Multiple Pregnancy

Multifetal pregnancies are on the increase globally due to several factors, the most
important being the use of assisted reproductive techniques (ART).
Early diagnosis is important for proper counselling and management so as to optimise maternal and perinatal outcome.
Though twin pregnancy brings happiness as you are expecting two kids at a time you also need to be very careful as twin pregnancy may cause complications.
The type of twins can be best established at 11 and 13 wks of gestation.
There can be excessive vomiting during early pregnancy and during second and third trimester you may feel breathlessness, backache and gastrointestinal symptoms.
Hypertension and diabetes can occur can be seen as a complication in twin pregnancy.
There is a increase chance for preterm delivery so serial monitoring of growth and cervical length and the preventive measures when the cervical length is < 2.5 cm may prevent the preterm delivery.
Proper bed rest and hospitalization is needed if there is a associated hypertension.
prophylactic cervical cerclage maybe effective if cervix is < 1.5mm
At the time of delivery there is a chance for postpartum haemorrhage and retained placenta so delivery to be planned in tertiary care centre.
There can be a difference in growth potential, placental insufficiency of one twin, and congenital anomalies are the usual causes of discordant twins. Delivery should be planned in an institution with neonatal care facilities.

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