Fetal Growth and Antenatal Testing in Uncomplicated Multiple Gestations

Area of Science:

• Perinatology
• Maternal-Fetal Medicine
• Obstetrics

Background:

• Multiple gestations often exhibit decelerated fetal growth during the third trimester.
• There is ongoing debate regarding whether increased fetal growth restriction diagnoses in twins are physiological or pathological.
• Multiple pregnancies are associated with a higher risk of unexpected third-trimester stillbirth, even in uncomplicated cases.

Purpose of the Study:

• To review current data and recommendations for fetal growth assessment in multiple gestations.
• To discuss antenatal surveillance strategies tailored for twin pregnancies.
• To provide guidance on optimal delivery timing for uncomplicated multiple gestations.

Main Methods:

• Review of existing literature on fetal growth in multiple gestations.
• Analysis of twin-specific growth charts and their utility.
• Examination of data on stillbirth risk in third-trimester multiple pregnancies.

Main Results:

• Twin-specific growth charts have been developed to better identify fetuses at risk.
• Evidence suggests an increased risk of stillbirth in apparently uncomplicated multiple gestations.
• Current recommendations focus on careful monitoring and timely intervention.

Conclusions:

• Accurate fetal growth assessment is crucial in multiple gestations.
• Antenatal surveillance and appropriate delivery timing are key to improving perinatal outcomes in twins.
• Further research may clarify the physiological versus pathological nature of growth changes in twins.