Twin Gestations Flashcards Preview

LC 02 > Twin Gestations > Flashcards

Flashcards in Twin Gestations Deck (14)
Loading flashcards...
1

Rate of twins

1:30 births

3.3% of all live births

2

If monozygotic twins cleave in first 0-4 days after fert you get

Dichorionic diamniotic twin
Di/Di

2 morula --> 2 blastocysts in own layer of trophoblast cells --> own chorion --> own amnion

3

If monozygotic twins cleave in 4-8 days after fert you get

monochorionic diamniotic twin
Mo/Di

*most common of the monozygotic twins (75%)

4

If monozygotic twins cleave in 8-12 days after fert you get

monochorionic monoamniotic twin
Mo/Mo

5

How many twin pregnancies are conceived spontaneously?

50%

6

Risk of twin pregnancies (12)

1. Miscarriage
2. Hyperemesis (high hCG)
3. high risk of aneuploidy and anomalies
4. Prenatal screening tests less sensitive and diagnostic procedures more difficult
5. Maternal anemia
6. Gestational diabetes ( high hPL)
7. Gestational hypertension/preeclamsia
8. Intrauterine growth restrictions
9. Preterm birth (~36 weeks)
10. Higher rate of Cesarean delivery
11. Postpartum hemorrhage
12. High perinatal mortality (first week)

7

Twin twin transfusion syndrome
- what is it?
- What does the recipient twin do?
- What does the Donor twin do?

20% of mo-di twins have unbalanced flow through connected vessels

1. Recipient twin (larger)
- increases urine production to reduce blood volume

2. Donor twin (smaller)
- Reduces urine production to retain blood volume

8

When do you have to treat TTTS by?

Prior to 24 weeks or else mortality of one or both twins in 80-90% of cases

9

WHAT causes death of donor twin

decreased blood vol --> lower Urinary output to maintain blood vol --> oligohydramnios --> shunt away nutrients and cant support fetal growth

10

What causes death of recip twin

getting too much bv --> huge strain on babys heart (HF) --> too much urine prod --> polyhydramnios --> uterine distention and early deliver
- sometimes fetal hydrops

11

Twin peak/ Lamda sign = ?

Thick dividing membrane = DI Di
- 0-4 days

12

T sign ?

MO/DI
- 4-8 days

13

TTTS, which twin is smaller, which is larger?

Recipient twin is larger

DOnor twin is smaller

14

TTTS most common in which twins?

Mo-Di