ultrasound diagnosis of fatal anomalies

DETERMINATION OF ZYGOSITY
Fig. 15.4 Quadruplets. Tetra-amniotic, tetrachorionic
quadruplets at 9 + 3 weeks.
Fig. 15.5 Triplets. Triamniotic, monochorionic triplets
at 8 + 3 weeks. There is a thin membrane (only
amnion, with no chorion) separating the amniotic
cavities.
Measurement of nuchal translucency at
13 weeks also allows risk evaluation of TTTS. In
early TTTS, fluid accumulation in the recipient
twin causes nuchal edema, and nuchal translucency
measurements are significantly higher
than in the donor twin. If there is no significant
difference in nuchal translucency measurements
between the two twins, then the risk of
developing TTTS is assumed to be low.
From 16 weeks onwards, regular ultrasound
assessment of fetal growth and amniotic fluid
volume is necessary. Early warning signs of TTTS
development can be detected in this way, and
various therapy options can then be considered.
It may even be necessary to hospitalize the
mother.
To improve the prognosis of TTTS, continuous
assessment during the whole of the pregnancy is
advisable. The complications foreseen can be
discussed with a pediatrician to ensure the best
clinical management for the twins in this very
precarious situation.
In summary, ultrasound examination in early
pregnancy is a simple and reliable method of detecting
zygosity and thus whether there is a
high-risk pregnancy—allowing for risk-adjusted
antenatal management of twin pregnancies.
Self-Help Organizations
Title: National Organization of Mothers of
Twins Clubs
Description: Opportunity for mothers of multiple
births share information, concerns, and
advice on dealing with their unique problems
and joys. Literature, quarterly newspaper,
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