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Twin pregnancies: risks and complications: review article

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  • Medicine
  • Psychology


Although twin pregnancies are usually welcome, the excitement of a twin pregnancy can often be overshadowed by unforeseen complications. These pregnancies are associated with an increased perinatal morbidity and mortality when compared to singleton pregnancies. In addition there may be significant maternal complications such as early onset pre-eclampsia and preterm labour. These factors certainly contribute to the psychological impact on the parents. The incidence of twins is variable but the increased use of assisted reproductive technology has increased the frequency of multiple pregnancies in developed societies. Approximately two-thirds of twins are dizygotic (non-identical) and one-third monozygotic (identical). Early ultrasound can confirm the diagnosis and accurately establish chorionicity, amnionicity and gestational age. Later, structural anomalies can be excluded and growth monitored, while Doppler velocimetry of the umbilical artery can detect placental insufficiency. Monochorionic pregnancies are at highest risk of adverse outcome due to specific complications, such as twin-to-twin transfusion syndrome. O & B Forum Vol.14(2) 2004: 13-19

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