W2 - Multiple Pregnancy Flashcards
what are monozygous twins
identical
what are dizygous twins
non-identical twins
dizygotic twins have
2 chorions
2 amniotic sacs - 2 ovum and 2 sperm
monozygotic twins have depending on the timing of the split
- morula splitting - 2 chorion and 2 placenta
- hatching split - 2 amniotic sacs 1 placenta
3 blastocyst split - 1 amniotic sac 1 placenta
- any time later - conjoined twins
what are the % of each of the different splits
- morula 25%
- Hatching 75%
- blastocyst <1%
how do you determine chorionicity
USS at 11-14 weeks
what are the features of Di-Chorionic
Thicker dividing line
- ‘Lamba (λ) sign’
what are the features of Mono-Chorionic
Thinner dividing line
1 shared placenta
Monochorionic diamniotic twins will always be identical.
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T
Dichorionic diamniotic twins will always be identical.
T/F
F
Dichorionic diamniotic twins may be identical.
T/F
T
what complications should be considered in multiple pregnancy for the mother
hyperemesis/ fatigue/ back pain/ cramp
anaemia
VTE
Pre-eclampsia
what complications should be considered in multiple pregnancy for the babies
growth restriction - 25%
prematurity - 50% by 37weeks
10% <32weeks
pregnancy loss
malpresentation
what is twin to twin transfusion syndrome
10% of MCDA twins
Vascular anastomosis in placenta enabling unequal sharing between foetal circulations
Discordant fluid → heart failure →death
MCDA twins scanned 2 weekly from 16 weeks.
what is the treatment for twin to twin transfusion syndrome
Treatment by laser ablation of communicating vessels
if untreated 80% mortality
Approximately 30% of twins are born before 37 weeks.
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F
Approximately 10% of DCDA twins get TTTS.
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F
LSCS is recommended for all twins.
T/F
F
Twins have a higher incidence of pre-eclampsia than singletons
T/F
T
what is the chorion
The chorion is the outer membrane surrounding the developing foetus and placenta.
