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[Multiple pregnancy].

K Hirtenlehner-Ferber1, E Krampl, H Strohmer

  • 1Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und Gynäkologie, Universität Wien. Kora.Hirtenlehner@akh-wien.ac.at

Therapeutische Umschau. Revue Therapeutique
|February 15, 2003
PubMed
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Multiple pregnancies, including twins and higher-order multiples, have increased due to infertility treatments and maternal age. Chorionicity is key, with monochorionic twins facing risks like twin-to-twin transfusion syndrome.

Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Neonatal Care

Background:

  • The incidence of multiple pregnancies has significantly risen globally over the last two decades.
  • Assisted reproductive technologies (ART) and increased maternal age are primary drivers of this trend.
  • Multiple pregnancies represent a significant adverse outcome associated with infertility treatments.

Purpose of the Study:

  • To highlight the increasing rates of multiple pregnancies and their causes.
  • To emphasize the critical role of chorionicity in determining pregnancy outcomes and management.
  • To discuss the complications and management strategies for multiple gestations, particularly monochorionic twins.

Main Methods:

  • Ultrasound determination of chorionicity is crucial, ideally performed by 14 weeks of gestation.

Related Experiment Videos

  • Identification and management of specific complications like twin-to-twin transfusion syndrome (TTTS).
  • Review of obstetric and neonatal outcomes in multiple pregnancies.

    • Main Results:

    • Approximately 20% of twin pregnancies are monochorionic, with 15% developing severe TTTS requiring laser intervention.
    • Monochorionic twins exhibit a higher incidence of obstetric complications, including preterm labor and intrauterine growth restriction.
    • Neonatal complications such as low birth weight and congenital malformations are more prevalent in multiple births.

    Conclusions:

    • Despite increased risks, neonatal mortality for twins and triplets has decreased due to advances in neonatal intensive care.
    • Early determination of chorionicity via ultrasound is vital for appropriate management and improved outcomes.
    • Effective management of complications like TTTS is essential for reducing morbidity and mortality in multiple pregnancies.