TWINNS Flashcards

1
Q

twins born what week

A

37

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

trips born what week

A

34

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

quads born what week

A

33

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fetal mortality rates are _____X that of singleton pregnancies

A

3-6X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Neonatal mortality _____X that of single pregnancies.

A

7X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

why does multiple have higher fatality

A

Primarily due to much higher incidence of premature labour.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Increased chance of dizygotic twins if:

A
increased maternal age 
frequent pregnancies 
pregnancy techniques -> hormone stimulation 
heredity -> mom is a twin 
race-> african
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

if there is a single outer membrane the twins must be

A

monozygotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

1/3 of monozygotic twins are

A

dichorionic/diamniotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

two types of DCDA

A

seperated and fused

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

0-4 days for split =

A

DCDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

8-13 days =

A

MCMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why is chorionicity important

A

Monochorionic twin pregnancies have 3-5 times higher risk of perinatal mortality and morbidity than Dichorionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Chorionicity best evaluated in ___ trimester

A

1st

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Di chorion gives what sign

A

twin peak (lambda sign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how many yolk sacs in monochorionic

A

1 usually

17
Q

3 primary complications of multifetal pregnancies

A

Premature delivery
IUGR
Demise of a co-twin

18
Q

2 risks closely related to monochorionicity

A

congenital malformations and congenital heart disease

19
Q

since monochorionic twin pregnancies share the one placenta the are prone to

A

haemodynamic complications

20
Q

main monoamniotic complication

A

entangled cords

21
Q

what is twin growth discordance

A

refers to a significant size or weight difference between the two fetuses of atwin pregnancy

22
Q

To be classified as a growth discordance:

A

Weight discordance (weight disparity of greater than 15-25%)
Some consider that the estimated fetal weight (EFW)
of the smaller twin should fall under the 10thpercentile.

23
Q

weight % difference equation

A

(Larger twin EFW – Smaller Twin EFW) / Larger twin EFW * 100

24
Q

intra uterine growth restriction (IUGR) characterized by

A

impaired fetal growth and inadequate placental function

25
Q

the greater the discordance the higher the likelyhood of (4)

A

Placental insufficiency
Twin-twin transfusion syndrome
Higher incidence with avelamentous cord insertion
Higher incidence with asingle umbilical artery

26
Q

growth differences most profound > ____ _weeks

A

> 30 weeks

27
Q

A weight discordance is assessed by taking the estimated fetal weight (EFW) difference at ___-____%

A

15-25%

28
Q

twin to twin transfusion occurs in twins that are

A

identical twins that are monochorionic, diamniotic.

29
Q

what happens in twin to twin transfusion

A

single placenta contains blood vessel connections between the twins.

30
Q

is twin to twin transfusion genetic or from trauma

A

no

31
Q

what is the result of the twin getting too much blood

A

increase urine production and will have distended bladder as well as too much amniotic fluid around it (polyhdramnios)

32
Q

what happens to the donor twin

A

twin will produce less than the usual amount of urine. The amniotic fluid around the donor twin will become very low or absent (oligohydramnios).

33
Q

what is a stuck twin

A

the donor twin becoming wrapped in amniotic membrane becuase there is no fluid around it

34
Q

alternative term for twin to twin transfusion is

A

Twin Oligohydramnios/polyhydramnios syndrome

35
Q

what is Twin Reversed Arterial Perfusion sequence (TRAP)

A

A late separation of the embryonic cell mass results in a monochorionic-diamniotic twin pregnancy.
Anastomosis of vessels establishes a connection between the 2 circulations (unbalanced AA anastomosis).
Retrograde perfusion interferes with normal cardiac development, which rarely goes beyond the stage of tubular heart.
Thus the acardiac fetus becomes dependent on the perfusion of the “pump” twin.

36
Q

what happens to the acardiac twin

A

lower half of body better developed but upper half not at much

37
Q

Twin Reversed Arterial Perfusion sequence (TRAP) occurs in what type of twin

A

monochorionic-diamniotic

38
Q

acardiac twin is really just a

A

parasite (TOUGH LIFE) lol

39
Q

the pump twin in TRAP is at risk for

A

high output cardiac failure