Twins

Question 1

incidence of twins?

Answer 1

1/80

Question 2

difference between dizygotic and monozygotic?

Answer 2

• monozygotic- identical
  
  • one egg
  • chorionicity depends on when splitting of embryo occurred
• dizygotic - non identical
  
  • 2 eggs
  • each have their own placenta and membrane (dichorionic, diamniotic)

Question 3

options for monozygotic chorionicity?

Answer 3

Question 4

ante-natal care for twins?

Answer 4

• close monitoring on scans
  
  • 2 weekly scans from 16 weeks for monochorionic twins
  • 4 weekly scans from 20 weeks for dichorionic twins

Question 5

delivery option for monoamniotic twins?

Answer 5

elective C section at 32-34 weeks

Question 6

delivery option for di-amniotic twins?

Answer 6

aim for delivery 37-38 weeks

• if presenting twin in cephalic position can do vaginal delivery
• if not, elective C section advised

Question 7

risks of multiple pregnancy on mother?

Answer 7

• hyperemesis
• risk of opertive delivery
• gestational diabetes
• PET
• anaemia

Question 8

risks of multiple pregnancy on foetus?

Answer 8

• IUGR
• IUD
• twin-twin transfusion syndrome
• prematurity

Question 9

what is twin-twin transfusion syndrome?

Answer 9

• connection between blood supplies of 2 babies
• recipient gets majority of blood & can become fluid overloaded whereas donor is starved and becomes anaemic