multiple pregnancies Flashcards
What 3 things must you know in a twin pregnancy
zygosity- how many eggs were there
Chorionicity- how many placentas there are
Amnionicity- how many amniotic sacs there are
what is the difference between Monozygous and dizygous pregnancies
Monozygous= 1 egg = identical Dizygous= 2 eggs = non-identical
What is a DCDA twin
Dichorionic-Diamniotic twins (same as dizygous) 2 placentas and 2 amniotic sacs
What is an MCDA twin
Monochorionic-Diamniotic twins, 1 placenta shared and 2 amniotic sacs
What is an MCMA twin
the rarest form splits really late.
1 placenta shared and 1 amniotic sac shared.
How are twin pregnancies diagnosed
Uterine size, up to 50% at delivery worldwide
ultrasound
What are some first-trimester managements for twin pregnancies
- screening for chromosomal anomalies
- determine chorionicity
- discuss fetal reduction if triplets or more.
What are some some-trimester managements for twin pregnancies
Detection of fetal abnormality
serial scans for growth
check for maternal complications
check for twin-twin transfusion syndrome (TTTs)
What are the risks of monochorionic twins
More fetal malformations
more fetal growth restrictions
twin to twin to twin transfusion is more common
What causes twin to twin transfusion, what does it cause and how is it treated
Unbalanced placental vascular anastomoses
donor smaller and recipient bigger
both will likely die if not treated.
treated with laser or amnio-reduction
early c-section
What are managements for twin pregnancies in the 3rd trimester
scanning as in 2nd
monitor BP
pre-term labour
delivery planning
