Exam 3 - Multiples

Multiples are at greater risk for...

Premature delivery

Low birth weights/FGR

Congenital anomalies

Fetal demise

Cord knotting

Placenta abruption/previa/vasa previa

Preeclampsia/HTN

Bleeding/post-partum hemorrhaging

Dizygotic Twins

Fraternal twins

70% of twins

2 of everything

Sonographic Appearance of Dizygotic Twins

Twin peak sign

Thick membrane

Twin Peak Sign/Lambda Sign

All Dizygotic Twins must be classified as...

Dichorionic diamniotic

Monozygotic Twins

Identical twins

Single ovum that divides

Dichorionic Diamniotic

25% of monozygotic twins

Divides between 0-3 days

10% mortality rate

Monochorionic Diamniotic

75% of monozygotic twins

Divides between 4-7 days

25% mortality rate

Monochorionic Monoamniotic

Divides after 8-13 days

50% mortality rate

High risk of conjoined twins

Monoamniotic twins must be classified as...

Monochorionic and monozygotic

Monoamniotic twins are associated with...

Cord knots

Conjoined twins

Monochorionic twins must be classified as...

Monozygotic

Can be monoamniotic or diamniotic

Sonographic Appearance of Monochorionic Twins

Thin membrane

Monochorionic twins are associated with...

TTTS

TRAP

FGR

Sonographic assessment protocol for twins

Number of sacs & fetal poles

Number & location of placentas

Membrane thickness and movement

Gender of the feti - after 16 weeks

Biometry comparison

Umbilical cord Doppler

Fluid assessment

Presence of anomalies

Assign a letter to each baby - baby A is always closest to the internal os of the cervix