Multiple Gestations Flashcards
diagnosis of twins
- first and/or second trimester ultrasound
- size-date discrepancy
- elevated AFP
what to look for on ultrasound of twins
number of genders, placentas, sacs
what are all twins at risk for?
cesarean section
prematurity
placenta previa
post-partum hemorrhage
ultrasound revealed different genders
di-zygote
- breech = c/section
- preterm
ultrasound revealed one gender
check number of placentas
ultrasound revealed one placenta
is there a septum?
ultrasound revealed one placenta and no septum
mono-zygotic
mono-chorionic
mono-amniotic
risk of monozygotic/monochorionic/monoamniotic
cord entanglement
conjoined
ultrasound revealed one placenta and a septum
mono-zygotic
mono-chorionic
di-amniotic
risk of mono-zygotic/mono-chorionic/di-amniotic
twin-twin transfusion
ultrasound revealed multiple placentas
mono-zygotic
di-chorionic
di-amniotic
what is ___zygotic?
number of eggs/fertilizations
what is ___chorionic?
number of placentas
what is ___amniotic?
number of sacs
what is a dizygotic/dichorionic/diamniotic
two normal pregnancies at the same time
- two eggs, two fertilizations, two sacs, two placentas
risks for having dizygotic/dichorionic/diamniotic
hormones to induce ovulation -> release of multiple eggs
risks of dizygotic/dichorionic/diamniotic
vanishing twin
- one pregnancy dies and gets reabsorbed
what is monozygotic/dichorionic/diamniotic
product of the same fertilization and have the same genetic material
- separate early = days 0-3
identical twins
- two sacs, two placentas, but one egg so same gender
what is monozygotic/monochorionic/diamniotic
product of the same fertilization
- separate on days 4-8, so share placenta (blood supply)
added risk of monozygotic/monochorionic/diamniotic
twin-twin transfusion
- one twin donates blood supply to other
- small twin does better because of reduced bilirubin load
what is monozygotic/monochorionic/monoamniotic
same fertilization with same genetic material
- separate late (days 9-12) for nonconjoined
- splitting >12days for conjoined twins
added risks of monozygotic/monochorionic/monoamniotic
cord entanglement
conjoined twins
delivery decisions of twins
cephalic-cephalic = vaginal cephalic-breech = 'clinical judgment' breech-breech = c-section
