A nurse in a prenatal clinic is discussing the risks of twin to twin transfusion syndrome with an 18 week pregnant client with monochorionic-monoamniotic (mono-mono) twins.
Which of the following statements by the client shows an understanding of the education?
"My twins are at higher risk of twin to twin transfusion because they share a placenta.”.
"Twin to twin transfusion results in over perfusion to both babies causing circulatory overload and CHF.”.
"Twin to twin transfusion is very common in all multiple gestation pregnancies.”.
"My twins are at a lower risk for twin to twin transfusion because they share the placenta.”. .
The Correct Answer is A
Choice A rationale
Monochorionic-monoamniotic twins share a single placenta and amniotic sac, increasing the risk for twin to twin transfusion syndrome (TTTS). This condition occurs due to unbalanced blood flow through the shared placenta, leading to discrepancies in blood volume between the twins.
Choice B rationale
TTTS does not result in overperfusion to both babies. Instead, it causes one twin (the donor) to become underperfused, leading to anemia and growth restriction, while the other twin (the recipient) becomes overperfused, causing polycythemia and circulatory overload, which can lead to heart failure.
Choice C rationale
TTTS is not very common in all multiple gestation pregnancies; it primarily affects monochorionic twins. In dichorionic twins, each twin has its own placenta, making TTTS highly unlikely.
Choice D rationale
Monochorionic twins sharing a placenta actually increases their risk for TTTS, not lowers it. The shared placenta creates a scenario where blood vessels can cross and lead to uneven blood flow between the twins. .
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Asthma is a respiratory condition and is not directly linked to an increased risk of placental abruption. While chronic conditions can affect pregnancy, asthma is not a direct risk factor for abruption.
Choice B rationale
Hyperthyroidism is a thyroid condition that can cause complications during pregnancy, but it is not a known risk factor for placental abruption. It affects the mother's metabolism and can impact fetal development, but does not typically cause placental detachment.
Choice C rationale
Previous cesarean delivery is associated with risks such as uterine rupture in future pregnancies, but not specifically with placental abruption. The scar tissue from a cesarean may affect the placenta's position, but does not increase the risk of abruption directly.
Choice D rationale
Hypertension, or high blood pressure, is a significant risk factor for placental abruption. It can damage the blood vessels in the placenta, leading to separation from the uterine wall and resulting in abruption, which can be dangerous for both mother and baby.
Correct Answer is D
Explanation
Choice A rationale
Methotrexate is used for treating ectopic pregnancies and certain cancers, but it is not an antidote for Magnesium Sulfate toxicity.
Choice B rationale
Labetalol is a beta-blocker used for hypertension management in pregnancy, not for reversing Magnesium Sulfate toxicity.
Choice C rationale
Nifedipine is a calcium channel blocker used to manage high blood pressure and preterm labor, not for counteracting Magnesium Sulfate toxicity.
Choice D rationale
Calcium gluconate is the specific antidote for Magnesium Sulfate toxicity, effectively reversing its effects.
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