WARD SEMI MULTI Flashcards
development of two fetuses
Twin Pregnancy
five FETUS
quintuplets
six fetus
setuplets
two types of twins
Dizygotic
Monozygotic
Results from fertilization of two ova
Dizygotic (80%)
this type of twin is where Sex and Genetic features differ.
Dizygotic
number of chorion and amnion for dizygotic
2 amnions and 2 chorions
percentage of diamniotic moniochorionic
- 70%
two separate placenta, chorion, amnion what do u call this
diamniotic-dichorionic
two amniotic sacs and share one outer membrane (chorion). This setup is called
diamniotic monochorionic
if the division takes place within 72 hours what type of twin is it?
diamniotic-dichorionic)
if the division takes place within (Intermediate split) 4th and 8th day what type of twin is it?
diamniotic monochorionic twins
during n (Intermediate split) 4th and 8th day what is formed and developed?
chorion
if the division takes place within r (late split) 8th day what type of twin is it?
monoamniotic monochorionic twins
during (late split) or 8th day, what is already formed
amniotic cavity
Division after two weeks or davit of embryonic disc resulting in the formation of
conjoined twins
factors are linked to having a multiple pregnancy
Heredity
Older age
High parity
Race
SIGNS of multipreg
Severe nausea and vomiting
Rapid weight gain
tender breasts.
symptoms of multipreg
Uterus is larger
Increased morning sickness
Increased appetite
Excessive weight gain
GENERAL EXAMINATION for multipreg
- Increased prevalence of anemia
- Unusual weight gain
- Evidence of preeclampsia
ABDOMINAL EXAMINATION FOR MULTIPREG
barrel shaped uterus
abdomen is unduly enlarged
Palpation of too many fetal parts
diff diagnosis for multifetus
Big baby
Elevation of the uterus by a distended bladder
Hydramnios
Ascites with pregnancy
(also called molar pregnancy; a gestational trophoblastic disease GTD
Hydatidiform mole
COMPLICATIONS OF TWIN PREGNANCY : maternal
Increased miscarriage
risk
Malpresentation
Anemia
Antepartum Hemorrhage
COMPLICATIONS OF TWIN PREGNANCY : during labor
PROM
Cord prolapse
Postpartum
hemorrhage
COMPLICATIONS OF TWIN PREGNANCY : post partum
Subinvolution (no return of normal size sa fetus)
Lactation failure
COMPLICATIONS OF TWIN PREGNANCY : FETUS
Abortion
neonatal
death/stillbirth
Risk of cord
accidents
Congenital anomalies in twin pregnancy
- Neural tube defects (NTD)
- Bowel Atresia
- Conjoined twins
- Twin reversed arterial perfusion (TRAP)
meaning of TRAP
Twin reversed arterial perfusion
Complication of Monochorionic twins
➢ Twin-twin transfusion syndrome (TTTS)
➢ Dead fetus syndrome,
survived twin-cerebral palsy, microcephaly
➢ Twin reversed arterial perfusion (TRAP)
➢ Conjoined twins
TTTS meaning
Twin-twin transfusion syndrome
Conjoined twins types:
○ Anterior (thoracopagus)
○ Posterior (pyopagus)
○ Cephalic (craniopagus)
○ Caudal (ischiopagus)
DURING PRENATAL CARE management for multipreg
Increased nutrition
Physician referrals
Increased rest
frequent prenatal visit
medicines- to help slow or stop contractions in multipreg
Tocolytic medicines
medication- given to help mature the lungs of the fetuse
Corticosteroid
during labor why does bed rest emphasized
prevent early rupture of membrane
Internal examination should be done soon after the rupture of the membrane to exclude what
cord prolapse
Vaginal delivery, interval between twins not to exceed how many minutes
20 minutes
Vaginal delivery by senior obstetrician
Vertex- Breech
Safer to delivery by cesarean to avoid interlocking twins
Breech- Vertex
Usually by cesarean type of delivery
Breech- Breech
Forceps delivery if necessary should be under what type of anesthesia
pudendal block anesthesia,
what anesthesia should be avoided
general
anesthesia
what medication should be avoided during delivery of first baby
ergometrine
why should we deliver baby by C-section. give examples:
To deliver babies in abnormal positions
When the mother has certain medical conditions
If the babies are in fetal distress
If the pregnancy is monochorionic
two or more eggs are released during ovulation and are fertilized by different sperm
Dizygoticc (Fraternal) Twins
Each zygote develops its own placenta and amniotic sac. This is called
polyzygotic twinning
ART meaning
assisted reproductive technologies
a single fertilized egg (zygote) splits into two or more embryos
Monozygotic (Identical) Twins:
if one or more fetuses don’t receive adequate blood
supply they may experience what condition
intrauterine growth restriction (IUGR)
Nursing interventions for multiple pregnancies
Nutritional Support
Psychosocial support
Anxiety Management
Sleep hygiene Promotion
Fetal Growth monitory
