ARRT CH 31

advanced maternal age

35 or older

21. conjoined twins that are attached at the abdomen are referred to as a. omphalopagus b. thoracopagus c. ileopagus d. craniopagus

a

singleton pregnancy

a single developing fetus

twin reversed arterial perfusion sequence

acardiac twinning

16. identical twins result from a. monozygotic twinning b. dizygotic twinning c. heterotopic pregnancies d. monochorionic pregnancies

a

18. asymmetry in fetal weight between twins is indicative of a. discordant growth b. preeclampsia c. dichorionic diamniotic twinning d. intrauterine infections

a

2. twins that have the threat of being conjoined are a. monoc monod b. monoc diamniotic c. dizygotic d. dic dia

a

22. monozygotic twins result from a. a single zygote that splits b. two zygotes that are fertilized by same sperm c. two morulla d. a single zygote that is fertilized by two sperm

a

24. the term that indicates the presence of two separate placentas a. dichorionic b. bichorionic c. monoamniotic d. diamniotic

a

26. the shunting of blood from one twin to the other is termed a. TTTS b. twin embolization syndrome c. twin peak sign d. conjoined twins

a

35. the most common form of monozygotic twins is a. monoc dia b. dic monoa c. monoc monoa d. none of above

a

40. the demise of a twin can lead to the development of neurologic complications in the living twin as a result of a. twin embolization syndrome b. TTTS c. TRAP syndrome d. dichorionicity

a

8. which of the following would not increase the likelihood of multiple gestations a. gestational diabetes b. maternal age >40 c. maternal history of twins d. ART

a

acardiac twin

abnormally developed twin that has an absent upper body and no heart

parasitic twin

acardiac twin

23. demise of a twin during the second or third trimester can lead to a. TTTS b. twin embolization syndrome c. twin peak sign d. acardiac twinning

b

3. which of the following would a newborn most likely suffer from if he or she were born prior to 32 weeks as a result of multiple gestation complications? a. ascites b. pulmonary hypoplasia c. amnnionitis d. preeclampsia

b

30. the abnormal twin in acardiac twinning is also referred to as a. pump twin b. parasitic twin c. stuck twin d. vanishing twin

b

31. the twin that will appear larger in TTTS is the a. donor b. recipient c. both will be same d. both will be demised

b

32. fraternal twins result from a. monozygotic twinning b. dizygotic twinning c. heterotopic pregnancies d. monochorionic pregnancies

b

36. all of the following complications are associated with multiple gestations except a. preterm delivery b. high birth weight c. maternal anemia d. maternal preeclampsia

b

39. which form of monozygotic twinning is least common? a. monoc dia b. monoc monoa c. dic dia d. dic bia

b

5. twins that result from the fertilization of two separate ova are called a. diamniotic b. dizygotic c. monozygotic d. monochorionic

b

6. what condition is pregnancy induced maternal high blood pressure and excess protein in the urine after 20 weeks gestation a. gestational diabetes b. preeclampsia c. proencephaly d. maternal mirror syndrome

b

13. which term relates the number of amniotic sacs? a. chorionicity b. placentation c. amnionicity d. embryology

c

17. the sonographic examination of twins reveals a triangular extension of the placenta at the base of the membrane. this finding is indicative of a. monoc monoa twins b. monoc dia twins c. dic dia twins d. monoc dia twins

c

33. what is the term for conjoined twins attached at the sacral region a. sacralpagus b. omphaloagus c. pyopagus d. thoracopagus

c

37. acardiac twinning results from a. poor maternal nutrition b. dizygotic gestations c. abnormal links between placental vessels d. twin embolization syndrome

c

38. ovulation induction drugs not only increase likelihood of multiple gestations, but also increase likelihood of a. maternal diabetes b. ovarian prolapse c. heterotopic pregnancies d. choriocarcinoma

c

4. the inner membrane surrounding the fetus is referred to as the a. placenta b. chorion c. amnion d. yolk sac

c

zygote

cell formed by the union of two gametes, first stage of fertilized ovum

heterotopic pregnancy

coexisting ectopic and intrauterine pregnancies

monozygotic

coming from one fertilized ovum or zygote, later split beyond day 8 postconception will result in mono mono twins

anemia

condition of having a deficient number of red blood cells

omphalopagus

conjoined twins attached at the abdomen

thoracopagus

conjoined twins attached at the chest

pyopagus

conjoined twins joined back to back in the sacral region

1. which of the following is not a sonographic sign of a dichorionic diamniotic gestation? a. twin peak sign b. lambda sign c. delta sign d. t sign

d

11. twins having two placentas and one amniotic sac are referred to as a. monoc dia b. monoa dic c. dic monoa d. this does not occur

d

34. which of the following can occur as a result of monozygotic twinning a. monochorionic diamniotic twins b. monoc monoa twins c. dic dia twins d. all of the above

d

hydrops (fetal)

an abnormal accumulation of fluid in at least two fetal body cavities

discordant fetal growth

asymmetric fetal weight between twins

25. what is a treatment that separates abnormal placental vascular connections between twins that are suffering from TTTS a. cleavage laser resection treatment b. endoscopic guided laser photocoagulation c. endemic translocation of placental vessels d. circumvallate resection of shared placental vasculature

b

7. the outer membrane of the gestation is referred to as the a. placenta b. chorion c. amnion d. yolksac

b

9. twins whose bodies are connected at some point are said to be a. fraternal b. conjoined c. identical d. stuck

b

19. twins having two placentas and two amniotic sacs referred to as a. monoc dia b. bia dic c. dic dia d. dic bia

c

27. factors that increase the likelihood of having multiple gestations include all of the following except a. advanced maternal age b. ovulation induction drugs c. poor nutritional state d. maternal predisposition for twins

c

29. which of the following can occur as a result of dizygotic twinning? a. monochorionic diamnioti twins b. monochorioni monoamniotic twins c. dichorionic diamniotic twins d. all of the above

c

10. the term that indicates the presence of two separate amniotic sacs a. dichorionic b. bichorionic c. monoamniotic d. diamniotic

d

12. what is it called when a twin fetus, suffering from TTTS, experiences severe oligohydramnios and becomes closely adhered to the uterine wall a. acardiac monster b. vanishing twin c. acardiac twin d. stuck twin

d

14. twins having one placenta and one amniotic sac is referred to as a. dic monoa b. dic dia c. monoc dia d. monoc monoa

d

20. typically the first sonographic manifestation of TTTS is a. oligo b. poly c. dichorionic twinning d. discordant fetal growth

d

28. TRAP syndrome may also be referred to as a. TTS b. vanishing twin syndrome c. twin embolization syndrome d. acardiac twinning

d

stillborn

dead at birth

cleavage

division of a cell

amniotic sac

fluid filled space, created by amnion, surrounding developing embryo or fetus

vanishing twin

death and reabsorption of a twin

fetus papyraceus

death of one fetus in twin pregnancy that is mainteined throughout the pregnancy, means paperlike fetus

craniopagus

twins joined at the cranium

fraternal twins

twins that result from the fertilization of two separate ova and have dissimilar characteristics

diamniotic

two amniotic sacs

twin embolization syndrome

when vascular products travel from a demised twin to the surviving twin by means of the common vascular channels within the shared placenta

porencephaly

development of a cystic cavity within the cerebrum, may be result of intraparenchymal hemorrhage

factors that increase the likelihood of multiple gestations

elevated HCG compared to singleton pregnancy, large for dates, twins have 4times higher risk of fetal mortality and 6times high neonatal morbidity rate, maternal history of multiple gestations, assisted reproductive therapy, ovulation induction drugs, advanced maternal age, and maternal obesity increase probability,

placentation

formation or structure of a placenta, structural organization, and mode of attachment of fetal to maternal tissues during placental formation

amnion

inner sac that contains the embryo and amniotic fluid, echogenic curvilinear structure that may be seen during first trimester within gestational sac

delta sign

lambda sign

twin peak sign

lambda sign

conjoined twins

monoamniotic, monochorionic twins that are attached at the head, thorax, abdomen, or lower body, most common forms of conjoined twinning are thoracopagus and omphalopagus, 40% chance of being stillborn with many dying within first 24 hours

monoamniotic

one amniotic sac

monochorionic

one chorion

monochorionic monoamniotic

one placenta one amniotic sac

monochorionic diamniotic

one placenta two amniotic sacs

chorion

outer membrane of a gestation that surrounds the amnion and developing embryo

preeclampsia

pregnancy induced maternal high blood pressure and excess protein in the urine after 20 weeks gestation

mortality

rate of actual deaths

zygosity

related to the number of zygotes (fertilized ovum)

amnionicity

relates to number of amnion in a multiple gestation

chorionicity

relates to the number of chorions and the type of placentation in a multiple gestation

morbidity

relative frequency of occurrence of a disease

hypoxia

shortage of oxygen or decreased oxygen in the blood

twin twin transfusion syndrome

shunting of venous or arterial blood from one twin to another through placental circulation, donor twin often suffers from anemia and growth restriction where recipient experiences hydrops and CHF

findings of twin twin syndrome

sonographic: monochorionic twinning, discordant fetal growth, oligo around donor twin, poly around recipient twin, recipient may be hydropic

findings of acardiac twin

sonographic: normal pump twin, acardiac twin- absent upper body, absent heart, and hydrops

assisted reproductive therapy

techniques used to treat infertility

endoscopic guided laser photocoagulation

treatment that uses lasers to separate abnormal placental vascular connections between twins that are suffering from twin-twin transfusion syndrome

lambda sign

triangular extension of the placenta at the base of the membrane is indicative of a dichorionic diamniotic pregnancy, also called delta sign or twin peak sign or "t" sign

identical twins

twins that result from the split of a single zygote and share the same genetic structure

dizygotic

two ova are fertilized by two sperms

dichorionic

two placentas

dichorionic diamniotic

two placentas and two amniotic sacs

therapeutic amniocentesis

type of amniocentesis used to remove a large amount of amniotic fluid around a fetus suffering form polyydramnios

pulmonary hypoplasia

underdevelopment of the lungs

stuck twin

when a twin fetus, suffering from twin to twin transfusion syndrome, experiences severe oligohydroamnios and is closely adhered to the uterine wall

15. which term relates the number of placentas a. chorionicity b. zygocity c. amnionicity d. cleavage

a

ovum

unfertilized egg

anastomoses

vascular connections