Perinatal mortality in twin pregnancies: implications for clinical management

Perinatal deaths were studied among 374 consecutive twin births at a large medical center. The perinatal death rate per 1,000 births was 112.3 for twins compared with 15 for singletons. Neonatal deaths were twice as frequent as fetal deaths and were most often the result of prematurity. Recommendations to improve twin survival include early recognition of twin pregnancy, bed rest and a nutritious diet for the mother, and prompt recognition and management of complications, especially premature labor.