Twins And Malpresentation Flashcards
Difference between dizygotic twins and monozygotic twins?
Dizygotic is two separate eggs are fertilized by two separate sperm
Monozygotic is the cleavage of a single fertilized egg that splits
What is going on with amnion and chorion with different times when the egg can split for monozygotic twins?
0-3 days, 4-8 days, 9-12 days and greater than 13 days?
Di di
Monochroion and diamnion
Mono mono
Conjoined twins
Which placentation is most common and which one is most dangerous?
Monochor diamnion
Mono mono
Of spontaneous twins, which one is more common?
Dizygotic at 2/3.
How do we determine zygosity? 2 steps.
First, do an US. If dizygotic, different fetal gender, thick septum.
If mono, septum super thin.
If cant definitively say via US, then DNA analysis once born.
In order of decreasing frequency, most common interplacental vascular anastomoses?
Arterial arterial, arterial venous, and venous venous
What is the syndrome resulting from arterial to venous anastomoses and what is the big time complication for each?
Twin twin transfusion syndrome
Heart failure
2 treatments for twin twin transfusion syndrome?
Amniotic fluid reduction via amniocentesis
Laser photocoagulation of vessels that are anastomoses
What is Arcadiac twin?
When there is an arterial to arterial connection and the recipient is getting poorly oxygenated blood so nothing above the abdomen forms.
2 risks of twins?
Preterm birth and preeclampsia
2 things to do for first and second trimester management of twins?
Office visits every 2 weeks
Check cervical length via US
2 things to do for management of twins during third trimester?
Serial US for fetal growth
Antepartum testing
Recommended delivery for monoamniotic twins with complications like cord tangled and all other twins if everything is going good?
32
38
What presentation of twins occurs about half the time?
Vertex vertex
Two ways to deliver vertex transverse and vertex breech and which one is most common?
Most common is c section but can be vaginal
