The patient is carrying monochorionic-monoamniotic twins. The nurse teaches the patient what this is, and the implications of this finding. The nurse knows that teaching is successful when the patient states:
1. "My babies came from two eggs."
2. "About two thirds of twins have this amniotic sac formation."
3. "My use of a fertility drug led to this issue."
4. "My babies have a lower chance of surviving to term than fraternal twins do."
4
Rationale 1: Monochorionic-monoamniotic twins are both in one amniotic sac, and are also monozygotic, or identical, coming from one ovum.
Rationale 2: About 2% of twins are of this type.
Rationale 3: Fertility drugs lead to an increase in dizygotic, not monochorionic-monoamniotic, twinning.
Rationale 4: Monochorionic-monoamniotic twins are both in one amniotic sac. Because the umbilical cords can tangle or knot, there is a higher incidence of fetal demise than with dizygotic twins.
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