multiple pregnancy Flashcards
monozygotic
identical twins from a single zygote
dizygotic
non-identical from 2 zygotes
monoamniotic
single amniotic sac
diamniotic
two amniotic sacs
monochorionic
share a single placenta
dichorionic
two placentas
which twin pregnancies have best outcomes
diamniotic dichorionic
USS - lambda sign
dichorionic diamniotic
USS - T sign
monochorionic diamniotic
risks to mum
anaemia polyhydramnios htn malpresentation preterm birth instramental delivery, CS PPH
risk to baby
miscarriage stillbirth IUGR prematurity twin-twin transfusion syndrome twin anaemia polychythemia sequence congenital abnormalities
twin twin transfusion syndrome
one fetus (the recipient) may receive the majority of the blood from the placenta, while the other fetus (the donor) is starved of blood.
twin twin transfusion syndrome - the Recipent
gets majority of blood and becomes fluid overloaded
- heart failure
- polyhydramnios
twin twin transfusion syndrome - the donor
growth restriction
anaemia
oligohydramnios
Twin Anaemia Polycythaemia Sequence
similar to twin-twin transfusion syndrome, but less acute.
One twin becomes anaemic whilst the other develops polycythaemia
antenatal care - anaemia
additional monitoring for anaemia FBC at -booking -20wks -28wks
antenatal care - USS for monochorionic twins
2wkly scans from 16wks
antenatal care - USS for dichorionic twins
4wkly scans from 20wks
Planned birth - monochorionic monoamniotic twins
32 - 33+6
Planned birth - monochorionic diamniotic
36 - 36+6
planned birth - dichorionic diamniotic
37 - 37+6
planned birth - triplets
before 35+6
delivery - monoamniotic twins
CS 32-33+6
delivery - diamniotic twins
vaginal delivery if first baby cephalic
CS may be required for 2nd baby
elective CS if presenting twin not cephalic
