Multiple gestation

Question 1

Reasons for multiple birth (3)

Answer 1

• if more than 1 egg is released during 1 menstrual cycle
• if the zygote divides after fertilisation = identical
• IVF treatments - often more than 1 embryo to the uterus

Question 2

What is amnionicity?

Answer 2

the number pf amnions (inner membranes) that surround babies in multiple pregnancy

Question 3

amnions and type of pregnancy?

Answer 3

1 = share a sac - monoamniotic 
2= diaamniotic

Question 4

What is chorionicity?

Answer 4

number of outer membranes that surround babies in a mp - IF THERE IS ONLY ONE
= monochorionic
= dichoronic = 2 pregnancies

Question 5

What are the 3 types of twin pregnancies

Answer 5

1- dichorionic diamniotic

2. monochorionic diamniotic
3. monochorionic monoamniotic

Question 6

how can DCDA twin pregnancies happen?

Answer 6

2 separate eggs fertilised by 2 separate sperms = each baby has separate placenta and sac

Question 7

monochorionic diamniotic twins share?

Answer 7

a placenta, but have diff amniotic sacs

Question 8

monochorionic monoamniotic twins share?

Answer 8

both a placenta and sac

Question 9

Cleavage of a morula causes twins that are..

Answer 9

dichorionic diamniotic

Question 10

cleavage of a blastocyst causes twins that are..

Answer 10

monochorionic diamniotic

Question 11

cleavage of a implanted blastocyst causes twins that are..

Answer 11

monochorionic monoamniotic

Question 12

cleavage of a formed embryonic disk causes twins that are?

Answer 12

conjoined

Question 13

the lambda sign shows

Answer 13

2 placentas, dichorionic diamniotic

Question 14

The T sign shows

Answer 14

single placenta ,monochorionic diamniotic

Question 15

maternal complications of MB ?

Answer 15

pre - term labour
anaemia in pregnancy 
hypertension 
gestational diabetes
PPH

Question 16

fetal complications of MB ?

Answer 16

growth restriction
prematurity
birth complications increased
increased perinatal/ mortality and mobility

Question 17

monochorionic twins complications (4)

Answer 17

twin-twin transfusion syndrome
- blood moves from one to another by shared placenta, baby loses blood and becomes a donor

• selective growth restriction
• twin anaemia polycythaemia sequence
• twin reversed arterial perfusion (TRAP)
• SINGLE TWIN DEATH

Question 18

Antenatal care for MB’s

Answer 18

• trisomy 21 screening/ structural scans
• specialist clinic to monitor growth and any complications
• monitor bp look out for iron anaemia

Question 19

how many antenatal visits do dichorionic diamniotic twins require

Answer 19

8

Question 20

how many antenatal visits do monochorionic diamniotic twins require

Answer 20

11

Question 21

Aim for delivery?

Answer 21

37weeks = DCDA
36 weeks = MCDA
TRIPLETS = 35 WEEKS

Question 22

When would you offer cs?

Answer 22

if first twin isn’t cephalic in position