Twin gestations: I. Antenatal care and complications

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Perinatology

Background:

• Twin pregnancies are associated with increased maternal and fetal risks compared to singleton pregnancies.
• Antenatal complications significantly impact pregnancy outcomes in both mothers and neonates.

Purpose of the Study:

• To determine the incidence of common antenatal complications in twin gestations.
• To compare complication rates in twin versus singleton pregnancies.
• To analyze the influence of zygosity and antenatal care on complication rates in twins.

Main Methods:

• Retrospective review of 939 consecutive twin gestations.
• Comparison of antenatal complication rates with singleton gestation data.
• Analysis of complication rates based on zygosity and antenatal care levels.

Main Results:

• Twin gestations exhibited an 83% incidence of antenatal complications, compared to 32% in singleton gestations.
• Preterm labor, pregnancy-induced hypertension, and fetal death were disproportionately increased in twin pregnancies.
• Monozygotic twins had higher rates of fetal death; dizygotic twins had higher rates of pregnancy-induced hypertension.

Conclusions:

• Twin pregnancies face a substantially higher burden of antenatal complications.
• Specific complications like preterm labor, hypertension, and fetal demise require focused attention in twin gestations.
• Zygosity plays a role in the pattern of complications observed in twin pregnancies.