WARD SEMI MULTI Flashcards by KENITH V. LAGO

development of two fetuses

Twin Pregnancy

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five FETUS

quintuplets

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six fetus

setuplets

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two types of twins

Dizygotic
Monozygotic

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Results from fertilization of two ova

Dizygotic (80%)

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this type of twin is where Sex and Genetic features differ.

Dizygotic

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number of chorion and amnion for dizygotic

2 amnions and 2 chorions

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percentage of diamniotic moniochorionic

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two separate placenta, chorion, amnion what do u call this

diamniotic-dichorionic

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two amniotic sacs and share one outer membrane (chorion). This setup is called

diamniotic monochorionic

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if the division takes place within 72 hours what type of twin is it?

diamniotic-dichorionic)

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if the division takes place within (Intermediate split) 4th and 8th day what type of twin is it?

diamniotic monochorionic twins

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during n (Intermediate split) 4th and 8th day what is formed and developed?

chorion

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if the division takes place within r (late split) 8th day what type of twin is it?

monoamniotic monochorionic twins

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during (late split) or 8th day, what is already formed

amniotic cavity

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Division after two weeks or davit of embryonic disc resulting in the formation of

conjoined twins

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factors are linked to having a multiple pregnancy

Heredity
Older age
High parity
Race

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SIGNS of multipreg

Severe nausea and vomiting

Rapid weight gain

tender breasts.

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symptoms of multipreg

Uterus is larger

Increased morning sickness

Increased appetite

Excessive weight gain

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GENERAL EXAMINATION for multipreg

Increased prevalence of anemia
Unusual weight gain
Evidence of preeclampsia

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ABDOMINAL EXAMINATION FOR MULTIPREG

barrel shaped uterus

abdomen is unduly enlarged

Palpation of too many fetal parts

diff diagnosis for multifetus

Big baby

Elevation of the uterus by a distended bladder

Hydramnios

Ascites with pregnancy

(also called molar pregnancy; a gestational trophoblastic disease GTD

Hydatidiform mole

COMPLICATIONS OF TWIN PREGNANCY : maternal

Increased miscarriage
risk

Malpresentation

Anemia

Antepartum Hemorrhage

COMPLICATIONS OF TWIN PREGNANCY : during labor

PROM Cord prolapse Postpartum hemorrhage

COMPLICATIONS OF TWIN PREGNANCY : post partum

Subinvolution (no return of normal size sa fetus) Lactation failure

COMPLICATIONS OF TWIN PREGNANCY : FETUS

Abortion neonatal death/stillbirth Risk of cord accidents

Congenital anomalies in twin pregnancy

1. Neural tube defects (NTD) 3. Bowel Atresia 4. Conjoined twins 5. Twin reversed arterial perfusion (TRAP)

meaning of TRAP

Twin reversed arterial perfusion

Complication of Monochorionic twins

➢ Twin-twin transfusion syndrome (TTTS) ➢ Dead fetus syndrome, survived twin-cerebral palsy, microcephaly ➢ Twin reversed arterial perfusion (TRAP) ➢ Conjoined twins

TTTS meaning

Twin-twin transfusion syndrome

Conjoined twins types:

○ Anterior (thoracopagus) ○ Posterior (pyopagus) ○ Cephalic (craniopagus) ○ Caudal (ischiopagus)

DURING PRENATAL CARE management for multipreg

Increased nutrition Physician referrals Increased rest frequent prenatal visit

medicines- to help slow or stop contractions in multipreg

Tocolytic medicines

medication- given to help mature the lungs of the fetuse

Corticosteroid

during labor why does bed rest emphasized

prevent early rupture of membrane

Internal examination should be done soon after the rupture of the membrane to exclude what

cord prolapse

Vaginal delivery, interval between twins not to exceed how many minutes

20 minutes

Vaginal delivery by senior obstetrician

Vertex- Breech

Safer to delivery by cesarean to avoid interlocking twins

Breech- Vertex

Usually by cesarean type of delivery

Breech- Breech

Forceps delivery if necessary should be under what type of anesthesia

pudendal block anesthesia,

what anesthesia should be avoided

general anesthesia

what medication should be avoided during delivery of first baby

ergometrine

why should we deliver baby by C-section. give examples:

To deliver babies in abnormal positions When the mother has certain medical conditions If the babies are in fetal distress If the pregnancy is monochorionic

two or more eggs are released during ovulation and are fertilized by different sperm

Dizygoticc (Fraternal) Twins

Each zygote develops its own placenta and amniotic sac. This is called

polyzygotic twinning

ART meaning

assisted reproductive technologies

a single fertilized egg (zygote) splits into two or more embryos

Monozygotic (Identical) Twins:

if one or more fetuses don't receive adequate blood supply they may experience what condition

intrauterine growth restriction (IUGR)

Nursing interventions for multiple pregnancies

Nutritional Support Psychosocial support Anxiety Management Sleep hygiene Promotion Fetal Growth monitory