2017年复旦大学上海医学院妇产科学系教案

一． Objectives

1. Understanding what does the multiple pregnancy mean to mother and fetus, risk and complitications.

2. Mastering the methods of determination between monozygotic and dizygotic.

3. Mastering the mechanism and diagnosis of TTTS

4. Mastering the role of amnionic fluid and its circulation.

5. Understanding the methods to evaluate volume of amnionic fluid.

6. Understanding what is polyhydramnios or oligohydramnios, the associated conditions, diagnosis, and complications respectively.

二． Contents of courses

1. Have a view of multiple pregnancy in human being, the etiology and influence factors.

2. Introduce the complications of twin or multiple pregnancy.

3. Explain the genetic mechanism of dizygotic and monozygotic.

4. Introduce the methods of diagnosis and determination in twins.

5. Introduce the antepartum and intrapartum management in twins.

6. Introduce TTTS.

7. Introduce the role of amnionic fluid, and its circulation.

8. Introduce the measurement of amnionic fluid.

9. Explain polyhydramnios and its cause.

10.Explain oligohydramnios and its cause.

三．Teaching Plan and Time Distribution

（一） Contents and time plan

1. Multiple pregnancy: 45 min.

(1) Have a view of multiple pregnancy in human being, 3 min.

(2) The complications of twin or multiple pregnancy, 8 min.

(3) The etiology and influence factors, 1 min.

(4) The genetic mechanism of dizygotic and monozygotic, 8 min.

(5) The methods of diagnosis and determination in twins, 5 mom.

(6) The antepartum and intrapartum management in twins, 5 min.

(7) Diagnosis and treatment of TTTS, 15 min.

2. Disorders of amnionic fluid volum: 30 min.

(1) The role of amnionic fluid, 2.5 min.

(2) Amnionic fluid circulation, 2.5 min.

(3) Normal volume of amnionic fluid and ultrasonic measurement, 5min.

(4) Definition of polyhydramnios, and the cause, symptoms, diagnosis, treatment, 10min

(5) Definition of oligohydramnios, and the cause, symptoms, diagnosis, treatment, 10min

3. Summary: 15 minI

（二）Key points and Difficulty

Key points：The complications of twin or multiple pregnancy, the genetic mechanism of dizygotic and monozygotic, diagnosis of TTTS, definition and cause of polyhydramnios or oligohydramnios.

Difficulty：The genetic mechanism of dizygotic and monozygotic, the antepartum and intrapartum management in twins, diagnosis and treatment of TTTS, amnionic fluid circulation, ultrasonic measurement of amnionic fluid, the cause of polyhydramnios and oligohydramnios.

（三）Key words

双胎输血综合征：twin-twin transfusion syndrome，TTTS

单卵双胎：monozygotic

双卵双胎：dizygotic

羊水指数：amnionic fluid index, AFI

羊水过多：polyhydramnios

羊水过少：oligohydramnios

（四）Teaching tools（Figure、table、model、video and CAI etc.）

(Special Request from Dpt. of Teaching and Research ) N/A

（五）Questions？

1．What is the complications in multiple pregnancy?

2．What is the genetic mechanism of dizygotic and monozygotic?

3．What is TTTS?

4. Please narrate the role of amnionic fluid.

5. Please narrate the circulation of amnionic fluid.

（六）Requests for teaching assistant

Case discussion, ultrasonic diagnosis introduction, a real placenta analysis.

(七) References:

Obstetrics and Gynecology, 9th edition

Williams Obstetrics, 24rd edition