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2 results

  • Chapter 12 - Monochorionic Twin Pregnancy

  • from Section 1 - Obstetric Aspects of Antenatal Care
  • Edited by Amira El-Messidi, McGill University, Montréal, Alan D. Cameron, University of Glasgow
  • Book:
    OSCEs in Obstetrics and Maternal-Fetal Medicine
    Published online:
    23 February 2023
    Print publication:
    16 February 2023, pp 158-172

  • Summary

    A 34-year-old primigravida is referred by her primary care provider to your hospital center’s high-risk obstetrics unit after sonographic imaging confirmed viable intrauterine spontaneous monochorionic diamniotic (MCDA) twins with crown–rump lengths (CRL) of 47 mm and 44 mm, consistent for 12+4 weeks’ gestation by CRL of the larger twin. Twin A’s and twin B’s nuchal translucency (NT) measurements are 1.5 mm and 1.0 mm, respectively, with normal-appearing first-trimester fetal morphologies.

  • Chapter 13 - Multiple Gestation

  • from Part II - INTRAPARTUM AND POSTPARTUM
    • By V. Ravishankar, Clinical Assistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences State University of New York at Stony Brook Stony Brook University School of Medicine Stony Brook, New York, J. Gerald Quirk, Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Medicine State University of New York at Stony Brook
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book:
    Operative Obstetrics
    Published online:
    07 May 2010
    Print publication:
    04 August 2008, pp 322-347

  • Summary

    This chapter explores the maternal and fetal complications, advances in prenatal diagnosis, and management of complications unique to multiple gestations. Tidal volume and oxygen consumption in multiple gestations are increased, as is the normal alkalosis seen in singleton pregnancy. Hypertensive disorders increase by at least twofold in twin gestations. Hemorrhagic complications occur more frequently with twins. Growth of singletons and twins is comparable until 27 weeks gestation. The uterus accommodates the larger volume imposed by twins by overdistension, and beyond a certain limit, premature labor can result. Preterm deliveries (less than 37 weeks' gestation) occurred in 10.6% of singleton pregnancies against a phenomenal rate of 61.2% of live births in multiple gestations. Diagnosis of multiple gestations, establishing chorionicity, identifying anomalies, foreseeing possible maternal and fetal complications, prevention and treatment of preterm labor, and management of growth restriction are some of the areas of medicolegal concerns in multiple gestations.