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Flashcards in multiple pregnancy Deck (23):
1

what is a dizygotic twin

2 or more ova released and fertilised

2

what is a monozygotic twin

single fertilised ovum divides early

3

predisposing factors

prev twins, FHx twins, incr maternal age, induced ovulation/IVF, race

4

what happens in DZ twins (placenta, chorion, amnion)

have their own individual placenta, chorion, amnion

5

what happens in MZ twins (placenta, chorion, amnion)

share placenta and chorion. 98% MZ twins have their own amnionic sac

6

what happens if MZ share an amniotic sac

risk cord entanglement

7

features multiple pregnancy

early in pregnancy uterus is large for dates, two poles felt, multiplicity of fetal parts felt, hyperemesis, 2 FHR. ultrasound

8

maternal complications

polyhydramnios, anaemia, pre eclampsia, APH

9

fetal complications

perinatal mortality, growth restriction, prematurity, malformation rates incr, twin to twin transfusion syndrome, fetus papyraceous

10

what is fetus papyrecous

fetus dying in utero, shrinks and mummifies

11

what is twin to twin transfusion syndrome

net flow blood from one twin to the other resulting in poly/oligo hydramnios, placental vascular anastomoses.

12

complications of labour

PPH, malpresentation, vasa praevia rupture, cord prolapse, premature placental separation and cord entanglement

13

what should be taken throughout pregnancy

folic acid and iron supplementation

14

when should ultrasounds be done for fetal growth

to monitor fetal growth so every 2-3 weeks from 30 weeks

15

what should be looked at by ultrasound at 11-14 weeks

viability, chorionicity, nuchal translucency, malformation. monitor from 20 weeks

16

how often to do scans in MZ twins

every 2 weeks

17

when should elective birth take place in uncomplicated DZ twins

37 weeks

18

when should elective birth take place in uncomplicated MZ twins

36 weeks and give steroids

19

when should elective birth take place in uncomplicated triplets

35 and steroids

20

which twin has a greater risk of asphyxia

2nd twin

21

what are the risks of sharing a placenta

twin to twin transfusion

22

what should be given if contractions don't resume after first child

oxytocin

23

what is the risk of cerebral palsy in twins

4-5x greater (17x greater in triplets and quadruplets compared to singletons)