what about twin pregnancy

1. A RADIOLOGICAL MESSAGE TOA RADIOLOGICAL MESSAGE TO
OBESTETRICIANS IN MULTIPLEOBESTETRICIANS IN MULTIPLE
PREGNANCYPREGNANCY
DR. DOAA IRAQIDR. DOAA IRAQI
M.SCM.SC..

3. BEFORE 6 WEEKS,
Embrio& Its Heart Beat Are
Inveseble-----PREGNANCY
NUMBER Is Estimated By
CONTING THE NUMBER
OF GESTETIONAL SACS&
YOLK SACS( This number
may be under- or overcount on
followup).
AFTER 6 WEEKS,
COUNTING FETUSES.

4. OVERCOUNT-----
VANISHING TWIN
SYNDROME is when
one of a set of
twin/multiple fetuses
disappears in the uterus
during pregnancy.
UNDERCOUNT----
APPEARING TWIN.

5. PLACENTATION: CHORIONICITYPLACENTATION: CHORIONICITY
AND AMNIONISITYAND AMNIONISITY

9. DETERMENATION OFDETERMENATION OF CHORIONECITYCHORIONECITY
BASED ON MEMBRANE THICKNESSBASED ON MEMBRANE THICKNESS..

10. DIAGNOSIS OF DI AMNIOTIC TWINSDIAGNOSIS OF DI AMNIOTIC TWINS
BASED ON YOLK SACBASED ON YOLK SAC..

11. MONOAMNIOTIC TWINS DIAGNOSED IN THEMONOAMNIOTIC TWINS DIAGNOSED IN THE
FIRST TRIMESR( SINGLE AMNIOTIC MEMBRANEFIRST TRIMESR( SINGLE AMNIOTIC MEMBRANE(.(.

12. DETERMENATION OFDETERMENATION OF CHORIONECITYCHORIONECITY
BASED ONDEFFERENT FETAL SEXESBASED ONDEFFERENT FETAL SEXES..

18. ِِ
TWIN
OLIGOHYDRAMNIOS-
POLYHYDRAMNIOS
SEQUENCE IN A
MONOCHORIONIC
PREGNANCY.
22-week with
polyhydramnios
(arrowheads: thin
inter-twin
membrane.
20-week sized stuck
twin with severe
oligohydramnios

19. • DOPPLER
SONOGRAPHIC
FINDINGS OF TWIN-
TO-TWIN
TRANSFUSION
SYNDROME IN A
MONOCHORIONIC
DIAMNIOTIC TWIN
PREGNANCY.
significant discrepancy in
fetal sizes. Fetus A is
larger than fetus B by
more than 2 SD.
B. Color Doppler sonogram
demonstrates
approximate insertions
(arrows) of two umbilical
cords in a single placenta.
C, D. Umbilical arterial
Doppler sonogram of the
smaller fetus (C) depicts
increased vascular
resistance and absent
diastolic flow, while that
of the larger fetus (D)
shows normal diastolic
flow.

20. • SONOGRAPHIC DIAGNOSIS
OF ACARDIAC TWINSACARDIAC TWINS IN A
MONOCHORIONIC
DIAMNIOTIC PREGNANCY.
• significant discrepancy in
fetal sizes. The absence of a
heart and diffuse soft tissue
edema are demonstrated in
the larger fetus.
• No Head NO HEART
multiseptated cystic mass
suggesting a large Cystic
Hygroma is associated with
the acardiac fetus.
• C. Color Doppler sonogram
demonstrates Interfetal
Anastomoses (arrow) of
umbilical vessels between
the twins.
• D. Duplex sonogram verifies
that in the Umbilical artery
(UA) of the acardiac fetus B,
flow is reversed.
• E. Placental pathology
demonstrates anastomoses
(arrow) of the umbilical
vessels between the twins in
the monochorionic placenta.
Dye injection through the
umbilical vessels verified
interfetal artery-to-artery
and vein-to-vein
anastomoses (not shown.

21. ULTRASONOGRAPHIC AND
AUTOPSY FINDINGS OF
CONJOINED TWINS.
A. Ultrasonogram obtained
at gestational age 21
weeks depicts Fused
Cranium And Cerebra.
B. Fused anterior chest
with two "V"-shaped
spines (arrows) are
apparent.
C. Fused anterior abdomen.
D, E. Specimen radiographs
(D) and autopsy
specimen (E)
demonstrate conjoined
twins with fused
cranium, anterior chest
and abdomen
(craniothoracoomphalop
agus(.

22. SONOGRAPHIC FINDINGS
OF MONOCHORIONIC
DIAMNIOTIC TWINS
WITH CO-TWIN DEMISE
( Intrauterine fetal
death of one fetus(
A. Ultrasonogram obtained
at gestational age 14
weeks shows a fairly-
well visualized but
preserved
(arrowheads) thin
intertwin membrane
with a single placenta,
and intrauterine fetal
death of one fetus with
diffuse soft tissue
edema (arrows).
B. Ultrasonogram obtained
at gestational age 23
weeks depicts an
enlarged umbilical cord
(arrow) in the surviving
fetus.
C. Cardiomegaly with
thickened biventricular
walls (arrows)
developed in the
surviving fetus.