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Multiple Gestation

Multiple gestation, or a multiple pregnancy, occurs when a woman carries more than one fetus in the womb at the same time. There are two types of multiple pregnancies - twins, which can be either identical (monozygotic) or fraternal (dizygotic), and higher order multiples like triplets or more. Multiple pregnancies come with increased risks for both mother and babies, such as preterm birth, preeclampsia, and gestational diabetes. Nurses monitor and educate mothers on nutrition, activity levels, and signs of complications.

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1K views22 pages

Multiple Gestation

Multiple gestation, or a multiple pregnancy, occurs when a woman carries more than one fetus in the womb at the same time. There are two types of multiple pregnancies - twins, which can be either identical (monozygotic) or fraternal (dizygotic), and higher order multiples like triplets or more. Multiple pregnancies come with increased risks for both mother and babies, such as preterm birth, preeclampsia, and gestational diabetes. Nurses monitor and educate mothers on nutrition, activity levels, and signs of complications.

Uploaded by

Irish Ivy Vibeth
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
  • Multiple Gestation: Introduces the topic of multiple gestations and authors involved in the presentation.
  • Etiology: Discusses the definition, causes, frequency, and risk factors associated with multiple pregnancies.
  • Types of Multiple Gestation: Explores various types of multiple gestations, including twins and higher order multiples.
  • Identical Twins: Explains the monozygotic process of identical twin formation from one egg and one sperm.
  • Fraternal Twins: Describes the dizygotic process of fraternal twin formation from two separate eggs and sperms.
  • Higher Order Multiples: Outlines the existence and variations of triplets, quadruplets, and higher order multiples.
  • Treatments: Covers treatments for complications associated with multiple gestations like preterm labor and preeclampsia.
  • Treatments Continued...: Further discusses treatments, focusing on additional considerations such as activity and nutritional precautions.
  • Nursing Care: Introduces nursing care practices and interventions for multiple gestations.
  • Nursing Diagnosis: Mom: Presents various nursing diagnoses specifically related to the mother's experience during multiple gestations.
  • Nursing Diagnosis: Mom cont’d: Continues the nursing diagnoses for the mom, focusing on nutritional and stress-related concerns.
  • Nursing Diagnosis: Infants: Details potential nursing diagnoses relevant to infants born from multiple gestations.
  • Nursing Interventions: Lists interventions designed to address the previously identified nursing diagnoses for both mothers and infants.
  • Nursing Interventions Cont’d: Continues listing nursing interventions with a focus on sleep and bonding encouragement.
  • Nursing Interventions cont’d: Further extends nursing intervention strategies, emphasizing monitoring and facilitation of care.
  • Outcomes: Discusses expectations of care outcomes concerning duration and resolution of issues.
  • Expected Outcomes: Mom: Outlines participating mothers' expected health outcomes and associated precautions.
  • Potential Outcomes: Mom: Details potential health risks and medical outcomes for mothers during multiple gestations.
  • Potential Outcomes: Baby: Explores potential neonatal health outcomes arising from multiple pregnancies, including prematurity.
  • Caring for Multiple Babies: Provides guidance on caring strategies and external support for families with multiple births.
  • References: Lists references and sources used in compiling the presentation.
  • References Cont’d: Continues the list of academic references relevant to the information presented.

Multiple Gestation

Brooke Bracy, JB Kagabo, Danielle Loomis, Kristen Osip, & Jillian Queen
Etiology
● What is multiple pregnancy?
● Causes
● Frequency
● Associated risk factors
Types of Multiple Gestation
● Twins
o Identical
o Fraternal

● Higher order
multiples
o triplets, quadruplets, etc.
Identical Twins
● Monozygotic
● One egg, one sperm, divides into 2 embryos
Fraternal Twins
● Dizygotic
● 2 eggs, 2 sperm, 2 embryos
Higher Order Multiples
● Triplets, quadruplets, quintuplets, etc.
● Variations of identical or fraternal multiples.
Treatments
Common Complications with Multiple
Gestation and Treatments for them:
● Preterm Birth/Labor
● Preeclampsia
● Gestational Diabetes
● Placental Problems
Treatments Continued...
Other Considerations
● Activity Precautions
● Metabolic & Nutritional
● Monitoring
● Delivery of Baby
Nursing Care
● Nursing Diagnosis

● Nursing Interventions
Nursing Diagnosis: Mom
● Anxiety r/t uncertain outcome of pregnancy
● Fatigue r/t increased physiological demand of a
multifetal pregnancy and/or care of more than one
infant
● Deficient knowledge r/t multiple pregnancy or
caring for more than one infant
● Stress overload r/t multiple coexisting stressor,
family demands
Nursing Diagnosis: Mom cont’d
● Imbalanced nutrition: less than body requirement
r/t increased physiological demands.
● Insomnia r/t impairment of normal sleep pattern;
parental responsibility
● Increased risk for postpartum hemorrhage r/t
uterine atony
● Risk for ineffective breastfeeding r/t lack of
support, physical demands of feeding more than
one infant
Nursing Diagnosis: Infants
● Risk for delayed development: fetuses r/t multiple
gestation
● Neonatal jaundice r/t feeding pattern not well
established
● Risk for impaired attachment r/t inadequate time
with each newborn and lack of the ability to provide
care for multiple infants
● Imbalanced nutrition: less than body needs r/t
ineffective breastfeeding or lack of infant formula
Nursing Interventions
● Assess level of anxiety and physical reactions to
anxiety. Teach different ways to cope with stress
and anxiety.
● Encourage the pt. to take rest as needed, and help
her identify family members or others who can help
at home to do different chores.
● Educate pt. and family about multiple pregnancy
(increasing nutrition, preventing hypertension,
gestational diabetes, substance abuses,...)
Nursing Interventions Cont’d
● Assess sleep history such as bedtime routine, sleep
pattern, use of stimulant.
● From history asses the degree and chronic nature of
insomnia.
● Encourage pt. to focus on positive aspect of life, and
to avoid use of stimulant before bedtime
● Encourage the mother to breastfeed to facilitate
bonding and attachment.
● Tell the mother that formulas also can be used.
Nursing Interventions cont’d
● Frequently assess the mother for bleeding
● Assess uterine fundus, and do fundal massage if
found boggy
● Administer medication as prescribed
● Promote bonding and attachment with each child
● Encouraged participation in infant’s care
● Suggest parents to keep feeding and care schedule
so that they do not become confused
Outcomes
● Duration

● Resolution of Issue
Expected Outcomes: Mom
● Frequent check-ups
● Increased nutrients
● Weight gain
● Precautions
Potential Outcomes: Mom
● High blood pressure
● Gestational diabetes
● Early labor
● Delivery
● Medications
Potential Outcomes: Baby
● Premature birth
● Twin-twin transfusion
● TRAP
Caring for Multiple Babies
● Help from family and friends
● NICU
● Breastfeeding

[Link]
References
Al-Khan, A. (2008). 11 things you didn’t know about twin pregnancies. WebMD. Retrieved from

[Link]

pregnancies?page=3

Fletcher, G. (2012). Multiple births. Medscape. Retrieved from

[Link]

Formation of twins. (2014). University of Pennsylvania Health System. Retrieved from

[Link]

How a multiples pregnancy occurs. (2014). American Pregnancy Association. Retrieved from

[Link]
Ladwig, G. B, & Ackley, B. J (2010). Mosby's guide to nursing diagnosis (3rd ed., pp. 98-99).

Maryland Heights: Elsevier Health Sciences.

Multiple pregnancy. (2014). Children’s Hospital of Wisconsin. Retrieved from

References
[Link]

complications/multiple-pregnancy/

Multiple pregnancy and birth: Twins, triplets, and high-order multiples (2014). In Society for Assisted

Technology. Retrieved from [Link]

What twin pregnancy means for mom. (2011). Mayo Clinic. Retrieved from

[Link]

pregnancy/art-20048161?pg=2

Multiple Gestation Brooke Bracy, JB Kagabo, Danielle Loomis, Kristen Osip, & Jillian Queen
Etiology ●What is multiple pregnancy? ●Causes ●Frequency ●Associated risk factors
Types of Multiple Gestation ●Twins o Identical o Fraternal ●Higher order multiples o triplets, quadruplets, etc.
Identical Twins ●Monozygotic ●One egg, one sperm, divides into 2 embryos
Fraternal Twins ●Dizygotic ●2 eggs, 2 sperm, 2 embryos
Higher Order Multiples ●Triplets, quadruplets, quintuplets, etc. ●Variations of identical or fraternal multiples.
Treatments Common Complications with Multiple Gestation and Treatments for them: ●Preterm Birth/Labor ●Preeclampsia ●Gestati
Treatments Continued... Other Considerations ●Activity Precautions ●Metabolic & Nutritional ●Monitoring ●Delivery of Baby
Nursing Care ●Nursing Diagnosis ●Nursing Interventions
Nursing Diagnosis: Mom ●Anxiety r/t uncertain outcome of pregnancy ●Fatigue r/t increased physiological demand of a multife

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