multiple pregnancy

Question 1

monozygotic

Answer 1

identical twins from a single zygote

Question 2

dizygotic

Answer 2

non-identical from 2 zygotes

Question 3

monoamniotic

Answer 3

single amniotic sac

Question 4

diamniotic

Answer 4

two amniotic sacs

Question 5

monochorionic

Answer 5

share a single placenta

Question 6

dichorionic

Answer 6

two placentas

Question 7

which twin pregnancies have best outcomes

Answer 7

diamniotic dichorionic

Question 8

USS - lambda sign

Answer 8

dichorionic diamniotic

Question 9

USS - T sign

Answer 9

monochorionic diamniotic

Question 10

risks to mum

Answer 10

anaemia 
polyhydramnios 
htn 
malpresentation 
preterm birth 
instramental delivery, CS
PPH

Question 11

risk to baby

Answer 11

miscarriage
stillbirth 
IUGR
prematurity 
twin-twin transfusion syndrome
twin anaemia polychythemia sequence
congenital abnormalities

Question 12

twin twin transfusion syndrome

Answer 12

one fetus (the recipient) may receive the majority of the blood from the placenta, while the other fetus (the donor) is starved of blood.

Question 13

twin twin transfusion syndrome - the Recipent

Answer 13

gets majority of blood and becomes fluid overloaded

• heart failure
• polyhydramnios

Question 14

twin twin transfusion syndrome - the donor

Answer 14

growth restriction
anaemia
oligohydramnios

Question 15

Twin Anaemia Polycythaemia Sequence

Answer 15

similar to twin-twin transfusion syndrome, but less acute.

One twin becomes anaemic whilst the other develops polycythaemia

Question 16

antenatal care - anaemia

Answer 16

additional monitoring for anaemia 
FBC at
-booking
-20wks
-28wks

Question 17

antenatal care - USS for monochorionic twins

Answer 17

2wkly scans from 16wks

Question 18

antenatal care - USS for dichorionic twins

Answer 18

4wkly scans from 20wks

Question 19

Planned birth - monochorionic monoamniotic twins

Answer 19

32 - 33+6

Question 20

Planned birth - monochorionic diamniotic

Answer 20

36 - 36+6

Question 21

planned birth - dichorionic diamniotic

Answer 21

37 - 37+6

Question 22

planned birth - triplets

Answer 22

before 35+6

Question 23

delivery - monoamniotic twins

Answer 23

CS 32-33+6

Question 24

delivery - diamniotic twins

Answer 24

vaginal delivery if first baby cephalic
CS may be required for 2nd baby

elective CS if presenting twin not cephalic