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    Multiple Pregnancy

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    jane7arian7berzabal
    This document discusses multiple pregnancies, defined as any pregnancy with two or more fetuses in the uterus. It notes the increased risks of preterm delivery and morbidity for both mother and babies. Types of multiples are described as dizygotic or monozygotic twins, as well as higher order multiples. Causes include heredity, older maternal age, IVF, and ovulation induction. Diagnosis involves physical exam, ultrasound, and lab tests. Nursing care focuses on increased nutrition, rest, monitoring, and managing potential complications like preterm labor. Mode of delivery may be vaginal or cesarean depending on presentation.

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    Multiple Pregnancy

    Uploaded by

    jane7arian7berzabal
    249 views16 pages
    This document discusses multiple pregnancies, defined as any pregnancy with two or more fetuses in the uterus. It notes the increased risks of preterm delivery and morbidity for both mother and babies. Types of multiples are described as dizygotic or monozygotic twins, as well as higher order multiples. Causes include heredity, older maternal age, IVF, and ovulation induction. Diagnosis involves physical exam, ultrasound, and lab tests. Nursing care focuses on increased nutrition, rest, monitoring, and managing potential complications like preterm labor. Mode of delivery may be vaginal or cesarean depending on presentation.

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    This document discusses multiple pregnancies, defined as any pregnancy with two or more fetuses in the uterus. It notes the increased risks of preterm delivery and morbidity for both mother and babies. Types of multiples are described as dizygotic or monozygotic twins, as well as higher order multiples. Causes include heredity, older maternal age, IVF, and ovulation induction. Diagnosis involves physical exam, ultrasound, and lab tests. Nursing care focuses on increased nutrition, rest, monitoring, and managing potential complications like preterm labor. Mode of delivery may be vaginal or cesarean depending on presentation.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    249 views16 pages

    Multiple Pregnancy

    Uploaded by

    jane7arian7berzabal
    This document discusses multiple pregnancies, defined as any pregnancy with two or more fetuses in the uterus. It notes the increased risks of preterm delivery and morbidity for both mother and babies. Types of multiples are described as dizygotic or monozygotic twins, as well as higher order multiples. Causes include heredity, older maternal age, IVF, and ovulation induction. Diagnosis involves physical exam, ultrasound, and lab tests. Nursing care focuses on increased nutrition, rest, monitoring, and managing potential complications like preterm labor. Mode of delivery may be vaginal or cesarean depending on presentation.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 16

    MULTIPLE PREGNANCY

    Present by:
    Jane Arian Berzabal
    NBB-II
    Definition

     Any pregnancy which two or more embryos


    or fetuses present in the uterus at same time.
     It is consider as a complication of pregnancy
    due to;
     the mean gestational age of delivery of twins
    is approximately 36w.
     the perinatal mortality and morbidity
    increase.
    Terminology vs. Number

    Singletons one fetus


    Twins two fetuses
    Triplets three fetuses
    Quadruplets four fetuses
    Quintuplets five fetus
    Sextuplets six fetuses
    Septuplets seven fetuses
    Types

     Twins: mono or dizygotic - no. of maternal eggs in


    fertilization
     Dizygotic twins
     Fertilization of two separate ova by separate sperm
     Two placenta, two chorions, two amnions
     Non identical
     Placenta may be separate or fused
     Monozygotic twins
     Mitotic division of a single fertilized ova
     One placenta, one chorion, one amnion
    Causes

     Heredity
     Older women
     High parity
     Race
     Ovulation induction
     IVF
    Incidence and Epidemiology

     The incidence of multiple pregnancy in US is


    approximately 3%
     Monozygotic twins (approx. 4 in 1000 births)
     Triplets pregnancies (approx.m1 in 8000 births)
     Multiple gestation increase morbidity and mortality
    for both the mother and fetuses.
    Sign and Symptoms

     Uterine size is larger than expected gestational


    age.
     Multiple FHRs are heard
     Multiple fetal parts are felt
     hCG & serum alpha-fetoprotein levels are
    elevated
    Risk Factors

     preterm labor
     premature rupture of membranes
     gestational hypertension or preeclampsia
     gestational diabetes
     anemia
     thromboembolism.
    Diagnostic Examination

     Physical Assessment (weight gain, pre-


    eclampsia signs)
     Abdominal Examination (excessive uterine
    fundal growth, fetal heart rate)
     Sonographic Examination
    Nursing Diagnostic

     Fatigue related to increased stress on body


    functioning secondary to multiple gestation.
     Parental role conflict related to recent
    discovery of multiple pregnancy.
     Fear concerning her own and the babies health
    related to risks of multiple pregnancy.
    Nursing Management

     Increased nutrition -Mothers carrying two or more


    fetuses need more calories, protein and other
    nutrients, including folic acid.
     More frequent prenatal visits -multiple pregnancy
    increases the risk of complication.
     Physician referrals-You may need to see a maternal-
    fetal medicine specialist for special testing, ultrasound
    evaluations or coordinating the care of complications.
     Increased rest- Some women may also need bed rest. 
    Nursing Management

     Maternal and fetal testing- Testing may be needed to monitor


    the health of the fetuses, especially if there are pregnancy
    complications.
     Tocolytic medicines. If you experience preterm labor, you may
    be given tocolytic drugs to help slow or stop your contractions.
    These may be given orally, by injection or intravenously.
    Tocolytic medicines often include nifedipine.
     Corticosteroid medicines. Corticosteroid medicines may be
    given to help mature the lungs of the fetuses. Lung immaturity is a
    major problem for premature babies because it may cause
    breathing issues.
    Mode of delivery

     Vaginal
     Caesarean
    – Non-cephalic presentation of 1st twin
    – Placenta praevia
    – Antepartum death of 1st twin
    – Monoamniotic twin,IUGR,chronic TTTS
     Combined (ie CS for the 2nd twin)
    Thank you
    References

     Maternal & Child Health Nursing 6th Edition


    Adele Pillitteri

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