Multiple Gestations

Question 1

When compared to singleton pregnancy twins have _______ times higher risk of fetal mortality and ___ times higher neonatal morbidity rate

Answer 1

4 times

6 times

Question 2

_______ twins arise from a single zygote.

Answer 2

monozygotic

Question 3

The ____ is the structure that forms the placenta and develops before the amnion.

Answer 3

chorion

Question 4

Twins who have one shared placenta are referred to as:

Answer 4

monochorionic

Question 5

Twins who share the same amniotic sac are referred to as:

Answer 5

monoamniotic

Question 6

______ twins are the most common form of twinning, arise from two separate fertilized ova.

Answer 6

dizygotic

Question 7

Dizygotic twins are referred to as:

Answer 7

fraternal twins

Question 8

Dizygotic twinning always results in :

Answer 8

dichorionic diamniotic

Question 9

_____ twins arise from a single zygote that splits.

Answer 9

monozygotic

Question 10

Monozygotic twins are always:

Answer 10

identical

Question 11

There are three categories of monozygotic twins:

Answer 11

monochorionic diamniotic, dichorionic diamniotic, monochorionic monoamniotic

Question 12

______ _____ twins are the most common form of monozygotic twins:

Answer 12

Monochorionic diamniotic

Question 13

Division of the inner cell between _____ days will result in monochorionic diamniotic twinning.

Answer 13

4-8

Question 14

A division before day ____ leads to dichorionic diamniotic twins.

Answer 14

4

Question 15

Split beyond day ___ will result in mono mono twins

Answer 15

8

Question 16

With mono mono twins the amniotic sac is shared this carries the additional risk of:

Answer 16

conjoined twins

Question 17

The presence of one yolk sac and two fetuses is indicative of :

Answer 17

monoamniotic gestation

Question 18

Presence of two yolk sacs is indicative of :

Answer 18

diamniotic gestation

Question 19

Noting a triangular extension of the placenta at the base of the dividing membrane is indicative of dichorionic diamniotic pregnancy this is referred to as:

Answer 19

twin peak sign, lambda sign, or delta sign

Question 20

With monochorionic diamniotic pregnancy, the membrane will be thin and seen separating at the junction point with the placenta, sonographic sign referred to as:

Answer 20

T sign

Question 21

Same sex fetuses that have a single placenta and a thin membrane separating them are almost certainly:

Answer 21

monochorionic

Question 22

Complication that carries a high mortality rate for monocorionic twins is:

Answer 22

twin - twin transfusion syndrome

Question 23

With TTTS :

Answer 23

shunting occurs from one twin to the other

Question 24

The twin that shunts the blood to the other is called the:

Answer 24

donar twin

Question 25

The donor twin in TTTS often suffers from:

Answer 25

anemia and growth restriction

Question 26

The recipient twin in TTTS experiences:

Answer 26

hydrops and congestive heart failure

Question 27

Sonographic findings of TTTS:

Answer 27

``` monochorionic twinning discordant fetal growth oligohydramnios around donor twin polyhydramnios around recipient twin recipient may be hydropic ```

Question 28

_________ refers to severe oligohydramnios surrounding a twin that appears to be closely associated with the uterine wall.

Answer 28

Stuck twin

Question 29

Abnormal anastomoses of placental vessels may result in a :

Answer 29

parasitic twin or acardiac twin

Question 30

Parasitic twin or acardiac twin is considered to be a severe form of:

Answer 30

TTTS

Question 31

Acardiac twinning may also be referred to as:

Answer 31

twin-reversed arterial perfusion (TRAP)

Question 32

With acardiac twinning there is one normal fetus, the _______ and an abnormally developed fetus with no heart.

Answer 32

pump twin

Question 33

The normal twin in TRAP maintains the growth of the parasitic twin, typically resulting in:

Answer 33

absence of the head, cervical spine, and upper limbs

Question 34

Sonographic findings of acardiac twin:

Answer 34

Normal pump twin, acardiac twin - absent upper body, absent heart, and hydrops

Question 35

Conjoined twins can be attached at the:

Answer 35

head, thorax, abdomen, and lower part of the body

Question 36

The most common forms of conjoined twinning are:

Answer 36

thoracopagus, and omphalopagus

Question 37

Conjoined twins at the cranium are termed:

Answer 37

craniopagus or back to back in the sacral region which is termed pyopagus

Question 38

conjoined twins at the pelvis are termed:

Answer 38

ischiopagus

Question 39

The death of a twin, and subsequent reabsorption of the embryo during the first trimester is termed

Answer 39

vanishing twin

Question 40

If the fetus dies in the first trimester and is maintained throughout the pregnancy it is referred to as :

Answer 40

fetus papyraceus

Question 41

Death of a monochorionic twin in the 2nd or 3rd trimester can lead to vascular products traveling to the surviving twin from the demised twin complication known as:

Answer 41

Twin embolization syndrome