Multiple Gestations

Question 1

What does monozygotic mean?

Answer 1

1 fertilized ovum

pg. E 186

Question 2

What does dizygotic mean?

Answer 2

2 ova are fertilized by 2 sperm

pg. E 186

Question 3

What are the characteristics of dizygotic twins?

Answer 3

2 chorions
2 amnions
2 placentas (could be fused)
pg. E 186

Question 4

What is more common monozygotic or dizygotic?

Answer 4

dizygotic

pg. E 186

Question 5

What is a monozygotic pregnancy that divides during the first 3-5 days of gestation?

Answer 5

dichorionic diamniotic

pg. E 187 O 404

Question 6

What are the characteristics of a dichorionic diamniotic pregnancy?

Answer 6

2 gestational sacs
1 or 2 placentas
thick membrane
identical to dizygotic
pg. E 187

Question 7

What is a monozygotic pregnancy that divides 5-10 days after fertilization?

Answer 7

monochorionic diamniotic

pg. E 187 O 404

Question 8

What are the characteristics of a monochorionic diamniotic pregnancy?

Answer 8

2 gestational sacs
1 placenta
thin membrane
most common type of monozygotic twins
pg. E 187 O 404

Question 9

What is a monozygotic pregnancy that divides 10-14 days after fertilization?

Answer 9

monochorionic monoamniotic

pg. E 187 O 404

Question 10

What are the characteristics of a monochorionic monoamniotic pregnancy?

Answer 10

1 gestational sac
1 placenta
no membrane
pg. E 187 O 404

Question 11

What are twins that divide after 13 days gestation?

Answer 11

conjoined twins

pg. E 187

Question 12

What clinical findings are associated with multiple gestations?

Answer 12

elevated hCG
elevated MSAFP
large for dates
pg. E 188

Question 13

What are possible maternal complications with multiples?

Answer 13

HTN
pre-eclampsia
placental abruption
post-partum hemorrhage
pre term delivery
anemia
pg. E 188

Question 14

What are possible fetal complications with multiples?

Answer 14

prolaspe, entanglement of cord
cord knots (mono mono)
IUGR
increased risk of fetal anomalies
pg. E 188

Question 15

What is a vanishing twin?

Answer 15

early demise of one embryo

pg. E 188 O 405

Question 16

What happens to the twin that vanishes?

Answer 16

typically resorbed and can mimic an implantational bleed

pg. E 188 O 405

Question 17

What is another name for twin-to-twin transfusion?

Answer 17

Poly-Oli sequence

pg. E 189

Question 18

What type of twins can have twin-to-twin transfusion?

Answer 18

monozygotic monochorionic
same sex
one placenta
pg. E 189 O 405

Question 19

What is twin to twin transfusion?

Answer 19

arterial blood from one twin (donor) pumps into venous system of other twin (recipient) (arteriovenous anastomosis)
pg. E 405

Question 20

What is the outcome of twin-to-twin transfusion?

Answer 20

Donor twin is IUGR and oligohydramnios
Recipient develops hydrops fetalis and polyhydramnios
pg. E 189 O 405

Question 21

What is stuck twin phenomenon?

Answer 21

finding associated with twin to twin transfusion
"poli-oli" sequence
one twin has polyhydramnios
other twin has oligohydramnios
pg. E 189 O 405

Question 22

What is twin embolization syndrome?

Answer 22

Dead twin passes thromboplastic material or blood clots to live twin
pg. E 189

Question 23

What can result in twin embolization syndrome?

Answer 23

intrauterine death of live twin
hydrops
polyhydramnios
intraparenchymal hemorrhage
porencephaly
ventriculomegaly
enlarged, echogenic kidneys
pg. E 190

Question 24

What is an acardiac twin?

Answer 24

upper body not fully developed

pg. E 190 O 405

Question 25

What is the most common type of conjoined twins?

Answer 25

thoracopagus

pg. E 190

Question 26

What is a omphalopagus conjoined twin?

Answer 26

joined from xiphoid to umbilicus

pg. E 190

Question 27

What is a pyopagus conjoined twin?

Answer 27

joined at sacrum

pg. E 190

Question 28

What is a ischiopagus conjoined twin?

Answer 28

joined at ischium/pelvis

pg. E 190

Question 29

What is a craniopagus conjoined twin?

Answer 29

joined at the head

pg. E 190

Question 30

What can the number of yolk sacs determine?

Answer 30

Amnionicity