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Reproduction SOH > Multiple Pregnancy > Flashcards

Multiple Pregnancy Flashcards

1
Q

Definition

A

Presence of more than 1 foetus

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2
Q

Incidence increases with assisted conception. True or false?

A

True

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3
Q

Identical twins are MONOZYGOTIC / DIZYGOTIC ?

A

Monozygotic

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4
Q

What does monozygotic mean?

A

2 embryos develop from the one zygote

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5
Q

Definition of mono-chorionic?

A

One placenta

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6
Q

Definition of di-chorionic?

A

Two placentas

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7
Q

If the fertilised egg splits at day 3 after fertilisation, this results in di-chorionic or mono-chorionic twins?

A

Di-chorionic

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8
Q

If the fertilised egg splits at day 4-7 after fertilisation, this results in mono-chorionic or di-chorionic twins?

A

Mono-chorionic

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9
Q

If the fertilised egg splits at day 8-13 after fertilisation, this results in mono-chorionic or di-chorionic twins?

A

Mono-chorionic

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10
Q

If the fertilised egg splits at day 13-15 after fertilisation, this results in?

A

Conjoined twins

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11
Q

Monozygotic / Dizygotic twins are at higher risk of pregnancy complications?

A

Monozygotic

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12
Q

Non identical twins are MONOZYGOTIC / DIZYGOTIC ?

A

Dizygotic

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13
Q

What does dizygotic mean?

A

Fertilisation of 2 eggs by 2 sperm

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14
Q

Dizygotic twins are ALWAYS di-chorionic. True or false?

A

True

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15
Q

How can you determine chorionicity?

A

US

- look at shape and thickness of membrane

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16
Q

Determining chorionicity - Y sign

A

Di-chorionic, Di-amniotic

17
Q

Determining chorionicity - T sign

A

Mono-chorionic, d-iamniotic

18
Q

Complications of mono-chorionic twins

A

Single foetal death
Selective growth restriction
Twin anaemic polycythaemia sequence (TAPS)
Twin to Twin transfusion syndrome (TTTS)

19
Q

Twin to Twin transfusion syndrome is more common in early/late pregnancy?

A

Early

20
Q

Risk factors for multiple pregnancy

A 
Assisted conception
Race - African 
FH
Increased maternal age 
Increased parity
21
Q

Clinical features

A

Exaggerated pregnancy symptoms

Hyperemesis gravidarum

22
Q

Clinical signs

A

High AFP
Large for dates uterus
Multiple foetal pole

23
Q

All multiple pregnancies are under consultant led care. True or false?

A

True

24
Q

How often do mono-chorionic twins get screened?

A

Appointments and US every 2 weeks from 16 weeks gestation

25
Q

How often do di-chorionic twins get screened?

A

Appointments and US every 4 weeks

26
Q

Medications

A

Iron supplementation
Low dose aspirin
Folic acid

27
Q

When do you aim to deliver di-chorionic twins?

A

37-38 weeks

28
Q

When do you aim to deliver mono-chorionic twins?

A

Deliver after 36 weeks

29
Q

If you are delivering triplets (or more) then which mode of delivery?

A

Casarean section

30
Q

If you are delivering mono-chorionic twins then which mode of delivery?

A

Caesarean section

31
Q

If the leading twin is cephalic then aim for which mode of delivery?

A

Vaginal

32
Q

Inter-twin delivery time should be less than _____

A

30 mins

33
Q

There is a higher risk of perinatal mortality with multiple pregnancy? True or false

A

True

- 6X higher

34
Q

Foetal complications

A 
Congenital anomalies
Pre-term birth
Growth restriction
Cerebal palsy 
Twin to Twin transfusion
35
Q

Maternal complications

A 
Hyperemesis gravidarum
Anaemia 
Pre-eclampsia
Antepartum haemorrhage
Pre-term labour 
Caesarean section
36
Q

Twin to twin transfusion syndrome can occur in both monochorionic and dichorionic pregnancies. True or false?

A

False

- TTTS only in monochorionic

37
Q

What is Twin to twin transfusion syndrome

A

Where there is disproportionate blood supply to fetuses in monochorionic pregnancies

38
Q

How are monochorionic monoamniotic twins to be delivered

A

C-section

- due to risk of cord entanglement

Reproduction SOH (50 decks)

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