Multiple Gestation and Twin Classification

Twin pregnancy is defined as the presence of two fetuses in a single pregnancy, occurring in about 1-2% of all pregnancies.

Twins can be classified as monozygotic or dizygotic, and further categorized by their chorionicity (number of placentas) and amnionicity (number of amniotic sacs).

Risk factors for dizygotic twins include maternal age (increased likelihood after age 35) and family history of twins.

<p>One major complication of twin pregnancies is preterm birth, which can lead to increased neonatal morbidity.</p> Signup and view all the answers

<p>A twin pregnancy can be diagnosed using ultrasound imaging and measuring the fundal height.</p> Signup and view all the answers

<p>Multiple births can be classified into two categories: monozygotic, derived from one fertilized egg, and dizygotic, arising from two distinct fertilized eggs.</p> Signup and view all the answers

<p>Delivery planning for twin pregnancies involves assessing the presentation of the fetuses and the potential for cesarean delivery based on complications.</p> Signup and view all the answers

<p>Monochorionic twins share a single placenta, while dichorionic twins each have their own placenta.</p> Signup and view all the answers

<p>Monozygotic twins develop from a single fertilized ovum that splits, making them genetically identical, while dizygotic twins arise from two separate ova fertilized by two separate sperm, making them genetically different.</p> Signup and view all the answers

<p>This results in dichorionic diamniotic twins.</p> Signup and view all the answers

<p>Splitting after the 12th day results in conjoined twins.</p> Signup and view all the answers

<p>Monochorionic diamniotic twins occur when the zygote divides between days four and eight post-fertilization, having one placenta and two amniotic cavities.</p> Signup and view all the answers

<p>Dizygotic twins typically develop as dichorionic diamniotic twins, meaning each twin has its own placenta and amniotic cavity.</p> Signup and view all the answers

<p>Around 30% of twin pregnancies are monozygotic, while 70% are dizygotic.</p> Signup and view all the answers

<p>If splitting occurs after the 9th day, it results in monoamniotic monochorionic twins.</p> Signup and view all the answers

<p>Conjoined twins are defined as twins that result from the incomplete splitting of the zygote after day 13 of fertilization.</p> Signup and view all the answers

<p>The risk for abnormalities in each fetus in monochorionic twin pregnancies is four times higher than in singleton pregnancies.</p> Signup and view all the answers

<p>The chance is twice as high in dizygotic pregnancies compared to singleton pregnancies of the same maternal age.</p> Signup and view all the answers

<p>The best method is measurement of fetal nuchal translucency thickness by ultrasound at 10-14 weeks.</p> Signup and view all the answers

<p>Amniocentesis or chorion villus sampling can be performed if necessary.</p> Signup and view all the answers

<p>In monochorionic pregnancies, the co-twin faces a 25% risk of death or handicap due to acute haemodynamic shifts.</p> Signup and view all the answers

<p>Complications include placental vascular anastomoses that allow communication between the fetoplacental circulations.</p> Signup and view all the answers

<p>The risk level is influenced by whether the twins share the same chorion, with monochorionic twins being at greater risk.</p> Signup and view all the answers

<p>About 25 percent of cases experience risks associated with acute hypotensive episodes.</p> Signup and view all the answers

<p>About 1 percent.</p> Signup and view all the answers

<p>Monochorionic twins have a 10 percent chance of delivery between 24-32 weeks, while dichorionic twins have a 5 percent chance.</p> Signup and view all the answers

<p>37 weeks.</p> Signup and view all the answers

<p>Around six times higher.</p> Signup and view all the answers

<p>It is double the risk for each baby in dichorionic twins compared to singletons.</p> Signup and view all the answers

<p>The condition of both fetuses should be considered due to the risks of prematurity-related complications.</p> Signup and view all the answers

<p>Monochorionic twins face additional risks from twin-to-twin transfusion syndrome due to shared circulatory structures.</p> Signup and view all the answers

<p>It is the same for each fetus, making the chance of at least one affected fetus twice as high in twins.</p> Signup and view all the answers

<p>Elevated levels of diabetogenic placental hormones and larger placental area contribute to the increased prevalence.</p> Signup and view all the answers

<p>There is an increased plasma volume expansion and heightened feto-placental demand for these nutrients, leading to a higher prevalence of anemia.</p> Signup and view all the answers

<p>Gastro-oesophageal reflux, abdominal discomfort, back pain, leg swelling, bladder symptoms, and haemorrhoids.</p> Signup and view all the answers

<p>Antepartum hemorrhage significantly contributes to perinatal mortality due to a larger placental area and additional complications.</p> Signup and view all the answers

<p>Pregnancy in multiple gestations is associated with a higher risk of thromboembolic disease due to physiological alterations and venous compression.</p> Signup and view all the answers

<p>If the first twin is presenting by vertex and there are no other complications, vaginal delivery may be allowed.</p> Signup and view all the answers

<p>Obstetricians may prefer it due to potential complications during the delivery of the second twin that may require instrumental intervention.</p> Signup and view all the answers

<p>Consider previous obstetric history, presentation of the twins, presence of complications, and maternal preferences.</p> Signup and view all the answers