MULTIPLE GESTATIONS

Question 1

What are the two main groups?

Answer 1

monozygotic
dizygotic

Question 2

Dizygotic

Answer 2

formed from two fertilized eggs: two separate placentas develop each with own chorion and amnion

Question 3

monozygotic

Answer 3

formed from a single conceptus that undergoes fission before blastocyst stage; single placenta

Question 4

MCDA

Answer 4

separation of inner embryonic cells before amniogenesis results in single placenta with two amnios

Question 5

MCMA

Answer 5

separation of embryonic cells before development of embryonic axis results in single placenta with one amnion

Question 6

the dividing membrane will always consist of 4 layers

Answer 6

dizygozity

Question 7

Lamda sign

Answer 7

dizygosity, thick separating membrane

Question 8

T sign

Answer 8

monozygozity

Question 9

what confirms MCMA

Answer 9

cord entanglement

Question 10

Twin A

Answer 10

always close to internal os

Question 11

CRL measurements

Answer 11

45mm and 84mm

Question 12

lambda sign measurements

Answer 12

membrane >22mm

Question 13

maternal complications of twin pregnancies

Answer 13

1. preterm labor
   2.prom
   3.preeclampsia
   4.placental abnormalities
   5.pyelonephritis
   6.postpartum hemorrhage

Question 14

fetal complications with twin pregnancies

Answer 14

1.growth abnormalities
2.congenital malformations
3.admission to nicu
4.cerebral palsy
5.perinatal death

Question 15

complications unique to MCMA

Answer 15

1. TTTS
2. TAPS
   3.TRAP sequence

Question 16

TTTS

Answer 16

twin to twin transfusion syndrome

Question 17

TAPS

Answer 17

twin anemia polycythemia syndrome

Question 18

TRAP

Answer 18

twin reversed arterial perfusion

Question 19

TTTS definition

Answer 19

monochorionic twin complication caused by intrauterine transfusion of blood from donor to recipient via arteriovenous (AV) placental anastomes

Question 20

TRAP definition

Answer 20

monozygotic twin complication one twin develops normal (pump twin) and the second twin (recipient twin)perfused by deoxygenated blood from pump twin and shows cardiac malformation and gross anomalies incl. absent head and extremities

Question 21

TAPS definition

Answer 21

occurs due to a slow transfusion of blood from the donor to the recipient through few very small arteriovenous vascular anastomes

Question 22

placenta of anemic twin

Answer 22

thick and hyperechogenic

Question 23

placenta of polcythemic twin

Answer 23

thin and translucent

Question 24

polycythemia definition

Answer 24

increased number of red blood cells

Question 25

TTTS discordance

Answer 25

discordant liquor

Question 26

Selective IUGR

Answer 26

discordant growth

Question 27

TAPS

Answer 27

discordant MCA PSV

Question 28

TRAP

Answer 28

discordant fetal anomalies

Question 29

FETAL ANOMALIES

Answer 29

discordant fetal anomalies