MULTIPLE PREGNANCIES Flashcards by michaela gail

A pregnancy in which the
woman is carrying two or
more fetuses
Considered a complication
of pregnancy

multiple pregnancy

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true or false - It is sometimes difficult to determine by sonogram or at birth whether twins are identical or fraternal

true

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true or false - the lower a woman’s parity and age, the more likely
she is to have a multiple gestation

false 0 high the age

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___ appears to play a role in natural dizygotic
twinning; this has a familial maternal pattern of
occurrence

inheritance

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multiple (typically two) fetuses
produced by the splitting of a single zygote

monzygotic

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multiple (typically two) fetuses
produced by two zygotes

dizygotic

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multiple fetuses produced by two
or more zygotes

polyzygotic

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the offspring produced by a multiple birth in non-human placentals

litter

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name the labels of multiple pregnancies from 2-10

twins
quadruplets
triplets
quintuplets
sextuplets
septuplets
octuplets
nonuplets
decaplets

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name the labels of multiple pregnancies from 11-19

undecaplets
deodecaplets
tredecaplets
quattrodecaplets
quindecaplets
sexdecaplets
sepdecaplets
octdecaplets
nondecaplets

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*Also known as Siamese twins
*Identical twins whose bodies are joined in utero
*Higher incidence (Southwest Asia & Africa)

conjoined twins

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overall survival rate of conjoined twins

25%

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older & most generally accepted theory in which the fertilized egg splits partially

fission

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a fertilized egg completely separates, but stem
cells (which search for similar cells) find like-stem cells on
the other twin and fuse the twins together

fusion

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conjoined twins that share a portion of their front body

ventral union

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✓Two faces on opposite sides of a
single, conjoined head
✓Upper portion of the body is
fused while the bottom portions
are separate
✓Generally cannot survive

cephalopagus

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cephalopagus is also known as ___ or ___

janiceps or syncephalus

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✓Bodies fused in the
head and thorax
✓Has two faces facing in
opposite directions or
sometimes a single
face and an enlarged
skull.

cephalothoracopagus

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✓2 bodies fused from the
upper thorax to lower
belly.
✓The heart is always
involved in these cases.

thoracopagus

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percentage of cases of thoracopagus

18.5%

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✓ Two bodies fused at the lower chest
✓ Unlike thoracopagus, the heart is
never involved
✓ Twins share a liver, digestive
system, diaphragm and other
organs.

omphalopagus

percentage of cases of omphalopagus

10%

✓2 bodies fused from the upper
chest to the lower chest
✓Twins usually share a heart, and
may also share the liver or part of
the digestive system

thoraco-omphalopagus

percentage of cases of thoraco-omphalopagus

28%

2 bodies fused in the xiphoid cartilage -- these twins almost never share any vital organs, with the exception of the liver

xiphopagus

- ✓Fused lower half of the two bodies, with spines conjoined end-to-end at a 180° angle. - These twins have four arms; two, three or four legs; and typically one external set of genitalia and anus.

ischiopagus

- Fused in a similar fashion as ischiopagus twins, but facing each other with a joined abdomen akin to omphalopagus. - These twins have four arms, and two, three, or four legs.

omphalo-ischiopagus

Fused side-by-side with a shared pelvis.

parapagus

2 sub types of parapagus

- dithoracic parapagus - diprosopic parapagus - dicephalic parapagus

fused at the abdomen and pelvis, but not the thorax

dithoracic parapagus

have one trunk and one head with two faces

diprosopic parapagus

have one trunk and two heads, and two-four arms

dicephalic parapagus

conjoined twins that are joined at the back of their embryonic disc

dorsal union

✓Fused skulls, but separate bodies ✓Can be conjoined at the back of the head, the front of the head, or the side of the head, but not on the face or the base of the skull.

cranipagus

percentage of cases of craniopagus

✓ Two bodies joined at the pelvis

pygopagus (iliopagus)

✓ Fused dorsally above the sacrum & lumbar spine, involving different segments of the column ✓ rare occurrence

rachipagus

✓Twins that are asymmetrically conjoined, resulting in one twin that is small, less formed, and dependent on the larger twin for survival.

parasitic twins

percentage of cases of parasitic twins

10%

✓Situation in which an undeveloped fetus is encased in the body of its twin ✓Often presents as a cyst

fetus in fetu

One head w/ a single face but four ears, and two bodies

synecephalus

risk factors of multiple pregnancies

- parity - age - inheritance - race (prevalent in non-whites) - IVF - fertility drugs

common maternal implications

- physical discomfort - SOB - dyspnea - backaches - pedal edema - UTI

maternal complications during labor

- abnormal fetal presentations - uterine dysfunction - prolapsed cord - hemorrhage at birth

fetal-neonatal implications

- lower IUGR - fetal anomalies - spinal cord defect - prematurity - abnormal presentations - LBW - cerebral palsy - velamentous cord insertion -discordant infants - knotting and twisting of cord

auscultation of HRs that differ by at least ___ bpm

true or false - severe anemia is common in multiple pregnancies

true

In some instances, early ultrasound examinations reveal multiple amniotic sacs but then later in pregnancy, in as many as 30% of women, only one fetus remains.

vanishing twin syndrome

Maternal HPN = ??

bed rest in lateral position

FHR monitoring via ___

electronic fetal monitor EFM