Multiple pregnancy: an international perspective

This article discusses the following areas of interest related to the obstetric care of multiple pregnancy: 1) methods of diagnosis and ultrasound, 2) pregnancy protection through adequate maternal nutrition, 3) mode of delivery, 4) discordant twins, and 5) assisted reproductive technology. The article also emphasizes the FIGO/WHO concerns regarding safe motherhood and proposes a four point program to reduce perinatal death rates in multiple pregnancy. These elements are: 1) adequate primary health care including access to family planning information and technology, 2) prenatal care with referral of high risk patients to specialized centers, 3) the presence of trained personnel for all women in childbirth, 4) effective access to obstetric care for women who are pregnant, giving birth, or recently delivered.