click below
click below
Normal Size Small Size show me how
Twin Gestation
Question | Answer |
---|---|
Fertilization of 2 ova by 2 different fathers with only a short time between | Superfecundation |
Ovulation occurs when pregnancy already exists. One month difference in gestational age | Superfetation |
What are 2 types of twins? | Monozygotic and Dizygotic |
Maternal, occurs from fertilization of one egg. The egg divides into 2 zygotes after fertilization | Monozygotic |
What is the Monozygotic incidence around the world? | 3.5 per 1,000 pregnancies |
Fraternal, two ovum are released at ovulation. Each are fertilized and are different individuals with same parents | Dizgotic |
What is the Dizgotic incidence in different parts of the world? | Nigeria 1 in 20-25 US 1 in 100 Japan 1 in 150 |
What is amniocity? | Number of amniotic sacs |
What is Chorionicity? | Number of placentas |
Are always diamniotic and dizygotic | Dizygotic twins |
May be either diamniotic or monoamniotic and dichorionic or monochorionic, depending on the time of cleavage | Monozygotic twins |
Means two placentas/sacs | Di/amnicotic or chorionic |
Means one | Mono |
Timing of events for trophoblast | Differentiate at 4 to 6 days post-fertilization |
Timing of events for amnion | Differentiates at approx 8 days post-fertilization |
If the zygote divides before 4-6 day it will be | dichorionic and diamniotic this account for 1/3 of all monozygotic twins |
If the zygote divides between 6-8 days it is | monochorionic and diamniotic this accounts for 2/3rd of all monozygotic |
If the zygote divides after the 8th day it is | monoamniotic and monochorionic and accounts for less than 1% of monozygotic twins |
If the zygote divides after day 13 you will have | Siamese twins |
Conjoined twins accounts for about | 1 in 70,000 delivers in the US |
Siamese twins may have more than a | 3 vessel cord |
Name four classifications of conjoined twins | Thoracopagus Craniopagus (cephalic) Pygopagus (posterior) Ischiopagus (caudal) |
Will have one placenta or two placentas? one sac or two depending on the time of cleavage | Monozygotic |
TROPHOBLAST CELLS IMMATURE, DIFFERENTIATES AT 4-6 DAYS POST FERT, THEY KNOW WHAT THEY WILL BECOME | PLACENTA |
On day 8th these cell know what they will become | Amnion (sac) cells |
It's important to note the number of | placentas and amniotic sacs |
two placentas may be laying close together so look at the | location and gender of each twin |
Record what two things for each twin | Growth and measurements |
With one amnotic sac, the umbilical cord may get | twisted, rate of death is 50-70% |
Pathology, a twin pregnancy is considered a | High risk |
Rare, occurs in monozygotic twins, they share a placenta wit each having their own umbilical cord. There is an arterio-venous shunt With in placenta. Arterial blood of one twin (the donor) is pumped into the venous blood of the other twin | Twin to twin transfusion syndrome |
Twin to twin transfusion syndrome risk factors | Donor may become hydropic/anemic and grwoth retarded. Receipent may be normal orhydropic. Affects growth of both. Hydramnios in receipents sac. Donor may have 2 vessel cord and may be 20% difference in weight |
What is the Stuck-Twin syndrome | 1. One twin is in a severly oligohydramniotic sac 2. One twin is in a polyhydramniotic sac |
Stuck-Twin syndrome is manages by | serial amniocentesis and possible complications in survivors from sac |
Selective Reduction of fetuses in Mult gestations is done in the | 1st trimester, sac injected with potassium chloride to cause death |
What is the selection process to reduce number of fetuses | Anomalous fetus/small GS/monochorionic twins Both/Most accessible sac: high and anterior in the fubdus/ Do NOT select a predenting embryo/reduce # to twins |
Joined at the chest, most common | Thoracopagus |
Joined at the head | Craniopagus |
Joined posteriorly at the back | Pygopagus |
Joined at the caudal of their bodies | Ischiopagus |
One twin does not have a heart, blood from donor pumps blood into the body of the | Acardiac Monster |
Acardiac Monster can cause | CHF i donor twin |