complications

risk Fed
multiple pregnancy: Pre-eclampsia
-

-
·

:-
:

.
·

·
PPH (atomi traumatic PPH).
↑ed
paternal ant
,

gas ·
LSCS : -
If conjoint twins .
Ned
Nagle formula is valid only for 28 days cycle . pracental mass

tehr'sincisiondonenormal aes
·

↑ed SFLT levels

If for 30
I .

cycle days ,
add 2 days more to EDD
.
Placenta acreta spretum
-"
- 26
days ,
subtract - - · comprise sympho. mc twins : -

IITS # Dep
AV anastomosis
umbartery E umb. vein

1drigo
eastomosis
and twin .
-

Polyhymamics in in
·
Ned age , Ned parity Med twins chance.
(C)
·

Pedal oedema -
Fee compression , Pre-eclampsia- Quintero => 5 Stages
.
> clomiphene cinate Lehorole. ·

Hemorrhoids
twin -
,

Age : - ·

Infertity treatment -

Covulation induction)
constipation
·

polyhydron
.

Yed FSH depleted ow n at 3 5 .

yrs oligo
,
No No Thyroid / Epilepsy/ Asthma/TB

·Relycanencount
TB contact
·

Anemica
,
-

karum inhibin = ↑ FSH. Previous

pregnancy : -parity status ,

gender ,
foetal wts ·

Anemia
deliver a home Sky ? And Pac
Mean
New
FSH is indirect marken of menopause (740 units) .
·
I
.

CIAB ? complications-

Solomon technique
letrozole :
·

Aromatase O estrogent Feedback of Present

pregnancy : -POG .

FSH, 11 ovulation. conception ? ,

·

-
, what we of
An anastomos a
,
RFA of
IFA,DryRadhnpts. Mai-28 whe :
,
,
.
amenosshsa

Rish of multiple pregnancy

: (C > Letrozole
·
-

TDaPi-27 wks ISt Dose

RFArish Ned.
=

BHK monitor Atten

FAps
·

37 was: -
and Don : -

Tdi for
priigravda case
-

Human menopausal gonadotropin -HMG from mencause

·

: women.
for [in 3 yes :-I Booster dos
mulhph Pregnancy
previous
preg when t o terminate
.

HMG
functionally
·

=
FSH

Examination 3 Swks
·

:
SET : DCDA =
-

single embryo hansfer protocol.

·

Fed
for multiple pregnancy
- aromatase
↑
oversity is risk
.

edage more embryos implanted

·
:-
MIDA36 was

·onstopping oSurgeinFed Chance of

twinpregnan
d lacthn
Sugine
·

hypo in setome -measur

:
inta mua
32-3uwk

tims i mTP
conjoint
·
Typesmdg
·

Bpi-led due to excessive progesterone ↑

Recent times :
-Dizygotic,Suf
andof pregnay ↓
↓ DBP .

> 12
days :-conjoints Ned hemodulation in twin pregnancy
Pallar
-
·
=

cli-mention
HELLP, viral Hepatitis
·

Inters :- Ihcp not rule out

only
·

Cholestasis of
Ess
,

Intrahepatic
Etchinginpregnancy
:
pegnay
· · CUS RS
,
: - S, S26
nomrmus, where

Scabies/ungal infection (tenia

·

daneftasif
·
·

Ketokonazole : -hirsnitism here cli .

Give Clicoxazol ,

terbinafia
.
ee

:Palmsinsea level : -Bile acids bind to

Focalconditiyea
molar
pregnancy full placker, Placenta
·

overdistended polyhydrammies , molar

pregnary , ,

previe
finroids mass

module
Bi
,

ca
Randomle o SFH : in um
-

examiners : - 2 sites Ioan apart

Anscultation : Need 2
·
-
,

.
Difference in FHR be required
Rui-ursodeoxycholic Brm should
acid .
> 10

I opplers /stethoscope -
foeths-more Biteacids
-

Bile acids =
multiple pignary is risk facher .
More

M
.
bod
~

Ask for foetal movements

·

·
Pain Abdo :- red rish
of PTL , Dbnyhos

edishDohydrama a isk Red

ASIS

Auscultate on spiroumbilical line Bilaterally

.

management
placentaprov
risk
· :-

US ofchorioniy 10-1
us d e

Sign
· mc :- Inverte +

DA

Do FHS for
·

factal memar
pregnancy -Do rely
twin on
·

:
movements
DCDA : -38-39 wKS .
Induce labour

Many
Colour
Presenting twin : -Chalic pressing
Avoid
prostaglanding .

ItwinGhalom Blechpreared
·

not Hel in Bruch,

for anna s

# Don't no ECU .

complications of twin
-

pregnancy :

hEG
only if wo admission.
2nd facthy
·

and molage of
·

·
Ideal time zomins for 2nd Duly deling