Twins Flashcards
What are the risk factors for twins?
IVF
Increased maternal age
Increased parity
African race
Family history
Are dizygotic twins identical or non-identical?
Non-identical (fraternal)
- 2 sperm and 2 eggs
How many sperm and how many ova are involved in monozygotic twins?
One sperm and one egg (identical twins)
When should the dating scan be performed in twin pregnancy?
Before fusion of the membranes at 14 weeks
What are the maternal risks associated with twins?
Hyperemesis gravidarum
Pressure symptoms (constipation, pelvic pain)
Anaemia
Premature labour
PET
What are the intrapartum risks in a twin pregnancy?
Prolonged labour
Malpresentation
Cord prolapse
PPH
Increased risk of C-section
What are the foetal complications in a twin pregnanacy?
Miscarriage
Preterm delivery
IUGR
Congenital malformation
Single foetal demise
Cord prolapse or entanglement
What is twin-twin transfusion syndrome?
Twins share a placenta, imbalance of blood flow acorss the anastomosis - one twin is IUGR, one is hypervolemic
What classification system is used in TTTS?
Quintero classification
When should uncomplicated dichorionic twins be delivered?
38 weeks
When should uncomplicated monochorionic twins be delivered?
36-37 weeks
When can twins be delivered vaginally?
If both are cephalic or if the first twin is cephalic
What are the indications for C-section in a twin pregnancy?
Malpresentation
Foetal distress
Cord prolapse
IUGR
TTTS
What should be given to all mothers delivering twins in the third stage of labour?
40 IU oxytocin infusion to reduce risk of PPH
