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Multifetal Gestation

by Veronica Gillispie, MD, FACOG
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    Now we'll discuss multifetal gestation. So multifetal gestation pregnancies have increased due to artificial productive technologies such as invitrofertilization. The higher the order of multiples meaning twins versus triplets, versus quadruplets, the great the risk of complication. So chorionicity. There are four different types of chorionicities that we see in pregnancy. And it's determine by the day that the division takes place. So if the division happens 0 to 4 days after conception, then we have a dichorionic and diamniotic pregnancy. So two chorions to amnions. If the division takes place 4 to 8 days afterwards, then we have a monochorionic, diamniotic pregnancy. So one chorion, two amnion. If it happens 8 to 14 days after conception, then we have monochorionic, monoamniotic pregnancy. So one chorion, one amnion. And then if it happens after 14 days, this is what we see conjoint twins. So chorionicity is most easiest to see at the 1st trimester ultrasound. And what you're looking for is something called the Lambda sign where you can see the actual division between the two fetuses. It's a little difficult to see in the picture here. But you can see that thin line that's dividing the two babies there. So complications associated with multifetal gestation. Again the higher the number of multiples, the great the risk of complications. The first is Preterm labor. So even as one order multiple such as a twin gestation, there is an increased risk of preterm labor. Twin-twin transfusion is more common in mono twins. And basically what happens is that the recipient twin which is the larger twin, gets more blood flow from the smaller twin which is the donor twin. The recipient twin often has polyhydramnios and can actually suffer from high cardiac output. And with that they can actually have cardiac...

    About the Lecture

    The lecture Multifetal Gestation by Veronica Gillispie, MD, FACOG is from the course Antenatal Care. It contains the following chapters:

    • Multifetal Gestation
    • Complications Associated with Multifetal Gestation

    Included Quiz Questions

    1. Monochorionic/ diamniotic twins
    2. Dichorionic/ diamniotic twins
    3. Monochorionic/ monoamniotic twins
    4. Dichorionic/ monoamniotic twins
    5. Conjoined twins
    1. Dichorionic/ diamniotic twins
    2. Monochorionic/ diamniotic twins
    3. Monochorionic/ monoamniotic twins
    4. Conjoined twins
    5. Dichorionic/ monoamniotic twins
    1. Monochorionic/ monoamniotic twins
    2. Dichorionic/ diamniotic twins
    3. Monochorionic/ diamniotic twins
    4. Dichorionic/ monoamniotic twins
    5. Conjoined twins
    1. Fetal growth restriction
    2. Polyhydramnios
    3. High cardiac output
    4. Heart failure
    5. Kidney failure
    1. Monochorionic/ Monoamniotic twins
    2. Monochorionic/ Diamniotic twins
    3. Dichorionic/ diamniotic twins
    4. Conjoined twins
    5. Twin-twin transfusion is equally likely to occur in all types of twins.
    1. Fetal macrosomia
    2. Post-partum hemmorrhage
    3. Pre-term labor
    4. Gestational hypertention
    5. Pre-ecclampsia

    Author of lecture Multifetal Gestation

     Veronica Gillispie, MD, FACOG

    Veronica Gillispie, MD, FACOG


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