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Pregnancy double (Gomelli ) Pregnancy double or twin pregnancy is a pregnancy with two or more fetuses.

(Obstetrics: 386)
Etiology 1.Factors that affect: the nation, age, and parity, multiple

pregnancies often affect 2 eggs. the twins come from one egg, national factors, heredity, age and parity no or little influence twin pregnancy

If the inhibiting factors occurs after blastula but before the

amnion is formed, there will be a twin pregnancy with 2 amnion, before the primitive streak appears, there will be a twin pregnancy with 1 amnion. After the primitive streak is formed, there will be a Siamese twin with a variety of forms.
2. Factors ovulation induction drugs: Profertil, Clomid and

gonadotropins may lead to pregnancy hormones and dizygotic twins more than two.

3. In vitro fertilization twin pregnancies can also occur

if the eggs can be fertilized obtained more than one and if all embryos are then inserted into the cavity of the mother's womb to grow and develop more than one.
4. 5.

Heredity. Another factor that is not yet known

TYPE Gemelli 1. Monozygotic twin pregnancy Multiple pregnancies that occurred from one egg is called also called monozygotic twins are identical, homologous or univoler. Monozygotic twins that are sperm fertilized the egg, then divides in two.
2. Dizygotic twin pregnancy

Approximately two-thirds of pregnancies are dizygotic twins from 2 eggs; called heterologous, binovuler, or fraternal. The same sex or different, they are different like other children in the family. Dizygotic twins have two placentas, two amniotic chorion and 2. Sometimes 2 placenta into one.

Superfekundasi

Superfekundasi is the fertilization of two eggs released at ovulation same at 2 insertion is done with a short interval. Pregnancy is therefore difficult to distinguish from dizygotic twins. In 1910 by Archer reported that a white woman who did coitus in a row with a white man with a Negro and then gave birth to twins with one baby is white and the other in the form of mullato

Superfetasi is the second pregnancy occurred several

mingggu or months after the first pregnancy occurred. This situation has never been proven in humans, but can be found in horses.

EFFECT OF MOTHER AND FETUS 1. Against Mom The need for these substances increases, which can result in anemia and a deficiency of other substances. The possibility of the occurrence of hydramnios increase The frequency of pre-eclampsia and eclampsia more often.

Because of the large uterus, the mother complained

shortness of breath, frequent micturition, and there is edema and varicose veins in the legs and vulva. Can occur inertia uteri, postpartum hemorrhage, and solutio placenta after the first child was born.

2. Against Fetus Short gestational age plus the increasing number of fetuses in a twin pregnancy.who will be born four weeks before term. So the possibility of a premature will be high.
When the first baby born after solutio plasentae

happen, then both the high infant mortality rate.


Often the location of the fetus goes wrong, which will

also enhance fetal mortality.

HANDLING IN PREGNANCY Prenatal care to get to know a twin pregnancy and prevent complications that arise, and when the diagnosis has been established retrial should be more frequent (1 x week at more than 32 weeks gestation).
After 30 weeks of pregnancy, coitus and travel should

be avoided, as it will stimulate prematurus parturition.


Check hemoglobin, and blood type.

PROGNOSIS Mother: prolonged labor Taruma the birth canal Bleeding post partum The prognosis for the mother worse than in singleton pregnancies, due to frequent toxemia gravidarum, hydramnios, anemia, aid operative obstetrics, and postpartum bleeding. High perinatal mortality rate is mainly due to prematurity, prolapsed umbilical cord, placenta and acts obstetric solutio because the location of fetal abnormalities.

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