Multiple Pregnancy

Question 1

What is zygosity?

Answer 1

Number of eggs fertilised

Question 2

What is chorionicity?

Answer 2

Number of placenta

Question 3

What is amniocity?

Answer 3

Number of amniotic sacs

Question 4

How is multiple pregnancy diagnosed?

Answer 4

USS

Question 5

What is seen on DCDA USS?

Answer 5

Membrane with lambda sign

Question 6

What is seen on MCDA USS?

Answer 6

Membrane with T sign

Question 7

What is seen on MCMA USS?

Answer 7

No membrane seen

Question 8

What additional antenatal care is done for multiple pregnancy?

Answer 8

FBC

• booking
• 20 weeks
• 28 weeks

USS

• 2 weekly from week 16 - MC twins
• 4 weekly from week 20 - DC twins

Question 9

What are maternal risks of multiple pregnancy?

Answer 9

Anaemia 
HTN
Preterm birth 
Instrumental delivery 
PPH

Question 10

What are fetal risks of multiple pregnancy?

Answer 10

Fetal death
FGR
Prematurity
Twin-twin transfusion syndrome
Twin anaemia polycythaemia sequence

Question 11

When is delivery planned in multiple pregnancy?

Answer 11

MCMA = 32-33 weeks
MCDA = 36-37 weeks
DCDA = 37-38 weeks

Question 12

What is twin-twin transfusion syndrome?

Answer 12

Occurs when sharing placenta

One fetus gets majority of blood

• heart failure
• polyhydramnios

Other gets minority

• growth restriction
• anaemia
• oligohydramnios

Question 13

What is twin anaemia polycythaemia sequence?

Answer 13

One twin is anaemic

Other is polycythaemic