Multiple Gestations

Multiple Gestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Incidence is increasing! Inc 65% for twins Inc 500% for triplets+ Multifetal gestation = only 3% of total births, but >20% of complications like PTD, LBW, VLBW babies

On average… Twins deliver @ 35+2wk Triplets deliver @ 32+1wk BUT The lowest mortality for: Twins = 38 wk Triplets = 35 wk

Morbidity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

AMA, ART and ovum induction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Etiology: Monozygotic ,[object Object],[object Object],[object Object],[object Object],[object Object],Morula Day 0-3 Blastocyst Day 4-8 Implanted blastocyst Day 8-13 Embryonic disc Day 13-15

Etiology: Dizygotic Ultrasound image of "twin-peak" sign showing an extension of placental tissue into the intertwin membrane, confirming dichorionic twinning. 2/3 of all twins Diamniotic/dichorionic

Differential diagnosis for LGA uterus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Maternal Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Preterm Delivery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Fetal complications: TTTS ,[object Object],[object Object],[object Object],[object Object]

Fetal Complications: IUGR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Routine Antepartum Fetal Surveillance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Reduction/Selective Termination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ACOG Bulletin Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Multiple Gestations

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Multiple Gestations