Multiple Pregnancies Flashcards
RFs for multiple preg?
Assoc conception African origin Geography Fam Hx Increased maternal age Increased parity Tall woman higher than short woman in risk as well as height
Monozygotic?
Splitting of single infertilized egg
Dizygotic?
Fertilization of 2 ova by 2 sperm
Corionicity?
How many placentas
What can twins be depending on time of splitting fertilized ovum?
Monochorionic monoamniotic
Monochorionic Diamniotic
Conjoined twins
Dichorionic
Twin vibes picture?
Chorionicity is determined by?
US using shape and thickness of membrane: most reliably done at booking scan
What is required in monochorionic/monozygous twins and why?
2 weekly US to pick up early signs of twin-twin transfusion syndrome (TTTS)
Symptoms and signs of multiple ‘pergante’? (Meme speak for pregnant sorry Ellie x)
Exaggerates preg symptoms
High AFP
Large for dates uterus
Multiple Fetal poles
Complications of multiple pregnancy?
Higher perinatal mortality Congenital anomalies IUD of 1 or both Preterm birth Growth restriction Higher risk of Cerebral palsy TTTS Oligo/polyhydramnios Hyperemesis gravidarum, anaemia, pre-eclampsia are all more likely in the mother Risk of AP, abruption, placenta paraevia Preterm labour
Antenatal management of multiple pregnancy?
Iron and folic acid supplementation also LDA for HT
US is done from 16th week every 2 weeks where deep vertical pool, bladder and umbilical artery
Anomaly scan is done at 18- 20 weeks
What is TTTS?
Condition with disproportionate blood supply to each foetus in monochorionic pregnancies
Donor twin in TTTS?
Decreased blood volume Decreased growth and development Oliguria Anaemia Oligohydramnios
Recipient twin in TTTS?
Increased blood volume Increased urine output Polyhydramnios Polycythaemia Eventrual HF
Treatment of TTTS?
Fetoscopic laser ablation
Amnioreduction
Septostomy depending on gestation
