Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

DM2 Prep- Obstetrics > Multiple Pregnancy > Flashcards

Multiple Pregnancy Flashcards

(65 cards)

Start Studying
1
Q

Incidence of monozygous twin

A

3-5:1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Triplet birth rate

A

0.24: 1000 live births

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Twin birth rate

A

15.8 :1000 LB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Perinatal mortality : twins

A

37 : 1000

3 times higher than singleton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Perinatal mortality: triplets

A

52: 1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Perinatal mortality: higher order

A

231: 1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cerebral palsy in twins

A

8 fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cerebral palsy triplets

A

47 fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What percentage if monozygotic twins are DCDA

A

25-30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What percentage of monozygotic twins are monochorionic

A

75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What cleavage phase results in MCMA

A

Cleavage between days 8 and 13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most reliable time to determine chorionicity

A

10-13 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ultrasound features if monochorioninc twin (4)

A
  • early pregnancy 1 placental mass
  • T sign (thin intertwin membrane)
  • twin membrane <1.8mm
    -non discordant sex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Incidence of congenital malformation in monozygotic twins compared to dizygotic twins

A

3 fold compared to dizygotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When should screening for TTTS begin?

A

16 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How often should ultrasounds be performed in TTTS screening

A

Baseline: Every 2 weeks from 16 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is the most common time for TTTS to develop

A

16 - 24 weeks
(Only 1% of cases happen after 24 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When should fetal surveillance begin for DCDA twins

A

24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How often should ultraosund be done in DCDA

A

Baseline: every 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What has been proven to prevent preterm birth in multiple pregnancy?

A

Nothing.

Studies have found no clinical benefits of bedrest, tocolytics, progesterone and cerclage in multiple pregnancies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are maternal complications of twin pregnancies
Antepartum (3)

A
  • preeclampsia
  • anemia
  • gestational diabetes mellitus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What screening should be offered in twin pregnancies?

A

Aneuploidy
- first trimester combined (NT, hcg, pappa)

  • integrated screening ( NT + t1 screen + t2 screen)
  • cfdna ( 99% sensitive for trisomy 21)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Advantages of NIPT (4)

A
  • Higher detection rate
  • High negative predictive value for trisomy 21
  • Lower false positive rate
  • Less dependent on gestational age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the most common complications of monochorionic placentation

A
  • TTTS
  • TRAP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What percentage of MC are complicated by TTTS
10-15%
26
What is the postulated pathophysiology of TTTS
The presence of deep unidirectional flow through arterio-venous communications and minimal or no superficial bidirectional flow
27
How does oligohydramnios occur in TTTS
Hypovolemia of the donor twin results in activation of the renin- angiotensin system resulting in Vasoconstriction, oliguria, iugr
28
What system is used to classify TTTS
Quintero classification
29
Stage 1 TTTS
Oligohydramnios (<2cm DVP) one twin Polyhydramnios (>8cm DVP) other twin. Both bladders visible
30
Stage 2 TTTS
Bladder absent for donor twin
31
Stage 3 TTTS
Abnormal dopplers in either twin
32
Stage 4 TTTS
Fetal hydrops in either twin
33
Stage 5 TTTS
Death if one or both twins
34
What is the fetal mortality for untreated moderate-severe TTTS
up to 90%
35
What are the neonatal long term implications of TTTS (3)
- cardiac - renal - neurological complications
36
Treatment options for TTTS (5)
- laser ablation - serial amnioreduction - selective fetocide - septostomy - termination of pregnancy
37
What is the survival rate of MCT with TTTS following laser coagulation
Up to 70 %
38
What was the Eurofetus trial
RCT comparing laser therapy vs amnioreduction for TTTS before 26 weeks.
39
What were the findings of the eurofetus trial (3)
1) laser group had a higher likehood of Infant survival(of at least one twin) to 28days of life and 6mnths of age. 76% vs 56% 2) laser group has less periventricular leukomalacia 3) median gestational age of delivery laser 33.3 weeks and amnioreduction 29 weeks
40
How many MCT are affected by twin reversed arterial perfusion sequence
5%
41
What is TRAP
An acardiac "perfused twin" receives its blood supply from a large arterio-arterial anastamosis from the "pump twin" resulting in absent or rudimentary development of the head, heart and upper limb
42
What is the mortality rate of the pump twin in TRAPS
>50%
43
What is the cause behind mortality of TRAPS
High output congestive heart failure and hydrops
44
Definitive management on TRAP
Separation of the Cardiovascular circulation by diathermy occlusion of the cord of the acardiac twin
45
What is a significant twin discordance
20%
46
How is twin discordance calculated
(EFW larger twin - EFW smaller twin)÷ EFW larger twin x 100
47
What percentage of monchorionic twins are complicated by selective growth restriction
10-15%
48
What percentage of MCMA twins have cord entanglement in T3
Up to 100%
49
What feature is seen on doppler confirming cord entanglement
Galloping sign - two asynchronous heart beats
50
What is the perinatal loss rate of MCMA twins
10-15%
51
Incidence of conjoined twins
1: 90,000- 100,000
52
Overall risk of congenital malformations in twins
600 per 10000 twin births
53
What congenital anomalies are associated with monozygotic twins (3)
- holoprosencephaly - neural tube defects - cloacal extrophy
54
Risk of cardiac anomalies 1) MCDA 2) MCMA
MCDA: 7% MCMA: 57%
55
What percentage of live births are twin pregnancies
3%
56
What percentage of twins deliver before 37 weeks
50%
57
What percentage of twins deliver before 32 weeks
10%
58
What is the risk of neurological abnormality in surviving twin of iufd mcda
26%
59
What is the risk of second twin death if one twin dies in a monochorionic pregnancy
15%
60
Incidence of conjoined twins
1:100,000
61
What percentage of live births are twin
3%
62
What is the associated perinatal mortality of a twin compared to singleton
3 times higher
63
What percentage of ivf pregnancies are multiple preg
24%
64
What percentage of twins in the uk are monochorionic
30%
65
What percentage of live births are twins
3%

DM2 Prep- Obstetrics (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions