle

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6
Q

What are dichorionic diamniotic twins (DCDA)?

A

Babies that have a separate placenta and amniotic sac

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7
Q

What is a dichorionic pregnancy?

A

When babies have two separate placentas

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8
Q

What is a diamniotic pregnancy?

A

When babies have two separate amniotic sacs

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9
Q

What is the cause of a dichorionic diamniotic pregnancy?

A

It results from two separate eggs being fertilised by two separate sperms

It results from an early division of one zygote before implantation

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10
Q

What type of multiple pregnancy has the best outcome? Why?

A

Dichorionic diamnitoic

Each fetus has their own nutrient supply

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11
Q

What are monochorionic diamniotic twins (MCDA)?

A

Babies that share the same placenta but have separate amniotic sacs

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12
Q

What is the cause of monochorionic diamniotic pregnancy?

A

The zygote divides after implantation between day 6- 8

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13
Q

What is a monochorionic pregnancy?

A

When babies share a single placenta

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14
Q

What are monochorionic monoamniotic twins (MCMA)?

A

Babies that share the same placenta and amniotic sac

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15
Q

What is the cause of a monochrorionic monoamniotic pregnancy?

A

The zygote divides after day 8

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16
Q

What is a monoamniotic pregnancy?

A

When babies share a single amniotic sac

17
Q

What investigation is used to diagnose and determine the type of multiple pregnancy?

A

US scan

18
Q

What is the sign of dichorionic diamniotic twins on an US scan? Describe this sign

A

Lambda sign, also known as the twin peak sign

This refers to a triangular appearance where the membrane between the twins meets the chorion

This indicates a dichorionic pregnancy (two placentas)

19
Q

What is the sign of monochorionic diamniotic twins on an US scan? Describe this sign

A

T sign

This refers to the appearance to where the membrane between the twins abruptly meets the chorion, giving a T appearance

This indicates a monochorionic pregnancy (one placentas)

20
Q

What is the sign of monochorionic monoamniotic twins on an US scan?

A

The presence of no membrane separating the twins

21
Q

What are the six maternal complications of a multiple pregnancy?

A

Anaemia

Hypertension

Gestational Diabetes

Postpartum Haemorrhage

Preterm Labour

Malpresentation

22
Q

What are the six fetal complications of a multiple pregnancy?

A

Prematurity

Growth Restriction

Miscarriage

Stillbirth

Twin-Twin Transfusion Syndrome

Twin Anaemia Polycythaemia

23
Q

What is twin-twin transfusion syndrome?

A

It occurs when the fetuses share a placenta

When there is a connection between the blood supplies of the two fetuses, one fetus (the recipient) may receive the majority of blood from the placenta, while the other fetus (the donor) is starved of blood

24
Q

Which type of twins are commonly affected by twin-twin transfusion syndrome?

A

Monochorionic twins

25
Q

What are the two complications that can occur in the recipient of twin-twin transfusion syndrome?

A

Heart failure

Polyhydramnios

26
Q

What are the three complications that can occur in the donor of twin-twin transfusion syndrome?

A

Growth restriction

Anaemia

Oligohydramnios

27
Q

What is twin anaemia polycythaemia sequence?

A

It results in one twin becoming anaemic whilst the other develops polycythaemia

28
Q

When should we aim to deliver dichorionic diamnitoic twins?

A

37 weeks of gestation

29
Q

When do we deliver dichorionic diamniotic twins vaginally?

A

When the first baby has a cephalic presentation

30
Q

When do we deliver dichorionic diamniotic twins via an emergency c-section?

A

For the second baby after successful birth of the first baby

31
Q

When do we deliver dichorionic diamniotic twins via an elective c-section?

A

When the presenting twin is not cephalic presentation

32
Q

When should we aim to deliver monochorionic diamnitoic twins?

A

36 weeks gestation

33
Q

How do we deliver monochorionic diamniotic twins?

A

Elective c-section

34
Q

When should we aim to deliver triplets?

A

35 weeks of gestation

35
Q

How do we deliver triplets?

A

Elective c-section

Year Three - Reproductive System (52 decks)

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