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OB Notes Part 3

The document discusses various complications that can occur in multifetal pregnancies, including twin-twin transfusion syndrome (TTTS), twin anemia polycythemia syndrome (TAPS), and twin reversed arterial perfusion sequence (TRAPS). It provides details on the causes, effects on each twin, and characteristics of each complication.

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31 views4 pages

OB Notes Part 3

The document discusses various complications that can occur in multifetal pregnancies, including twin-twin transfusion syndrome (TTTS), twin anemia polycythemia syndrome (TAPS), and twin reversed arterial perfusion sequence (TRAPS). It provides details on the causes, effects on each twin, and characteristics of each complication.

Uploaded by

aaaalliah2
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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STILLBIRTH UMBILICAL CORD PROLAPSE/ FETAL GROWTH DISORDERS/ POST TERM PREGNANCY

PROM, PREMATURE LABOR, MULTIFETAL PREGNANCY


Timing of delivery

Dizygotic or Fraternal Fertilization of 2 ova


twins

Monozygotic or Identical Fertilization of 1 ova


twins that then divides into
2

Monozygotic dichorionic Zygote division at morula 38 -38 6/7 weeks AOG


diamniotic first 72 hours

DD

Monozygotic Zygote division at 4-8 blastocyst 34-37 6/7 weeks AOG


monochorionic days
diamniotic

MD

Monozygotic Zygote division at Implanted 32-34 weeks AOG


monochorionic 8-13 days blastocyst
monoamniotic

MM

Conjoined twins Zygote division at Formed embryonic


>13 days disc
SOME MULTIFETAL PREGNANCY COMPLICATIONS
Due to DONOR RECIPIENT

TWIN TWIN TRANSFUSION Anemic (pale) Polycythemia (volume excess)


SYNDROME (TTTS)
Small Large

Circulatory overload + heart failure


Large central artery-to-vein (Hydrops)
connections
Restrictive growth
Hyperviscosity + occlusive
complications →
hyperbilirubinemia + kernicterus

Oligohydramnios (Poly)hydramnios

TWIN ANEMIA POLYCYTHEMIA Anemic Polycythemic


SYNDROME (TAPS)
Small/restricted growth Large

NO AMNIOTIC FLUID DISCREPANCY


Tiny peripheral artery-to-vein UTZ: discordant MCA peak systolic velocities
connections

TWIN REVERSED ARTERIAL Grossly normal Malformed


PERFUSION SEQUENCE Large artery-to-artery placement
(TRAPS) aka ACARDIAC Cardiomegaly & heart failure No heart
shunt +/- vein-to-vein shunt
TWINNING
Higher arterial perfusion Receives deoxygenated blood

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