Multiple Pregnancy | Twin Pregnancy | Twins Babies: When more than one fetus is simultaneously develops in the uterus, it is called multiple pregnancy. Simultaneous development of two fetuses (triplets), four fetuses (quadruplets), five fetuses (quintuplets), or six fetuses (sextuplets) may also occur. The term ‘ Multiple Pregnancy | Twin Pregnancy | Twins Babies ’ is used to describe
» Read more
Multiple Pregnancy / Twin Pregnancy – Varieties : Binovular twins Uniovular twins Binovular twins (syn: fraternal, dizygotic) It is the commonest and results from the fertilization two ova, most likely ruptured from two different graffian follicles usually of the same or one from each ovary. Uniovular twins (syn: identical, monozygotic) Results from the fertilization of a single ovum, twinning
» Read more
Multiple Pregnancy / Twin Pregnancy – Etiology (causes) Race: the frequency is highest amongst Negrose. Lowest amongst Mongols and intermediate amongst Caucasians. Hereditary: there is hereditary predisposition likely to be more transmitted through the female (maternal side). Advancing age of the mother: increased incidence of twining is observed with the advancing age of the mother, the maximum being between the age of 30
» Read more
Diagnosis History collection History of ovulation inducing drugs specially gonadotrophins, for infertility. Family history of twining (more often present in the maternal side) Symptoms Increased nausea & vomiting Cardio pulmonary embarrassment. Tendency of swelling of legs, varicose veins and hemorrhoids. Unusual rate of abdominal enlargement and excessive fetal movements. General Examination Prevalence of anemia is more than in singleton pregnancy.
» Read more
Multiple Pregnancy / Twin Pregnancy – Investigations: Sonography: two gestational sacs can be detected as early as 10th week of pregnancy Detection of two fetal heads and their accurate measurement of biparietal diameters can be made by the 14th week For assessment of placenta ion, sonar is done between 16-24 weeks. Radiography: Is done less often these days. Two fetal heads and
» Read more
Multiple Pregnancy / Twin Pregnancy – Complications: Maternal During pregnancy: ♠ nausea and vomiting occurs with increased frequency and severity ♠ Anemia is more common in twin pregnancy. ♠ Pre-eclampsia (25%) is increased three times over singleton pregnancy. Over distension of the uterus may be the possible explanation. ♠ Hydramnios (10%) is more common in uniovular twins and usually involves the second sac. It is perhaps due to increased
» Read more
MultiplePregnancy / Twin Pregnancy – Prognosis – Maternal mortality is increased in twins than in a singleton pregnancy. Death is mostly due to hemorrhage, pre-eclampsia and anemia. Increased maternal morbidity is due to the prevalence of complications and increased operative interference.
» Read more
Multiple Pregnancy / Twin Pregnancy – Management Antenatal management The essence of successful outcome of a diagnose it at the earliest period of gestation. This will help the mother to take additional care not only for her own benefit but also for the fetuses. Advice: ¨ Diet increased dietary supplement is needed for increased energy supply to the extent of 300 K
» Read more
Multiple Pregnancy / Twin Pregnancy – Labour Management Place of delivery – as the twin pregnancy is considered a ‘high risk’, the patient should be confined in an equipped hospital preferably having an intensive neonatal care unit. First stage: Usual conduction of the first stage as outlined for a singleton fetus is to be followed with additional precautions. Patient should be
» Read more
Multiple Pregnancy / Twin Pregnancy – Puerperium Management: Management of third stage Routine administration of 0.2 mg methergin IV with the delivery of the anterior shoulder of second baby. Placenta is delivered by controlled cord traction Continue the oxytocin drip for at least one hour. Blood transfusion if necessary The patient is to be carefully watched for about 2hrs after
» Read more