Management of multiple pregnancy: labor and delivery

Over the past 20 years, the number and rate of multiple births have dramatically increased in the United States. The rise in multiple births is mainly attributable to the increased use of ovulation-inducing drugs and the newly developed assisted reproductive technologies such as in vitro fertilization. Multifetal gestation is associated with an increased risk of perinatal morbidity and mortality. Multiple births account for an increasing percentage of low-birth-weight infants, preterm births, and infant mortality. In this article, the management of the labor and delivery of multiple gestation are reviewed. Particular emphasis is placed on the mode of delivery of twin and triplet pregnancies.

Obstetricians & Gynecologists, Family Physicians

After completion of this article, the reader should be able to describe the effects of the rising rate of multiple pregnancies on perinatal morbidity and mortality, to recall the complications of diagnosing and treating abnormalities of multiple pregnancies and to list the different safe options in managing labor in a multiple gestation.