Multiple gestation Flashcards
Reasons for multiple birth (3)
- 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
What is amnionicity?
the number pf amnions (inner membranes) that surround babies in multiple pregnancy
amnions and type of pregnancy?
1 = share a sac - monoamniotic 2= diaamniotic
What is chorionicity?
number of outer membranes that surround babies in a mp - IF THERE IS ONLY ONE
= monochorionic
= dichoronic = 2 pregnancies
What are the 3 types of twin pregnancies
1- dichorionic diamniotic
- monochorionic diamniotic
- monochorionic monoamniotic
how can DCDA twin pregnancies happen?
2 separate eggs fertilised by 2 separate sperms = each baby has separate placenta and sac
monochorionic diamniotic twins share?
a placenta, but have diff amniotic sacs
monochorionic monoamniotic twins share?
both a placenta and sac
Cleavage of a morula causes twins that are..
dichorionic diamniotic
cleavage of a blastocyst causes twins that are..
monochorionic diamniotic
cleavage of a implanted blastocyst causes twins that are..
monochorionic monoamniotic
cleavage of a formed embryonic disk causes twins that are?
conjoined
the lambda sign shows
2 placentas, dichorionic diamniotic
The T sign shows
single placenta ,monochorionic diamniotic
maternal complications of MB ?
pre - term labour anaemia in pregnancy hypertension gestational diabetes PPH
fetal complications of MB ?
growth restriction
prematurity
birth complications increased
increased perinatal/ mortality and mobility
monochorionic twins complications (4)
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
Antenatal care for MB’s
- trisomy 21 screening/ structural scans
- specialist clinic to monitor growth and any complications
- monitor bp look out for iron anaemia
how many antenatal visits do dichorionic diamniotic twins require
8
how many antenatal visits do monochorionic diamniotic twins require
11
Aim for delivery?
37weeks = DCDA
36 weeks = MCDA
TRIPLETS = 35 WEEKS
When would you offer cs?
if first twin isn’t cephalic in position
