multiple pregnancy

Question 1

T/F twins or triplets (multiple preg) increases chances of pre-term delivery

Answer 1

T. <28 weeks and <37 weeks compared to singleton pregnancy

Question 2

T/F majority of IVF results in twins/multis

Answer 2

F. ~75% results in singletons

Question 3

T/F most twin births are due to IVF

Answer 3

False. only 15% are due to IVF

Question 4

why is it riskier to have monochorionic twins than dichorionic?

Answer 4

higher risk of: 
-twin to twin transfusion syndrome 
-twin anaemia polycythaemia sequence 
-twin reversed arterial perfusion.
-conjoined
Also,
-consequences of IUGR is severe
-consequence of death of co-twin is severe

Question 5

how do birth outcomes differ between mono and dichorionic twins

Answer 5

• delivery at earlier gestation (35 vs 36wks)
• lower birth weight
• increased perinatal mortality
• increased NISC admission rate
• increased necrotizing enterocolitis (NEC)

Question 6

how to screen for mono vs dichorionicity?

Answer 6

nuchal transulucency, T2 biochemistry, and nasal bones are ~90% for picking up dichorionicity

Question 7

how can 100% certainty of chorionicity be attained?

Answer 7

CVS (1% chance of miscarriage, 2% risk of double sampling)),
riskier than,
amnioscentesis (0.5% chance of miscarriage, minimal risk of double sampling)