Multifetal Gestation

Question 1

Twin-Twin Transfusion STages

Answer 1

1. Monochorionic-Diamnionic oligo
2. Bladder absent (empty) in donor
3. abnormal dopplers
4. Hydrops
5. Death of one twin

Question 2

tx of twin twin transfusion

Answer 2

laser coagulation/amnioreduction

Question 3

Monoamniotic twins incidence

Answer 3

1/10,000

Question 4

Incidence increased of monoamniotic for what kind of pt

Answer 4

in vitro with zona manipulation

Question 5

Monoamniotic twins delivery

Answer 5

32-34 wks

Question 6

Zygosity

Answer 6

Dizygous: 2 eggs/2 sperm
Monozygous: one egg/one sperm

Question 7

INcidence of mono/dizygosity

Answer 7

Dizygous 8/1000

Monozygous: 4/1000

Question 8

Splitting time for Monozygous twins

Answer 8

0-3 days: Dichorionic/Diamniotic
3-8 days: Monochorionic/Diamniotic
8-13 days: Monochorionic/Monoamniotic
>13 days: Conjoined (1/50-100K births; 18% survival from time of dx to separation)

Question 9

Dizygotic twins chorionicity and amionicity

Answer 9

ONLY Di/Di!

Question 10

How do you know if dizygotic by sono?

Answer 10

Different sex

Question 11

Acardiac twinning

Answer 11

monochorionic twin with one twin underdeveloped heart and head (1% of monochorionic twins)–placental anastamoses with blood shunt from “pump twin”–this twin is high CO state, subsequent cardiac failure –> IUFD 50%

Question 12

Uncomplicated twin pregnancies and delivery time

Answer 12

Di/Di = 38 wks
Mono/Di = 34-37 6/7 wks
Mono/Mono = 32-34 wks