Flashcards in Multiple Pregnancy Deck (26):
Biggest risk of multiple preg?
What twins are lower risk?
Dichorionic: two placentas
Kinds of monozygotic implantation?
Di chorionic, monozygotic
Monoamniotic twins (high risk)
Monochorionic twins, why dangerous?
Twin-twin transfusion Syndrome
TAPS-slower twin twin transfusion
If Monochorionic twin dies, what happens to other twin?
They will also die. Very dangerous
Nasal bones at 12 weeks?
If missing, likely trisomy 21.
Concordance between twins?
What maternal factor strongly associated with premature birth?
Poor weight gain by 24 weeks
Preeclampsia, how to reduce in multiple preg?
Aspirin 100mg/day from 12 to 36weeks
Maternal complications, Gestational DM, how manage?
Early GTT 14 weeks, 26 weeks.
Big psych for multiple preg?
Postnatal: 5x more likely
Marital disharmony: 50% of relationship end within 2 years of triplets arriving.
More likely in multiples, monochionic more than dichroic nic
Growth of multiples? After born?
Catch up growth happens in absence of pathology
What other growth do you look at in multiples?
Discordance in size between twins
Preterm Delivery prevention?
Cervical sutures: ineffective
When is safest time to delivery complicated twins?
When to deliver Monochorionic and Monoamniotic twins?
When to deliver Monochorionic and diamniotic?
Beware of TTTS
Difference between C-section or vaginal for twin delivery?
Not much difference. As long as same conditions in study which is access to theatre, obstetrician, paeds, anaesthetist.
Best way to deliver Monoamniotic twins?
Monochorionic twins vaginally?
Careful, twin B may exanguinate, twin twin transfusion in labour....
Best in C-section
How to deliver twin B?
Ensure longitudinal lie
Internal podalic`` version and breech extraction of twinB
Routine third stage
Discordant Monochorionic twins
Liquor volume - TOPS Twin Oligohydramnios POlyhydramniis sequence
MCA - TAPS - twin Anaemia-polycythaemia sequence
Growth: Selective IUGR
TTTS natural history?