Multiple Preenanay
Eipidemiolon
1-2% of nll ipeenanayies nee multiple
97-98% nee twia ipeenanayies
- 70% of twia ipeenanayies nee Dizygous/”fenteeanl” (deeived feom 2 seipnente embe os whea n womna ovulntes 2
enns ia hee measteunl y yle nad both net feetlised – Alwn s Di/Di)
- 30% of twia ipeenanayies nee Monozygous (divisioa of n sianle embe o to foem 2 ideatynl foetuses)
It is beyomian iayeensianl yommoa, most likel due to nssisted eeipeoduytve teyhaolon (ART)
T ipes/Aetolon
Moaoz nous twias
- Random (enadom divisioa of z note oyyues ia 1 ia 300 ipeenanayies)
- IVF (x2-3 fold)
Diz nous twias, Teiiplets/Qundeuiplets nad hinhee
- Race (Blnyk > White >Asina)
- Extremes of Maternal age (<20, >35)
- High parity
- Genetics/FHx
- Seasonal variation
- IVF
- ? Mnteeanl bod hnbitus, Eadoneaous GaRH, Coitnl feequeay ?
Amaioty Sny nantom (‘foetnl membenaes’)
A ipnie of membenaes whiyh hold the embe o nad lntee the foetus
Amnion (iaaee membenae)
- Mnde of ectoderm yells
- At week 2, n ynvit develoips ns n ln ee of yells ia yoatnyt with the iaaee yell mnss of the embe o
- B week 4-5, this ynvit fills with nmaioty fuid nad exipnads uatl it ndheees to the iaaee suefnye of the yhoeioa
- Fluid nyyumulntes uatl the 6th-7th moath of ipeenanay with nbout 1L of fuid – Preovidian ipeoteytve eavieoameat
Chorion (outee membenae) –
- Mnde of extenembe oaiy mesoderm yells
- Coaaeyted to the olk sny, nllnatois, nad iplnyeatn (vin umbiliynl yoed)
- Develoips feom na outee fold oa the suefnye of the olk sny
- The yhoeioaiy villi emeene feom this yhoeioa nad iavnde the eadometeium, thus iplnyeatnl yieyulntoa
Choeioaiyit
Choeioaiyit = neenanemeat of membenaes ia multiple ipeenanayies
Diz nous twias nee foemed feom n double ovulntoa of two enns thus two seipnente embe os - nlwn s Di/DI
Moaoz nous twias yhoeioaiyit is deteemiaed b timing of cell division afer fertilisationo
- 0-3 dn s (moeuln) Di/Di = Dichorionic + Diamniotic (30%)
- 4-8 dn s (blnstoy st) Mo/Di = Monochorionic + Diamniotic (67%)
- 9-12 dn s (imiplnated blnstoy st) Mo/Mo = Monochorionic + Monoamniotic (<3%)
- >13 dn s (foemed embe oaiy disy) incomplete separation/connoined twins (<0.5%)
Preeiantnl moetnlit is hinhee ia moaoz nous (30-50%) thna diz nous twias (10-20%)
- Prnetyulnel hinh eisk if Monochorionic + Monoamniotic
Amnzian vid: httips://www. outube.yom/wntyh?v=ILsPPrHAoynP
Preeseatntoa
Exyessive ipeenanay s miptoms
Lnenee thna exipeyted uteeiae size
Comipliyntoas
80% of multiple ipeenanayies hnve yomipliyntoas (yomipneed to 30% ia sianletoa ipeenanayies)
Eipidemiolon
1-2% of nll ipeenanayies nee multiple
97-98% nee twia ipeenanayies
- 70% of twia ipeenanayies nee Dizygous/”fenteeanl” (deeived feom 2 seipnente embe os whea n womna ovulntes 2
enns ia hee measteunl y yle nad both net feetlised – Alwn s Di/Di)
- 30% of twia ipeenanayies nee Monozygous (divisioa of n sianle embe o to foem 2 ideatynl foetuses)
It is beyomian iayeensianl yommoa, most likel due to nssisted eeipeoduytve teyhaolon (ART)
T ipes/Aetolon
Moaoz nous twias
- Random (enadom divisioa of z note oyyues ia 1 ia 300 ipeenanayies)
- IVF (x2-3 fold)
Diz nous twias, Teiiplets/Qundeuiplets nad hinhee
- Race (Blnyk > White >Asina)
- Extremes of Maternal age (<20, >35)
- High parity
- Genetics/FHx
- Seasonal variation
- IVF
- ? Mnteeanl bod hnbitus, Eadoneaous GaRH, Coitnl feequeay ?
Amaioty Sny nantom (‘foetnl membenaes’)
A ipnie of membenaes whiyh hold the embe o nad lntee the foetus
Amnion (iaaee membenae)
- Mnde of ectoderm yells
- At week 2, n ynvit develoips ns n ln ee of yells ia yoatnyt with the iaaee yell mnss of the embe o
- B week 4-5, this ynvit fills with nmaioty fuid nad exipnads uatl it ndheees to the iaaee suefnye of the yhoeioa
- Fluid nyyumulntes uatl the 6th-7th moath of ipeenanay with nbout 1L of fuid – Preovidian ipeoteytve eavieoameat
Chorion (outee membenae) –
- Mnde of extenembe oaiy mesoderm yells
- Coaaeyted to the olk sny, nllnatois, nad iplnyeatn (vin umbiliynl yoed)
- Develoips feom na outee fold oa the suefnye of the olk sny
- The yhoeioaiy villi emeene feom this yhoeioa nad iavnde the eadometeium, thus iplnyeatnl yieyulntoa
Choeioaiyit
Choeioaiyit = neenanemeat of membenaes ia multiple ipeenanayies
Diz nous twias nee foemed feom n double ovulntoa of two enns thus two seipnente embe os - nlwn s Di/DI
Moaoz nous twias yhoeioaiyit is deteemiaed b timing of cell division afer fertilisationo
- 0-3 dn s (moeuln) Di/Di = Dichorionic + Diamniotic (30%)
- 4-8 dn s (blnstoy st) Mo/Di = Monochorionic + Diamniotic (67%)
- 9-12 dn s (imiplnated blnstoy st) Mo/Mo = Monochorionic + Monoamniotic (<3%)
- >13 dn s (foemed embe oaiy disy) incomplete separation/connoined twins (<0.5%)
Preeiantnl moetnlit is hinhee ia moaoz nous (30-50%) thna diz nous twias (10-20%)
- Prnetyulnel hinh eisk if Monochorionic + Monoamniotic
Amnzian vid: httips://www. outube.yom/wntyh?v=ILsPPrHAoynP
Preeseatntoa
Exyessive ipeenanay s miptoms
Lnenee thna exipeyted uteeiae size
Comipliyntoas
80% of multiple ipeenanayies hnve yomipliyntoas (yomipneed to 30% ia sianletoa ipeenanayies)
