Multiple pregnancy Flashcards
Best outcome for twin pregnancy is seen in…
Dichorionic, diamniotic twin
Types of twin pregnancies
- Dichorionic, dizygotic
- Dichorionic, monozygotic
- Monochorionic, monozygotic
Multiple pregnancy is diagnosed when?
At booking scan
Ultrasound scan sign for dichorionic diamniotic multiple pregnancy
Lambda sign
Ultrasound scan sign for monochorinic diamniotic multiple pregnancy
T sign
Risks to mother with twin pregnancy [7]
Anaemia
Miscarraige
Hypertension/ pre-eclampsia/ GDM
VTE
Pre-term birth
Labour: Instrumental delivery/ c-section/ PPH
Risks to fetus in twin pregnancy
- All
- Monchorionic
- Monoamniotic
All
- Miscarriage/ stillbirth
- Malposition
- Foetal growth restriction
- Prematurity
Monochorionic
- Twin-twin transfusion syndrome (monochorionic)
- Twin anaemia polycythaemia sequence (TAPS)
- Congenital abnormalities (higher)
- Selective IUGR
- Twin reversed arterial perfusion sequence (TRAP)
- Death of a twin
Monoaminotic
- Cord enlargment
Definition of small for gestational age
Estimated foetal weight / abdominal circumference < 10th percentile
Definition of small for gestational age
Estimated foetal weight / abdominal circumference < 10th percentile
Causes of symmetrical IUGR [4]
Chromosomal problem
Foetal infection
Inborn metabolic error
Structural problems
Causes of asymmetrical IUGR
Placenta-mediated
- Pre-eclampsia
- Autoimmune disease
- Renal disease
- DM/ GDM
- Thrombophilia
Risk factors for IUGR
Non-modifiable
- Age >40
- Nulliparity
- Previous SGA/ stillbirth
- Renal disease, antiphospholipid syndrome
- IVF
- PAPP-A <0.4
Modifiable
- Smoking
- DM
- High/ low maternal BMI
- Hypertension
Foetal doppler looks at blood flow in…
Umbilical artery
Middle cerebral
Ductus venosus
Neonatal complications of IUGR
Pre-term delivery
Meconium aspiration/ pulmonary hypertension
Hypoglycaemia
Polycythemia/ hyperviscosity
Mortality
DCDA twins occur when the zygotes cleave during first ______ after fertilisation
3 days
