Multiple Pregnancy Flashcards
How are twin pregnancies classified?
Zygosity
Chorionicity
Amnionicity
What is zygosity?
Monozygotic twins - from same egg and sperm
Dizygotic twins - from different egg and sperm
What is chorionicity?
Monochorionic - single shared placenta
Dichorionic - separate placentas
What is amnionicity?
Monoamniotic - single shared amniotic sac
Diamniotic - separate amniotic sacs
What are the risks of monozygotic twins?
Increased sponatenous miscarriage
Prematurity
IUGR
Increased malformations
Twin to twin transfusion syndrome
What are the maternal complications of multiple pregnancy?
Anaemia
Polyhydramnios
Hypertension
Malpresentation
Premature labour
Instrumental delivery
Caesarean section
PPH
What are the predisposing factors to dizygotic twins?
IVF treatment
Previous twins
Family history
Increasing maternal age
Multigravida
Afro-carribean race
What are the fetal risks of multiple pregnancy?
Miscarriage
Stillbirth
IUGR
Prematurity
Twin-twin transfusion syndrome
Congenital abnormalities
What is twin-twin transfusion syndrome?
When one twin receives the majority of blood through the shared placenta, while the other is starved of blood
What are the complications to the recipient in twin-twin transfusion syndrome?
The recipient can become fluid overloaded leading to:
- Heart failure
- Polyhydramnios
What are the complications to the donor in twin-twin transfusion syndrome?
Growth restriction
Anaemia
Oligohydramnios
What is twin anaemia polycythaemic sequence?
Like twin-twin transfusion syndrome but less severe - one twin will be polycythaemic and the other will be anaemic
How often are women with multiple pregnancy scanned?
Every 2 weeks from 16 weeks for monochorionic twins
Every 4 weeks from 20 weeks for dichorionic twins
What type of twins require caesarean section?
Monochorionic monoamniotic
When should dichorionic diamniotic twins be delivered?
Between 37 and 37+6 weeks
