Multiple gestation Flashcards
reasons for multiple gestation
More than 1 egg released during a cycle
Zygote divides after fertilisation
IVF treatments often transfer more than one embryo
what is amnionicity
Number of amnions (inner membrane) that surround babies in multiple pregnancy
Pregnancies with one amnion {MONOAMNIOTIC}
Pregnancies two amnions {DIAMNIOTIC
what is chorionicity
Number of chorionic (outer) membranes that surround babies in a multiple pregnancy
Only one membrane {monochorionic}
Two membranes {dichornionic}
dichorionic diamniotic twins
each baby has a separate placenta and amniotic sac
can happen from 2 seperate eggs fertilized by two seperate sperms or early division zygote
monochorionic diamniotic twins
both babies share a placenta but have separate amniotic sacs
monochorionic monoamniotic twins
both babies share a placenta and amniotic sac
how is zygocity and chorionicity done
fetal US
lamda sign
T sign
Single placenta - monochorionic diamniotic twins
what may be complications for this type of twin
Twin to twin transfusion syndrome
Selective growth restriction
Twin anaemia polycythemia sequence
Twin reversed arter
what is typical antenatal care following multiple birth
- routine care trisomy screening/structural scans
- specialist clinic with regular scans to monitor growth and identify complications
- dichorionic diamniotic 8AN visits
- monochorionic require 11AN visit
- monitor BP comence oral iron
when should delivery be aimed for in dichorionic diamniotic twins
37 weeks
if 1st twin not cephalic offer CS
when should you aim for delivery in monochorionic diamniotic twins
36 weeks
if 1st twin not cephalic offer CS
when should you aim for delivery in triplets
35 weeks by caesarian
