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235 Pre-Eclampsia > Multiple Pregnancy > Flashcards

Multiple Pregnancy Flashcards

1
Q

What are the predisposing factors to multiple pregnancy?

A

Increasing maternal age

Family history

Race

Assisted conception

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2
Q

What are the two types of twins?

A

Monozygotic - single zygote splits into two equal zygotes - share same genetic material

Dizygotic - two different zygotes are formed by fertilisation of two eggs by two sperm - different genetic material

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3
Q

What is amniocity?

A

Refers to the relation of the amniotic membranes between the two twins.

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4
Q

What is chorionicity?

A

It refers to the placentation. Whether it is shared or each baby has its own.

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5
Q

What is dichorionic diamniotic twinning?

A

When each baby has its own placenta, two chorions and two amnions

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6
Q

What is monochorionic diamniotic twinning?

A

Each baby has its own amniotic sac, with a shared placenta. One chorion and two amnions

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7
Q

What is monochorionic-monoamniotic twinning?

A

Twin babies share both the amniotic sac and the placenta. One chorion and one amniotic sac.

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8
Q

In terms of chorionicity and amniocity, what are dizygotic twins?

A

Diamniotic Dichorionic

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9
Q

In terms of amniocity an chorionicty, what are monozygotic twins?

A

They can result in any of the three, depending on when the single zygote divides into two separate zygotes

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10
Q

What are the risks associated with monochorionic twin pregnancies? and twin pregnancies in general

A

Miscarriage

Congenital Abnormalities

Preterm

IU growth restriction

Perinatal loss

Twin to twin transfusion syndrome - imbalance of blood due two anastamosis of vessels between the twins (Donor and recipient)

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11
Q

What are the maternal complications of multiple pregnancy?

A

Hyperemesis gravidarum

Miscarriage

Pregnancy-induced hypertension/Pre-eclampsia

Gestational Diabetes

Anaemia

Ante/post-partum haemorrhage

Placenta Praevia

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12
Q

What is the antenatal management of twin pregnancies?

A

Chorionicity - during dating scan (1st trimester)

If MC → scan at 16 weeks for TTT, then every 2-3 weeks (monitor growth)

If DCDA → Serial growth scans

BP + Urine dipstick

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13
Q

What are the delivery times for the following?

Uncomplicated DCDA

Uncomplicated MCDA

A

Uncomplicated DCDA: 37-38 weeks

Uncomplicated MCDA: 36-37 weeks

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14
Q

What are the complications of delivery for twins?

A

Insufficient uterine action

Fetal distress

Cord prolapse when ruputure membrane

PPH

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235 Pre-Eclampsia (5 decks)

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