multiple pregnency Flashcards
whats the dizygotic twin ?
from 2ova and 2 sperm
they have dichorionic and dizygotic placentation
same or diifer sex
2/3 the most common type of twins
ehatre the factors that affecting the D Z twins incidence ?
1-natural
from the herditory of th emother
or increase the maternal age
or increase the parity
2- induction of the ovulation bygonadotrophin by 30% and 10%clomide
what the monozygotic twin ?
they arise from 1ova &1sperm the split
they are the same sex and same gentic somsitution
they ‘re rare 1/3
cause of the MZ twin incidence ?
not related to inhertanc eor the induction of ovulation
what happen if the zygot split early after 2days of fertilization ?
twin may have teo option either :
- they seperaltly have own sac and placenta so ( dichorionic diamniotic twin )
- but must commnly they share one pal enta with two sac so (monochorionic diamniotic )
if the zygot split late after 13 days of the fertilization ?
this will inccrease the mortalitlty rate as the twins will share the same organs they called conjoined twin (التوائم السياميه )
in general when the incidance rate increase of having twins ?
1- taking drugs that induct the ovulation
2- twin increase with age and parity
3-its more in the black race
How to dignosis pt with twin ?
1-pt feel large abdomen more than normal and excess of the fetal movment
2- family history of twin and usage of drugs
on Examination
- gain large wieght
- uterus is much larger than normal and feeling of 2 fetal heart
confirm by the u/s
what’re the complication of having twins on the mother ?
1- hyperemsis
2-anemia
------------ 3-hypertion and precalmpsia 4-polyhyramnios 5-perterm rupture membrane 6-perterm labour
7-peranteral heamorrge
8-postanter heamorrage
9- increase the risk of abortion
whatre the complication of two babys on the fetus them self ?
1-prematurty
2-intrautrine resistrctive growth
3-congintal abnormality
4-increase the morbidty and mortality
5-umblical cord prolapse
other complication in MZ twin ?
singlton twin (malformation )
umblival cord abnoramlity
twin to twin transfusion
means there is anastmosis happen in monzygotic who have monochorionic
so one fetus is large and the other is small one os the donor and the other is receipant
receipant ( كبير )
donor (صغير)
method of delivery of the twin ?
if vertex -vertex in 50% its vaginal
1st wint is the indicator if it ecphaic 70 or breech 30
time between th edelivery of 1st and the 2nd twin ?
30mintues
if the zygot split late after 8-13 days of the fertilization ?
same placenta and one sac
if the zygot split late after4-8 days of the fertilization ?
one placenta and two sac