Beckman multifetal gestation

Question 1

why is rate of twins rising?

Answer 1

incrase in maternal age and more frequent use of assisted reproductive technologies/ovulation induction agents

Question 2

dizygotic vs monozygotic

Answer 2

Dizygotic: 2 separate ova fertilized by 2 sperm

Mono: division of the fertilized ovum after conception

Question 3

Days post fertilization:

Diamniotic/Dichorionic; Di/Mono; Mono/Mono

Answer 3

3; 4-8; 9-12

Question 4

most significant cause of morbidity with multifetal gestation

Answer 4

Preterm Labor and Delivery

Question 5

Twin-twin Transfusion syndrome: donor vs recipient twin

Answer 5

Donor: Impaired growth, anemia, hypovolemia
recipient: hypervolemia, hypertension, polycythemia, CHF

Question 6

What should you use US to look for if a difference of 4cm or more btwn the weeks of gestations and fundal height?

Answer 6

1. Inaccurate dating, 2. multiple gestation, 3. hydramnios
2. gestational trophoblastic disease
3. pelvic tumor

Question 7

discordant growth (among twins)

Answer 7

defined as 15-25% reduction in the estimated fetal weight of the smallest fetus compared with the largest

Question 8

2 primary manipulations if 2nd twin is presenting any way other than cephalic

Answer 8

1. External cephalic version (abdominal massage using US visualization)
2. Breech extraction: (physician puts hand into uterine cavity and grasps legs to deliver breech)