Twin Pregnancy Flashcards

1
Q

Incidence of monozygotic twins changes

A

False it remains same
1 in 250

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2
Q

Hellens rule

A

If incidence of twins is 1 in 80
Triplets will be 1 in 80*2
Quadruplets will be 1 in 80 3

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3
Q

Incidence of dizygotic twins

A

Nigeria 1 in 20
India 1 in 80
Japan 1 in 200

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4
Q

Superfecundation

A

One cycle
2 ova at different times
Foetus are days are apart
May occur in humans

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5
Q

Superfetatiom

A

2 ova in 2 cycles
Theorical possibility
Practically not possible
Fetous 1 month. Apart

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6
Q

Risk factors

A

Geography distribution
Maternal age
Maternal predisposing
Ivf clomifine citrate, hmg

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7
Q

Chorion is formed by

A

8 days of fertilisation

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8
Q

A minion is formed by

A

10 days of fertilisation

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9
Q

If the division occurs on 8-12 days

A

Monochorionic monoamniotic

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10
Q

4-8 days division

A

Monochorionic di amniotic

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11
Q

More than 12 days

A

Conjoined twins

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12
Q

How conjoined twins are managed

A

C section
32-34 weeks after giving corticosteroids for lung

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13
Q

Most common variate of monozygotic twins

A

Mono chorionic di amniotic

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14
Q

Prognosis depends on

A

Choriocinity

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15
Q

Investigation of choice of choriocinity

A

Ultrasound

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16
Q

Twin peak sign /lambda sign

A

Is seen in Monochorionic diamniotic twins

17
Q

T sign is seen in m

A

Monochorionic diaamniotic
Monochorionic monoamniotic

18
Q

Complication of Monochorionic diamniotic

A

Twin to twin transfusions syndrome

19
Q

Complications of Monochorionic monoamnio

A

Cord entanglement

20
Q

Delivery of dichorionic diamniotic

A

38 weeks

21
Q

Monochorionic diamniotic delive

A

36

22
Q

Monochorionic monoamniotic delivery

A

32-34 weeks

23
Q

Best time to do ultrasound

A

10 weeks

24
Q

Why ultra sound is done

A

To look for unchallenged tuberosity
To know gestational age
To know chorionocity

25
Q

Earliest time where we can do use for chorionicity

A

7 weeks

26
Q

Markers of dichorionicity

A

Membrane thickness >2 mm
Difference placentas
Twin peak sign4 layers of membranes

27
Q

Complications of conjoined twins

A

Paraphagus joined at abdomen and pelvis

28
Q

Least complication of conjoined twins

A

Rachiphagus joined at level of vertebral column
If rachiphagus not there craniophagus

29
Q

Maternal risks of twin pregnancy

A

Haemo dynamic changes
Placental size preeclampsia
Abrubtio placenta
Placenta Previn
Hcg increases hyperemesis gravidarum
Human placental lactogen gestational diabetes
Intrahepatic cholestasis
Acute fatty liver
Polyhydrominos

30
Q

Twin pregnancy is the risk factor for pih

A

Start mother on low dose aspirin 80-150 mg/ day before 16 weeks ideally at 12 weeks

31
Q

3 complications which are related to twin pregnancy all not relating to chorionicity or amniocity

A

Preterm labour
Ingrid
Congenital anomalies

32
Q

Most common twin pregnancy complications

A

Pretermlabour

33
Q

Feral reduction is commonly done at

A

10 -13 weeks
Does not effect the survival

34
Q

What are criterion for cervical cerclage

A

2 nd term abortion
Per term labour
Short cervix < 2.5 cm