Timing of birth in multiple pregnancy
Timing of delivery of twins should be decided when the benefit of prolonging the pregnancy outweighs the risk of stillbirth. Perinatal mortality of singletons is increased significantly after 42 weeks,…
Optimal antenatal care for twin and triplet pregnancy: The evidence base
Twin and triplet pregnancy is a high-risk situation, with increased risk of mortality and morbidity for both mother and babies. It is, therefore, essential that high-quality antenatal care is provided…
Prenatal screening and diagnosis of aneuploidy in multiple pregnancies
Prenatal screening for aneuploidy has changed significantly over the last 30 years, from being age-based to maternal serum and ultrasound based techniques. Multiple pregnancies present particular challenges with regards to…
Prevention of preterm delivery in twin pregnancy
The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery…
Prediction of preterm birth in twins
About 13% of twins are born before 34 weeks and 7% before 32 weeks. The prediction of preterm birth in twins is based on the same tests as in singleton…
Single-twin demise: Pregnancy outcome
Single-twin demise can pose substantial risks for the surviving co-twin, including increased risk of fetal loss, preterm delivery, neurovascular injury, and end-organ damage. In this chapter, we summarise recently published…
Selective reduction in multiple gestations
The frequency of multiple gestations has increased dramatically. Twins and higher order multiple gestations have pregnancies with increased risks for almost every complication of pregnancy, especially preterm labour, preterm delivery,…
Twin–twin transfusion syndrome: Treatment and outcome
Twin–twin transfusion syndrome complicates up to 15% of monochorionic pregnancies in the mid-trimester, and results in high perinatal mortality and morbidity if left untreated. Although some humoral factors play a…
Diagnosis of twin-to-twin transfusion syndrome, selective fetal growth restriction, twin anaemia-polycythaemia sequence, and twin reversed arterial perfusion sequence
Monochorionic twin pregnancies are well known to be at risk for a variety of severe complications, a true challenge for the maternal–fetal medicine specialist. With current standards of care, monochorionicity…
Early pregnancy assessment in multiple pregnancies
Early ultrasound assessment and accurate determination of chorionicity is crucial so that appropriate care of multiple pregnancy can be provided. It is best achieved in the first trimester of pregnancy…
