multiple pregnancy

Question 1

what sign can be seen in dichorionic diamniotic twins?

Answer 1

lambda and twin peak sign

Question 2

what sign can be seen in monochorionic diamniotic twins?

Answer 2

T sign

Question 3

what are complications of twin pregnancy for mother?

Answer 3

• anaemia
• HTN
• malpresentation
  spontaneous preterm birth
• instrumental delivery or C-section
• post partum haemorrhage

Question 4

what are risks of twin pregnancy to the foetus?

Answer 4

• miscarriage
• stillbirth
• fetal growth restriction
• prematurity
• twin-twin transfusion sundrome

Question 5

how may twin-twin transfusion be treated?

Answer 5

treated in tertiary centre with laser treatment to destroy the connection between the two blood supplies

Question 6

what happens in twin anaemia polycythaemia sequence?

Answer 6

Twin anaemia polycythaemia sequence is similar to twin-twin transfusion syndrome, but less acute. One twin becomes anaemic whilst the other develops polycythaemia (raised haemoglobin).

Question 7

when do women with multiple pregnancies need additional monitoring for anaemia?

Answer 7

• booking clinic
• 20 weeks of gestation
• 28 weeks of gestation

Question 8

how often do monochorionic twins require ultrasound scans?

Answer 8

• 2 weekly scans from 16 weeks gestation

Question 9

how often do dichorionic twins require ultrasound scans?

Answer 9

• 4 weekly scans from 20 weeks

Question 10

when is planned birth offered for monochorionic mono amniotic twins?

Answer 10

32 and 33 + 6 weeks for uncomplicated monochorionic monoamniotic twins

Question 11

when is planned birth offered to monochorionic diamniotic twins?

Answer 11

36 and 36 + 6 weeks

Question 12

when is planned birth offered to dichorionic diamniotic twins?

Answer 12

37 and 37 + 6 weeks for uncomplicated dichorionic diamniotic twins

Question 13

when are triplets usually delivered?

Answer 13

Before 35 + 6 weeks

Question 14

how are mono amniotic twins usually delivered?

Answer 14

elective caesarean section at between 32 and 33 + 6 weeks.

Question 15

what are the birthing options for diamniotic twins?

Answer 15

(aim to deliver between 37 and 37 + 6 weeks):

Vaginal delivery is possible when the first baby has a cephalic presentation (head first)
Caesarean section may be required for the second baby after successful birth of the first baby
Elective caesarean is advised when the presenting twin is not cephalic presentation