Multiple Gestations

Question 1

factors that increase the likelihood of multiple gestations

Answer 1

history
advanced maternal age
assisted therapy
maternal obesity

Question 2

singletons vs. multiples mortality rate

Answer 2

twins have 4x ^ risk for fetal mortality and 6x ^ risk for neonatal morbidity rate

Question 3

zygote

Answer 3

fertilized egg

Question 4

zygosity

Answer 4

in multiple gestations, this term refers to the number of eggs that are fertilized

Question 5

monozygotic

Answer 5

twins arising from a single zygote

Question 6

dizygotic

Answer 6

twins form from 2 separate zygotes

Question 7

chorion

Answer 7

structure that forms the placenta

Question 8

chorionicity

Answer 8

how many placentas are present
monochorionic = twins who share a placenta
dichorionic = twins that have separate placentas

Question 9

amnionicity

Answer 9

how many amnions or amniotic sacs are present
monoamniotic = twins who share the same sac
diamniotic = twins that have their own sac

Question 10

dizygotic twinning

Answer 10

2 separate fertilized ova
**most common form of twinning
“FRATERNAL TWINS”

Question 11

monozygotic twinning

Answer 11

arise from a zygote that splits
monochorionic-diamniotic twins = more common
“IDENTICAL TWINS”

Question 12

at what days does the split and result in monochorionic-diamniotic

Answer 12

zygote splits between 4 & 8 days

Question 13

split (days) that results in a dichorionic-diamniotic pregnancy

Answer 13

zygote splits prior to day 4

Question 14

split (days) that results in a mono-mono pregnancy

Answer 14

zygote splits late, after 8 days

Question 15

split (days) for conjoined twins

Answer 15

split extremely late, 8-12 days

Question 16

twin peak sign

Answer 16

“Lambda Sign”

indicative of a di-di pregnancy

Question 17

delta sign

Answer 17

“T-sign”

monochorionic-diamniotic pregnancy

Question 18

different gender twins vs. same gender twins

Answer 18

dichorionic
vs.
monochorionic

Question 19

vanishing twin

Answer 19

death and reabsorption of the embryo during the 1st trimester
if embryo is not reabsorbed = fetal papyraceus
monochorionic twins, death of one, results in the death of other

Question 20

twin embolization syndrome

Answer 20

vascular products travel from the demised twin to the surviving twin by means of the common vascular channels with the shared placenta

Question 21

what risk ^ with multiple gest. pregnancies?

Answer 21

preterm labor

Question 22

chorion frondosum

Answer 22

the fetal contribution of the placenta derived from the blastocyst and contains the chorionic villi

Question 23

causes of placentomegaly

Answer 23

diabetes
maternal anemia
infection
fetal hydrops
Rh isoimmunization 
multiple gestations
(>4 cm thick)

Question 24

causes of a thin placenta

Answer 24

long-standing diabetes
IUGR
placental insufficiency
poly-
preeclamsia

Question 25

what is a common cause of painless vaginal bleeding in 2nd and 3rd trimester

Answer 25

placenta previa

Question 26

when is placenta previa more likely to occur

Answer 26

hx of multiparity advanced maternal age prior c-section

Question 27

vasa previa is often assoc. with what type of cord insert

Answer 27

velamentous

Question 28

placental abruption

Answer 28

premature separation of the placenta from the uterine wall before the birth of the fetus

Question 29

maternal causes of placental abruption

Answer 29

``` HTN preeclampsia cocaine cigarettes poor nutrition trauma ```

Question 30

chorioangioma

Answer 30

most common placental tumor ^ MSAFP most common location is adjacent to the umbilical cord insertion assoc. with poly-, IUGR, and fetal hydrops

Question 31

allantoic cyst

Answer 31

a mass adjacent to the cord near the fetal abd | assoc. with omphalocele and aneuploidy

Question 32

hemangioma

Answer 32

most common tumor of the umbilical cord (but very rare) | located near the cord insert on placenta

Question 33

fetal malformations assoc. with polyhydramnios

Answer 33

``` cardiac/chest anomalies chromosomal anomalies duodenal atresia esophageal atresia facial anomalies gastroschisis neural tube defects omphalocele Rh incompatibility twin to twin transfusion syndrome ```

Question 34

what does TORCH stand for

Answer 34

``` toxoplasmosis other infections rubella cytomegalovirus herpes simplex virus ```

Question 35

sonographic findings of TORCH

Answer 35

presence of intracranial calcifications microcephaly ventriculomegaly hepatosplenomegaly

Question 36

diethylstilbestrol

Answer 36

drug used to treat threatened AB & PTL in 1970s | can cause cervical incompetence

Question 37

cervical cerclage

Answer 37

the placement of stitches in the CX to hold it closed | for incompetent CX