Pnm-23: Ultrasound Evaluation of Multiple Pregnancies

Over the past 25 years the rate of twin and higher - order multifetal birth have increased between 1980 and 2005. The twining rate rose from 18.9 to 32.1 per 1000 live birth. Multifetal gestations are at high risk of fetaland complication such as; growth restricted fetal death, LBW and cerebral palasy. Maternal complication are that also increased such as: preeclampsia, diabetes, maternal death and PROM. Multiple pregnancies are characterized by a significantly higher fetal morbidity and mortality than singleton pregnancies. This places them in the category of high risk pregnancies. Ultrasound Is crucial for the diagnosis of twin. Sonography allows determination of zygosity, chorionicity, amnionicity, placental location, and fetal presentation and the detection of complications such as growth discrepancy, amniotic fluid volum imbalance. Etiology of multifetal gestations: 1. Fertilization of two or more oocytes (in two - third of cases) 2. Early embryonic splitting of single ovum (in one - third of cases). The role of ultrasound in first trimester: 1. Detection of all sac 2. Detection of viable embryo in each sac 3. Size comparision of embryos (CRL) 4. Detection of a vanishing twin 5. Determination of chorionicity and amniocity:precise determination of zygocity and chorionicity is the most important step for management of multipie pregnancies 6. Early detection of anomaly. The role of ultrasound in second and third trimesters: 1. Biometry 2. Detection of anomalies 3. Invasive testing as indicated 4. Amniotic fluid volumes 5. Detection of twin-twin transfusion syndrome 6. Doppler examinations 7. Fetal lie 8. Placental location.