Medicine an Surgery notes

Apr 25th, 2015
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MULTIPLE GESTATIONBySridevi Abboy, MDDefinition(Multi-fetalGestation)MULTIPLE PARITY-Twins (two babies)-Monozygotic(Division of 1 ova fertilized by the same sperm)-Dizygotic(Fertilization of 2 ova by 2 sperm)-Triplets (three babies)-Quadruplets (four babies)Incidence Twins - 1 in 100 birthsAfrican Americans: 1 in 70Caucasians: 1 in 88Japanese: 1 in 150Chinese: 1 in 300 Triplets are about 1 in 7,500 births Quadruplets are about 1 in 650,00 birthsPredisposing FactorsMaternal age and parityMaternal height and weightGenetic and racial factorsPrior use of oral contraceptive agentsSocial classSeasonalityCauses of Multiple Gestation Spontaneously In Vitro fertilizationIntrauterine inseminationAssisted HatchingGIFT, ZIFTFrozen Embryo Transfer, Blastocyte Embryo Transfer Fertility Drugs Clomiphene citrate (clomid, serrophene) Gonadotropins (GonalF, follistim, humagon)Twins Dizygotic twins(66% of US twins) Dichorionic separatechorion (placenta) Diamniotic separateamnion (amniotic sac) Monozygotic twin(33% of US twins)Ova division: < 72 hours: Dichorionic,diamniotic 4-8 days: Monchorionic,diamniotic 8-13 days:Monochorionic,monoamniotic > 13 days: conjoinedtwinsConjoined TwinsCraniopagusPygopagusThoracopagusCephalopagusEpholothoracopagusParapagusIsch

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