Obs - Small and Large for Dates Flashcards
what is a monochorionic/monoamniotic set of twins?
one amniotic sac
one placenta
what is a monochorionic/diamnotic set of twins?
one placenta
two amniotic sacs
what is a dichorionic/diamniotic set of twins?
two placenta
two amniotic sacs
features of twin pregnancies?
high AFP
large for dates
worse symptoms
risks associated with twins?
pre term
IUGR
APH
congenital anomolies
what medications should mum be taking if carrying twins?
aspirin
iron
folic acid
is multiple pregnancy a risk factor for VTE?
YES (must have other also for LMWH)
what can cause polyhydramnios?
twins
DM
hydrops fetalis
idiopathic
what is twin to twin transfusion syndrome?
disproportionate blood supply in monochorionic pregnancies (one is taking more blood)
what are the fetal risks associated with DM?
polyhydramnios
macrosomia
shoulder dystocia
stillbirth
what steps should be taken during the delivery of twins?
? c section
CTGs continuously
<30 mins between twins
syntocinon given after first (keeps contractions)
active 3rd stage (PPH risk)
what can cause IUGR?
smoking alcohol drugs age maternal disease placental problems infections chromosome abnormalities
what is SGA classified as (centiles)?
weight less than the 10th centile
what are the pre term classifications?
extreme = 24-27+6 very = 28-31+6 moderate = 32-36+6
if pre term birth occurs, how should the patient be managed?
avoid PV Abx for chorioamniotis tocolytics (nifedipine) steroids <36wks magnesium sulphate (tocolytic) CTGs
