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  • Twins and Higher Multiple Gestations Not Completed

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    Melissa Aina Mohd Yusof
    5 views12 pages
    This document discusses twins and higher multiple gestations. It begins by classifying multiples based on number of fetuses, fertilized eggs, placentae, and amniotic cavities. It then differentiates between identical (monozygotic) and non-identical (dizygotic) twins. Identical twins develop from one fertilized egg, while non-identical twins develop from two separate eggs. The document outlines various complications that can occur in twin pregnancies, such as miscarriage, perinatal mortality, fetal growth restriction, and complications unique to monoamniotic or monochorionic twins. It concludes by discussing the antenatal and intrapartum management of twin pregnancies.

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    twins and multiple higher gestation for obs and gyn

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    This document discusses twins and higher multiple gestations. It begins by classifying multiples based on number of fetuses, fertilized eggs, placentae, and amniotic cavities. It then differentiates between identical (monozygotic) and non-identical (dizygotic) twins. Identical twins develop from one fertilized egg, while non-identical twins develop from two separate eggs. The document outlines various complications that can occur in twin pregnancies, such as miscarriage, perinatal mortality, fetal growth restriction, and complications unique to monoamniotic or monochorionic twins. It concludes by discussing the antenatal and intrapartum management of twin pregnancies.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    5 views12 pages

    Twins and Higher Multiple Gestations Not Completed

    Uploaded by

    Melissa Aina Mohd Yusof
    This document discusses twins and higher multiple gestations. It begins by classifying multiples based on number of fetuses, fertilized eggs, placentae, and amniotic cavities. It then differentiates between identical (monozygotic) and non-identical (dizygotic) twins. Identical twins develop from one fertilized egg, while non-identical twins develop from two separate eggs. The document outlines various complications that can occur in twin pregnancies, such as miscarriage, perinatal mortality, fetal growth restriction, and complications unique to monoamniotic or monochorionic twins. It concludes by discussing the antenatal and intrapartum management of twin pregnancies.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 12

    Twins and higher multiple

    gestations
    >2 fetuses

    Classification
    Number of fetuses : twins, triplets,
    quadruplets
    Number of fertilized eggs : zygosity
    Number of placentae : chorionicity
    Number of amniotic cavities :
    amnionicity

    Non-identical twins
    Fraternal twins, dizygotic
    Fertilization of 2 separate
    eggs
    2 functionally separated
    placentae but can be fused
    and appear as single
    placental mass
    Separate amniotic cavities&
    2 cavities separated by
    thick 3 layer membrane
    (chorion on either side)
    Same-sex/diff-sex

    Identical twins

    Monozygotic
    Fertilization of same egg
    Always same-sex pairings
    Single/double placentae
    (monochorion/dichorion)
    Dichorionic placenta can
    fused together, appear as
    single placental mass
    Vast majority is MCDA, but
    dividing membrane is thin,
    single layer of amnion alone

    Etiology
    Dizygotic twins

    Monozygotic twins

    Familial/racial in origin
    and increases with
    maternal age
    Ovulation indiction
    treatment
    Assisted conception
    eg IVF

    Single fertilizied ivum


    splits into 2 identical
    strcutures
    Type of monozygotic
    twin depends

    Other physiology
    Maternal
    Allphysiological
    changes of pregnancy
    increased
    - CO
    - volume expansion
    - relative
    haemodilution
    - diaphragmatic
    splinting
    - weight gain
    - lordosis

    Fetal
    Monochorionic
    placentae have unique
    ability to develop
    vascular connections
    between 2 fetal
    circulations
    - potential
    complications

    Complications relevant to twin


    pregnancy
    Miscarraige
    & severe
    preterm
    delivery

    Perinatal
    mortality in
    twins

    Death in
    one fetus in
    twin
    pregnancy

    Fetal growth
    restriction

    Fetal
    abnormalitie
    s

    Chromosom
    al defects &
    twinning

    Complicatiosn
    unique to
    monochorionic
    twinning

    Complications
    unique to
    monoamniotic
    twinning

    Differential diagnosis
    -

    Polyhydramnios
    Uterine fibroids
    Urinary retention
    Ovarian masses

    Antenatal
    management

    Intrapartum
    management

    Determinin
    g
    chorionicity

    Screening
    for fetal
    abnormaliti
    es

    Preparation

    Analgesia
    during
    labour

    Monitoring
    fetal
    growth &
    well-being

    Threatened
    preterm
    labour

    Fetal wellbeing in
    labour

    Mode of
    delivery

    Preterm
    twins

    PPH

    Support
    groups

    Higher multiples

    Twin-to-twin transfusion
    syndrome

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