Multiple Pregnancy Flashcards Preview

Women's Health > Multiple Pregnancy > Flashcards

Flashcards in Multiple Pregnancy Deck (17):
1

What proportion of twin births result from natural conception?

50 - 60%

2

What factors predispose to multiple gestation?

- Fertility treatments
- Maternal age
- Race
- Parity
- FHx
- Maternal BMI and height

3

What maternal age bracket confers greatest risk of twins?

15 - 35y = 4x increased risk of twins

4

Describe chorionicity

-A: DCDA (Dizygotic twins or Monozygotic twins with cleavage day 3)
-B: MCDA (Monozygotic twins with cleavage days 4- 8)
-C: MCMA (Monozygotic twins with cleavage days 8-12)

5

US features of twinning?

Twin peak or lambda sign

6

What complications are increased due to twin pregnancy?

ALL complications except post term gestation and macrosomia

7

What are the maternal complications of multiple gestation?

- Nutrition
- PIH and PET
- APH / PPH
- GDM
- Hyper emesis
- DVT/ PE
- Cholestasis
- MSK issues
- Social stressors

8

Foetal complications of multiple gestation?

- Perinatal mortality
- CP
- Congenital anomalies
- IUGR
- Prematurity

9

What is average gestation of twins?

35- 36 / 40

10

What are the principles of managing a multiple pregnancy?

Routine antenatal plus:
- Early USS (dates and chorionicity)
- FTCS
- Tertiary morph scan
- Surveillance of twins
- Surveillance for complications
- Multi disciplinary approach (diet, SW, paeds)
- Timing

11

Timing of twin delivery?

- DCDA 37 - 37+6
- MCDA 36 - 36+7
- MCMA 32 - 33+6 (act on abnormal CTG after 26w)

12

What is the risk of PET in primigravida twin pregnancy?

30% in primigravida twin pregnancies

13

Which women carrying twins should take aspirin for PET minimisation?

From 12 weeks if RFx of:
- first pregnancy
- 40y+
- FHx
- pregnancy interval 10y+
- BMI 35 +
(almost all multiples)

14

Complications of donor twin in TTTS?

- Anaemia
- Oliguria
- Hypovolemia
- Oligohydramnios
- IUGR
- FDIU

15

Complications of recipient twin in TTTS?

- Polycythaemia
- Polyuria
- Hypervolemia
- Polyhydramnios
- Cardiomyopathy
- FDIU

16

What is TTTS?

MC twins share a single placenta with intertwin anastomoses. Unbalanced twin transfusion results in TTTS

17

Treatment options in TTTS?

- Amniodrainage +/- septosotomy
- Selective laser photocoagulation of placental vessels