Multiple Pregnancies Flashcards
How often do multiple pregnancies occur in?
1 in 80
what types of twins can you have (in terms of eggs/sperm)
Dizygotic
Monozygotic
What causes increased risk of dizygotic twins?
maternal age
IVF, clomiphene
What can monozygotic twins share depending on timing of splitting after fertilisation?
<3 days after fertilisation: dichorionic diamniotic
4-8 days after fertilisation: monochorionic diamniotic
8-12 days after fertilisation: monochorionic mono amniotic
>13 days after fertilisation: COINJOINED
What are the tablets a mother expecting multiple babies should be given?
Iron
Folic acid
Vitamin B12
Why is a mother with twins more likely to have anaemia?
- Greater increase in blood volume > this has dilutional effect
- Greater iron, folic acid needed
What does monochorionic mean?
ONE placenta > shared
What does monoamniotic mean?
ONE amniotic sac > shared
What are maternal complications with multiple pregnancy
ALL normal complications are exacerbated
Especially at risk of GDM, PET, anaemia
What are foetal complications in multiple pregnancy?
Increased mortality, disability, IUGR, pre term labour
What can occur with miscarriage (death) of one twin in multiple pregnancy?
Miscarriage: one twin can vanish in 1st trimester
Miscarriage in one monoichorionic twin: sudden drop in BP in dead twin causes acute transfusion of blood to alive twin > hypovolaemia of alive twin > death of alive twin
Why does twin-twin transfusion syndrome occur?
Due to unequal blood distribution through vascular anaestamosis and shared placenta
What is twin-twin transfusion syndrome
Unbalances distribution of blood between the twins
What are the two twins like in twin-twin transfusion syndrome
One twin is DONOR: volume depleted, anaemic, IUGR, oligohydrosis
One twin is RECEPIENT; volume overload, polycythaemia, cardiac failure, polyhydramnios
What type of twins does twin-twin transfusion syndrome occur in
Monochorionic diamniotic
