MULTIPLE PREGNANCIES Flashcards
- A pregnancy in which the
woman is carrying two or
more fetuses - Considered a complication
of pregnancy
multiple pregnancy
true or false - It is sometimes difficult to determine by sonogram or at birth whether twins are identical or fraternal
true
true or false - the lower a woman’s parity and age, the more likely
she is to have a multiple gestation
false 0 high the age
___ appears to play a role in natural dizygotic
twinning; this has a familial maternal pattern of
occurrence
inheritance
multiple (typically two) fetuses
produced by the splitting of a single zygote
monzygotic
multiple (typically two) fetuses
produced by two zygotes
dizygotic
multiple fetuses produced by two
or more zygotes
polyzygotic
the offspring produced by a multiple birth in non-human placentals
litter
name the labels of multiple pregnancies from 2-10
twins
quadruplets
triplets
quintuplets
sextuplets
septuplets
octuplets
nonuplets
decaplets
name the labels of multiple pregnancies from 11-19
undecaplets
deodecaplets
tredecaplets
quattrodecaplets
quindecaplets
sexdecaplets
sepdecaplets
octdecaplets
nondecaplets
*Also known as Siamese twins
*Identical twins whose bodies are joined in utero
*Higher incidence (Southwest Asia & Africa)
conjoined twins
overall survival rate of conjoined twins
25%
older & most generally accepted theory in which the fertilized egg splits partially
fission
a fertilized egg completely separates, but stem
cells (which search for similar cells) find like-stem cells on
the other twin and fuse the twins together
fusion
conjoined twins that share a portion of their front body
ventral union
✓Two faces on opposite sides of a
single, conjoined head
✓Upper portion of the body is
fused while the bottom portions
are separate
✓Generally cannot survive
cephalopagus
cephalopagus is also known as ___ or ___
janiceps or syncephalus
✓Bodies fused in the
head and thorax
✓Has two faces facing in
opposite directions or
sometimes a single
face and an enlarged
skull.
cephalothoracopagus
✓2 bodies fused from the
upper thorax to lower
belly.
✓The heart is always
involved in these cases.
thoracopagus
percentage of cases of thoracopagus
18.5%
✓ Two bodies fused at the lower chest
✓ Unlike thoracopagus, the heart is
never involved
✓ Twins share a liver, digestive
system, diaphragm and other
organs.
omphalopagus
percentage of cases of omphalopagus
10%
✓2 bodies fused from the upper
chest to the lower chest
✓Twins usually share a heart, and
may also share the liver or part of
the digestive system
thoraco-omphalopagus
percentage of cases of thoraco-omphalopagus
28%
2 bodies fused in the
xiphoid cartilage – these
twins almost never share
any vital organs, with the
exception of the liver
xiphopagus
- ✓Fused lower half of the two
bodies, with spines conjoined
end-to-end at a 180° angle. - These twins have four arms;
two, three or four legs; and
typically one external set of
genitalia and anus.
ischiopagus
- Fused in a similar fashion as
ischiopagus twins, but facing each
other with a joined abdomen akin
to omphalopagus. - These twins
have four arms, and two, three, or
four legs.
omphalo-ischiopagus
Fused side-by-side with a shared pelvis.
parapagus
2 sub types of parapagus
- dithoracic parapagus
- diprosopic parapagus
- dicephalic parapagus
fused at the abdomen and
pelvis, but not the thorax
dithoracic parapagus
have one trunk and one
head with two faces
diprosopic parapagus
have one trunk and two
heads, and two-four arms
dicephalic parapagus
conjoined twins that are joined at the back of their embryonic disc
dorsal union
✓Fused skulls, but separate bodies
✓Can be conjoined at the back of the head, the front
of the head, or the side of the head, but not on the
face or the base of the skull.
cranipagus
percentage of cases of craniopagus
6%
✓ Two bodies joined at the pelvis
pygopagus (iliopagus)
✓ Fused dorsally above the sacrum & lumbar spine, involving different
segments of the column
✓ rare occurrence
rachipagus
✓Twins that are asymmetrically conjoined, resulting
in one twin that is small, less formed, and dependent on the larger twin for survival.
parasitic twins
percentage of cases of parasitic twins
10%
✓Situation in which an
undeveloped fetus is encased
in the body of its twin
✓Often presents as a cyst
fetus in fetu
One head w/ a single face
but four ears, and two
bodies
synecephalus
risk factors of multiple pregnancies
- parity
- age
- inheritance
- race (prevalent in non-whites)
- IVF
- fertility drugs
common maternal implications
- physical discomfort
- SOB
- dyspnea
- backaches
- pedal edema
- UTI
maternal complications during labor
- abnormal fetal presentations
- uterine dysfunction
- prolapsed cord
- hemorrhage at birth
fetal-neonatal implications
- lower IUGR
- fetal anomalies - spinal cord defect
- prematurity
- abnormal presentations
- LBW
- cerebral palsy
- velamentous cord insertion
-discordant infants - knotting and twisting of cord
auscultation of HRs that differ by at least ___ bpm
10
true or false - severe anemia is common in multiple pregnancies
true
In some instances, early
ultrasound examinations
reveal multiple amniotic
sacs but then later in
pregnancy, in as many as
30% of women, only one
fetus remains.
vanishing twin syndrome
Maternal HPN = ??
bed rest in lateral position
FHR monitoring via ___
electronic fetal monitor EFM
