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Medicine II: OBGYN > Twin Gestation > Flashcards

Twin Gestation Flashcards

1
Q

What percentage of twins are monozygotic?

A

30%

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2
Q

Is the frequency of monozygotic twins constant across all age and ethnic groups?

A

Yes

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3
Q

What increases the frequency of dizygotic twins?

A

African Americans
older women
+ FHx
Use of ovulation induction

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4
Q

What is the frequency of spontaneous twins?

A

1%

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5
Q

What is the frequency of ovulation induction?

A

5-8%

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6
Q

What is the explanation of increases in frequency of twins and triplets?

A

older age of mothers and increased use of ART

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7
Q

What are some findings that are suggestive of twins?

A

Uterus is large for dates
maternal perception of excess emotion
auscultation of two distinct heart beats

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8
Q

How do you diagnose that the mother has twins

A

US

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9
Q

If the placenta is monchorionic and monoamniotic what is the zygosity?

A

monozygotic

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10
Q

If the placenta is monochorionic and diamniotic, what is the zygosity?

A

monozygotic

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11
Q

If the placenta is dichorionic and diamniotic what is the zygotisity?

A

Either

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12
Q

What determines the type of twins?

A

the timing of the egg cleavage

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13
Q

What are possible antenatal complications?

A 
spontaneous abortions
anomalies
preterm labor- 30%
impaired growth of one or both twins
polyhydramnios
twin to twin transfusion syndrome
pre-eclampsia
placental abnormalities
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14
Q

What are possible peripartum complications?

A 
dysfunctional labor
malpresentation
abruption
abnormal FHR tracing
Cesarian delivery
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15
Q

What are complications with cesarian delivery during peripartum?

A

abnormal labor
abnormal presentation
abnormal FHR

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16
Q

What are possible postpartum complications for twin gestation?

A

severe parenting stress
postpartum hemorrhage- due to uterine anomaly
maternal depression
child abuse

17
Q

How do we look out for and manage twin gestation

A 
early prenatal care
early US to determine zygosity
second trimester scan (anomalies and cervical length)
Cerclage?
Third trimester scan for fetal growth
frequent prenatal apts
limited activity
antepartum monitoring
18
Q

What is the usual timing of delivery of monozygotic twins?

A

37 weeks

19
Q

What is the usual timing of delivery of dizygotic twins?

A

38 weeks

20
Q

What is the method of deliver when both babies present cephalic?

A

vaginal

21
Q

what is the method of delivery if both babies present abnormal?

A

Cesarian

22
Q

what is the method of delivery if the babies present cephalic-breech?

A

cesarian, vag, or vag-breech

23
Q

What causes higher order multiples?

A

ovulation induction with gonadotropins

ivf- 2 embryos transferred

24
Q

What is a dominant complication of higher order multiples?

A

preterm delivery

worse prognosis with more fetuses

25
Q

beneficience

A

greatest good for the greatest number

Medicine II: OBGYN (18 decks)

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