Multiple Pregnancy Flashcards
What are dizygotic twins?
- Formed from 2 eggs
- Non-identical twins
What are monozygotic twins?
- One fertilised eggs splits into 2
- Usually identical, but can be non-identical
- Always the same sex
What are the 3 possible outcomes of monozygotic twins?
- Split at 3 days = 2 placentas
- Split at 4-7 days = 1 placenta
- Split at 13 days = conjoined twins
Describe the possible placentation for monozygotic and dizygotic twins
- 2 placentas, 2 chorions, 2 amnions
2. Fused placentas, 2 chorions, 2 amnions
Describe the possible placentation for just monozygotic twins
- 1 placenta, 1 chorion, 2 amnions
2. 1 placenta, 1 chorion, 1 amnion
What is chorionicity?
Scan to determine how many chorions/ amnions
What do MCDA, MCMA and DCDA mean?
MCDA = Monochorionic, diamniotic MCMA = Monochorionic, Monoamniotic DCDA = Dichorionic, diamniotic
Which type of twins is at increased risk of congenital anomalies?
Monozygotic
What is twin to twin transfusion syndrome?
Blood transfuses from one twin to the other via placental blood vessels (occurs usually in MCDA twins) causing unequal growth
What are the complications of twin to twin transfusion syndrome for the recipient?
- Polycythaemia
- Circulatory overload
- Polyhydramnios
What are the complications of twin to twin transfusion syndrome for the donor?
- Anaemia
- Oedema
- IUGR
- Olighydramnios
What are some of the treatment options for twin to twin transfusion syndrome?
- Serial amniocenteses to drain liquor
- Laser ablation of placental vessels
- Selective fetocide
What does monochorionic mean?
1 placenta
What does monoamniotic mean?
1 amniotic sac
What is the management for a multiple pregnancy?
- Consultant care
- SGTT
- Scans every 2 weeks
- Give steroids 48 hours before delivery
