The U.S. maternal mortality rate for multiple pregnancy is only slightly higher than for singleton. A history of previous dizygotic twins increases the likelihood of subsequent multiple pregnancy 10-fold. Hemorrhage is about 5 times…

Although the blood volume is increased in multiple pregnancy, maternal anemia often develops because of greater demand for iron by the fetuses. However, prior anemia, poor diet, and malabsorption may precede or…

A. Maternal

The incidence of spontaneous abortion of at least one of several fetuses is increased in multiple pregnancy. Stillbirth occurs twice as often among twins as among singleton pregnancies. Premature labor and delivery…

A. Labor and Delivery

Admit the patient to the hospital at the first sign of labor, if there is leakage of amniotic fluid, or if significant bleeding occurs. An ultrasound evaluation should be performed…

A. Multiple Pregnancy

Although human pituitary gonadotropin and other ovulation induction agents result in fewer multiple pregnancies when used by experts, even in the best of hands it is inevitable that some multiple pregnancies…

Multiple pregnancy must be distinguished from the following conditions.

A. Singleton Pregnancy

Inaccurate dates may give a false impression of the duration of the pregnancy, and the fetus may be larger than expected.…

With the ready availability of ultrasound, fewer than 10% of twin gestations are undiagnosed before labor and delivery. Early diagnosis facilitates appropriate prenatal care.

A. Symptoms and Signs

All of the common annoyances…

A. Monozygotic Multiple Gestation

Monozygotic twins, resulting from the fertilization of a single ovum by a single sperm, are always of the same sex. However, the twins may develop differently depending on the time…