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Multiple pregnancies 

Multiple pregnancies
Chapter:
Multiple pregnancies
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0025
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date: 29 May 2020

The incidence of multiple births has risen, mainly due to assisted reproduction techniques (ART), in the last 30 years and they currently account for 3% of all live births. Multiple pregnancies are more complex than singleton pregnancies. The higher the order, the greater the risks. This chapter describes the chorionicity, types of multiple pregnancies and complications in general, as well as those specifically related to monochorionic twins, triplets, etc. Management principles are addressed in accordance with national guidelines including regular monitoring, timing and mode of delivery. Twin-to-twin transfusion syndrome and the Quintero grading of severity, vanishing twin syndrome, TRAP sequence, issues pertaining to a survivor twin or when one twin is diagnosed with malformations/chromosomal defects are considered. Selective fetal reduction and indications for tertiary centre referrals are discussed. Care pathways offer recommended schedules of antenatal visits for mono- and dichorionic twins including scans, investigations, and clear documentation of plans for intrapartum/postnatal care.

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