Multiple Gestations and Complications

Question 1

What percentage of pregnancies deliver singleton pregnancies?

Answer 1

70%

Question 2

What type of twins result from a single fertilized ovum?

Answer 2

monozygotic

Question 3

What type of twins result from two seperate fertilized ovum?

Answer 3

dizygotic

Question 4

Dizygotic pregnancies are always?

Answer 4

di-di

Question 5

Fetus in fetu

Answer 5

twin becomes incorporated into co-twin

Question 6

Predisposing factors for multiple gestations

Answer 6

advanced maternal age (>35 years), family history of hyperovulation, ART

Question 7

True or False: All twin pregnancies are considered high risk

Answer 7

True

Question 8

Risks for mother with a twin pregnancy

Answer 8

anemia, hypertension, hyperemesis, UTI, postpartum hemorrhage, placenta previa, placental abruption

Question 9

Risks for fetus with a twin pregnancy

Answer 9

preterm labor and delivery, IUGR, anomalies, increased mortality

Question 10

Categories of dizygotic twins

Answer 10

dichorionic-diamniotic (always di-di)

Question 11

Categories of monozygotic twins

Answer 11

monochorionic-diamniotic, di-di, mono-mono

Question 12

What percentage of twin pregnancies are dizygotic?

Answer 12

75%

Question 13

What is the most common type of monozygotic twins?

Answer 13

monochorionic-diamniotic

Question 14

Fraternal twins are produced by what zygosity?

Answer 14

dizygotic

Question 15

Identical twins are produced by what zygosity?

Answer 15

monozygotic

Question 16

Which type of pregnancies have two placentas?

Answer 16

dizygotic (two separate trophoblasts) or dichorionic

Question 17

What is the most common type of zygosity?

Answer 17

dizygotic

Question 18

What establishes dizygocity?

Answer 18

male:female

Question 19

Di-di twins have how many layers? what are they?

Answer 19

4; two chorions and two amnions

Question 20

Which type of twins have the least risk for complications?

Answer 20

di-di; most separation

Question 21

What determines the chorionicity and amnionicity for monozygotic twins?

Answer 21

day the fertilized ovum splits

Question 22

Lambda sign

Answer 22

projection of placental tissue (chorion)

Question 23

The lamba sign is seen with what type of chorionicity and amnionicity?

Answer 23

di-di

Question 24

Di-di monozygotic twins result from separation on what day?

Answer 24

Early; 5th day

Question 25

Monochorionic-diamniotic twins result from separation on what day?

Answer 25

5-10

Question 26

Monochorionic-diamniotic twins have how many layers?

Answer 26

2

Question 27

True or False: Zygosity can be established sonographically

Answer 27

False

Question 28

mono-mono twins separate on what day?

Answer 28

10-14

Question 29

How many layers do mono-mono twins have?

Answer 29

0

Question 30

Which type of twins have a high association with cord entanglement?

Answer 30

mono-mono

Question 31

Division after day 14 results in?

Answer 31

conjoined twins

Question 32

The lambda sign only occurs in?

Answer 32

dichorionic pregnancies

Question 33

The lambda sign is also known as?

Answer 33

twin peak

Question 34

The T sign is only seen with?

Answer 34

monochorionic pregnancies

Question 35

when is the best time to establish chorionicity and amnionicity?

Answer 35

first trimester

Question 36

What can be seen after the first trimester to establish chorionicity?

Answer 36

cleft sign

Question 37

what is the cleft sign?

Answer 37

hypoechoic line in placenta

Question 38

Which twin is labeled twin A?

Answer 38

one closest to cervix

Question 39

Most common fetal presentation of twins?

Answer 39

vertex-vertex

Question 40

Twin reversed arterial perfusion syndrome

Answer 40

artery-artery and vein-vein anastomoses inside placenta

Question 41

Twin reversed arterial perfusion syndrome is also known as?

Answer 41

TRAP, TRAP Sequence, acardiac/monster twin

Question 42

Twin-twin transfusion syndrome

Answer 42

artery-vein anastomoses in placenta

Question 43

TTTS occurs in what type of pregnancies?

Answer 43

monochorionic

Question 44

Most cases of TTTS occur in?

Answer 44

mono-di

Question 45

in TTTS, the "donor" twin has?

Answer 45

growth restriction; not receiving blood

Question 46

Which twin has oligohydramnios and which has polyhydramnios with TTTS?

Answer 46

donor= oligo; recipient = poly

Question 47

Which twin appears as the "stuck" twin?

Answer 47

donor

Question 48

Stuck twin only occurs with?

Answer 48

TTTS with a mono-di pregnancy

Question 49

Thoracopagus

Answer 49

twins joined at throax

Question 50

omphalopagus

Answer 50

twins joined at abdomen

Question 51

pygopagus

Answer 51

twins joined at sacrum

Question 52

craniopagus

Answer 52

twins joined at head

Question 53

ischiopagus

Answer 53

twins joined at ischium

Question 54

Vanishing twin

Answer 54

early ultrasound shows two embryos, then later ultrasound shows one

Question 55

fetus papyraceus

Answer 55

demise of twin too large to absorb; pressed flat by living fetus; appears thin

Question 56

lithopedion

Answer 56

dead calficied fetus; stone baby

Question 57

sirenomelia

Answer 57

lower extremity fusion; mermaid syndrome

Question 58

Characteristics of sirenomelia

Answer 58

absent bladder, oligohydramnios, hypoplastic lungs, absent sacrum/lumbar spine, imperforate anus

Question 59

True or False: TTTS only occurs with diamniotic twins

Answer 59

False; can occur in monoamniotic with no stuck twin