KULIAH MAHASISWA: Kehamian Kembar/Ganda - Apa yang harus diwaspadai

Summary

This informative video script discusses multiple pregnancy, also known as twin or multifetal pregnancy, covering its types, diagnosis, and implications. It explains the differences between monozygotic (identical) and dizygotic (fraternal) twins, the factors influencing the occurrence of multiple pregnancies, and the associated risks such as anemia, preeclampsia, and preterm birth. The script also touches on the importance of regular prenatal care and potential complications like Twin-to-Twin Transfusion Syndrome (TTTS), emphasizing the need for careful monitoring and professional medical intervention.

Takeaways

• 🤰 Pregnancy can be multiple, with twins being the most common form of multiple pregnancy, but it can also involve more than two fetuses at the same time.
• 👶 Multiple pregnancies are categorized into dizygotic (from two or more eggs) and monozygotic (from a single egg that splits).
• 👀 Subjective signs of a twin pregnancy may include the mother feeling more frequent or multiple fetal movements.
• 🤮 Hyperemesis gravidarum, excessive nausea and vomiting, especially in the first trimester, can be an indicator of a twin pregnancy.
• 🔍 Physical examination, such as palpation, may reveal a uterus size larger than expected for the gestational age, suggesting a multiple pregnancy.
• 💓 Auscultation can detect two fetal heartbeats at different locations with a frequency difference of more than 10 beats per minute as a sign of twins.
• 🏥 Ultrasonography (USG) is the most accurate method to diagnose multiple pregnancies, determining the number of fetuses and other details.
• 🧬 Factors that can increase the likelihood of a twin pregnancy include ovarian stimulation, assisted reproductive technologies, a history of twin pregnancies, and a family history of twins.
• ⚠️ Twin pregnancies carry more risks, including anemia, preeclampsia, premature birth, and congenital anomalies, compared to single pregnancies.
• 👼 The management of twin pregnancies requires close monitoring of the health of both the mother and the fetuses, with more frequent prenatal visits.
• 👫 In the case of identical twins (monozygotic), complications can arise from the type of placental and amniotic sac sharing, with certain configurations posing higher risks.

Q & A

What is the medical term for a pregnancy with two or more fetuses?

The medical term for a pregnancy with two or more fetuses is multifetal pregnancy, commonly referred to as a twin pregnancy when there are exactly two fetuses.

What are the two types of twin pregnancies mentioned in the script?

The two types of twin pregnancies mentioned are monozygotic (identical twins from a single fertilized egg that splits) and dizygotic (fraternal twins from two separately fertilized eggs).

What is the approximate frequency of twin pregnancies in the general population?

The frequency of twin pregnancies in the general population is about 2-3 per 1000 pregnancies, with a higher percentage of dizygotic twins compared to monozygotic twins.

What are some subjective signs that might indicate a twin pregnancy?

Subjective signs of a twin pregnancy can include the pregnant mother feeling more frequent or multiple fetal movements, experiencing hyperemesis gravidarum (excessive nausea and vomiting), and having a uterus size that is larger than expected for the gestational age.

How can healthcare providers initially suspect a twin pregnancy during a physical examination?

Healthcare providers can initially suspect a twin pregnancy during a physical examination by palpation, where the uterus feels larger than expected for the gestational age, and by detecting two fetal heartbeats in different locations.

What is the most accurate method to confirm a twin pregnancy?

The most accurate method to confirm a twin pregnancy is through an ultrasound (ultrasonography), which can visualize the number of fetuses, the presence of separate amniotic sacs, and other diagnostic features.

What are some factors that can increase the likelihood of having a twin pregnancy?

Factors that can increase the likelihood of having a twin pregnancy include ovarian stimulation (often for fertility treatments), assisted reproductive technologies like in vitro fertilization (IVF), a family history of twin pregnancies, and certain ethnic backgrounds.

What are some complications that can be associated with twin pregnancies?

Complications associated with twin pregnancies can include anemia, hyperemesis gravidarum, increased risk of miscarriage, hydramnios (excessive amniotic fluid), preeclampsia, preterm labor, and postpartum hemorrhage.

What is Twin-to-Twin Transfusion Syndrome (TTTS), and which type of twins does it affect?

Twin-to-Twin Transfusion Syndrome (TTTS) is a condition that affects identical twins who share a single placenta with interconnected blood vessels, leading to an imbalance in blood flow between the twins. It can cause one twin to receive too much blood and the other too little, leading to various health issues for both.

How do the management and monitoring of twin pregnancies differ from singleton pregnancies?

The management and monitoring of twin pregnancies involve closer observation and more frequent prenatal visits due to the increased risk of complications. This includes monitoring the health of both the mother and the fetuses, managing potential issues like preeclampsia and preterm labor, and planning for the mode of delivery.

What are the considerations for the mode of delivery in twin pregnancies?

The mode of delivery in twin pregnancies depends on various factors, including the presentation of the first twin, the condition of the second twin, and any obstetric complications. Vaginal delivery may be possible for the first twin if it presents with a head-first position, while the second twin may require a different approach, such as forceps or vacuum extraction, depending on its presentation and the mother's condition.