We’re back on scheduled wombmates! This week we’re talking about management of twin pregnancies as Dr. Moise takes us through the following topics:
- The role of ultrasound in twin pregnancies
- CRL = Crown Rump Length for dating
- Chorionicity determination
- Transvaginal cervical length measurement
- Importance of the 18-20 week anatomy scan and fetal echocardiogram
- Ultrasound monitoring based on chorionicity
- Dichorionic pregnancies should be followed every 3 to 4 weeks with a growth scan ultrasound
- Monochorionic pregnancies should begin regular ultrasound monitoring at 16 weeks gestation
- Every 2 weeks – measurements of fluid levels and fetal bladders
- Then at 20 weeks ISUOG says to start monitoring umbilical artery (UA) and middle cerebral artery (MCA) Dopplers during regular growth scans
- Discordant anomalies and their rate of occurrence in twin pregnancies
- Screening for chromosomal problems
- Cell free DNA (cffDNA) – consider vanishing twin as source of abnormal result
- Nuchal translucency with analytes
- Maternal complications in twin pregnancies & how they are managed prenatally
- Timings & method of delivery for twin pregnancies
- Treatment options for short cervix in twin pregnancies
- Antenatal testing in twin pregnancies and when to start
- Management of monoamniotic twin pregnancies
