Multiple Pregnancy

multiple pregnancies

simultaneous dev of 2+ fetuses in uterine cavity

types of multiple pregnancy

dizygotic (2 amniotic sacs, 2 placentas)

monozygotic (division fertilized egg, 4 varieties of monzygotic twin pregnancy)

Ultrasound suggestive signs to differentiate the dychorionic pregnancy from the monochorionic pregnancy are optimally obtained at

10-14w

lambda sign

sign of multiple pregnancy

echogenic triangle located at the fusion site of two placentas, with the tip projected between the two amniotic sacs

US signs of multiple pregnancy

• lambda sign

• half twin peak

• t sign

dichorionic pregnancy US signs

two placentas and dividing membranes (half twin peak) or highlighting a placenta with a dividing membrane plus the " " sign

monochorionic-diamniotic pregnancy US signs

highlighting of a placenta and a dividing membrane plus the "T" sign

transfusion-transfusion sd

discordant growth of the two fetuses must be investigated comparatively by Doppler, in the presence of a single placenta

twin-twin transfusion sd

in monochorionic pregnancy

weight diff bw fetuses - 1 fetus w/ distended bladder and polhydramnios, second has no bladder and olighydramnios

Important ultrasound parameters that should be evaluated in multiple pregnancy - in trimester 1

• detection of embryos, size compairons

• gross anomalies

• amnionicity and chorionic activiry

• vanishing twin detection

Important ultrasound parameters that should be evaluated in multiple pregnancy - trimester II

• biometry

• anomaly scan

• evaluation amount of amniotic fluid

• twin-twin transfusion sd

• doppler exam

complications of multiple pregnancy

second trimester miscarriage

premature birth

twin-twin transfusion