Multiple Births Workup

  • Author: Garth E Fletcher, MD; Chief Editor: Ted Rosenkrantz, MD   more...
 
Updated: Mar 27, 2012
 

Laboratory Studies

The evaluation of a multifetal pregnancy involves routine prenatal and postnatal care, as well as specific evaluation directed by the type of multiple pregnancy and neonatal complications. Guidelines for complicated multifetus pregnancies have been established by American College of Obstetricians and Gynecologists.[8]

  • Obstetrical: Routine prenatal laboratory studies are indicated.
  • Neonatal: A CBC count is obtained to evaluate for anemia and polycythemia.
  • ABG and cord blood gas (CBG): These are measured to evaluate for respiratory distress, hypoxia, acidosis, and perinatal depression.
  • Metabolic panel: Fluid and electrolyte levels should be obtained and metabolic status should be determined, including screening for hypoglycemia and hypocalcemia.
  • Bilirubin level: This is obtained to screen for increased risk of hyperbilirubinemia associated with prematurity and polycythemia.
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Imaging Studies

  • Obstetrical: Prenatal ultrasonography is used to confirm multifetal pregnancy and to monitor intrauterine fetal growth.
  • Fetal echocardiography: This is used to screen for congenital heart disease in neonates.
  • Fetal MRI: This is used to screen for fetal anomalies.
  • Neonatal: Chest radiography is used to evaluate respiratory distress.
  • Ultrasonography: This is used to screen for intraventricular hemorrhage, periventricular leukomalacia, and abdominal abnormalities.
  • Echocardiography: This is used to screen for congenital heart disease.
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Other Tests

  • Obstetrical: Antepartum surveillance is indicated.
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Procedures

  • Specific to obstetrical or neonatal complications (ie, ablation procedure in twin-to-twin transfusion syndrome [TTTS], surgery in conjoined twins)
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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Garth E Fletcher, MD  Assistant Professor of Pediatrics and Staff Neonatologist, Joint Division of Newborn Medicine, University of Nebraska Medical Center and Creighton University

Garth E Fletcher, MD is a member of the following medical societies: American Academy of Pediatrics and National Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Terence Zach, MD  Department Vice-Chair, Professor, Department of Pediatrics, Section of Newborn Medicine, Creighton University

Terence Zach, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, and Nebraska Medical Association

Disclosure: Nothing to disclose.

Arun K Pramanik, MD, MBBS  Professor of Pediatrics, Director of Neonatal Fellowship, Louisiana State University Health Sciences Center

Arun K Pramanik, MD, MBBS is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society, National Perinatal Association, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Susannah P Ford, MD  Fellow, Department of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

David N Sheftel  MD, Assistant Professor of Pediatrics, Chicago Medical School at Rosalind Franklin University of Medicine and Science

David N Sheftel is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine and American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

David A Clark, MD  Chairman, Professor, Department of Pediatrics, Albany Medical College

David A Clark, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Pediatric Society, Christian Medical & Dental Society, Medical Society of the State of New York, New York Academy of Sciences, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Carol L Wagner, MD  Professor of Pediatrics, Medical University of South Carolina

Carol L Wagner, MD is a member of the following medical societies: American Academy of Pediatrics, American Chemical Society, American Medical Women's Association, American Public Health Association, American Society for Bone and Mineral Research, American Society for Clinical Nutrition, Massachusetts Medical Society, National Perinatal Association, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Ted Rosenkrantz, MD  Professor, Departments of Pediatrics and Obstetrics/Gynecology, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine

Ted Rosenkrantz, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Pediatric Society, Connecticut State Medical Society, Eastern Society for Pediatric Research, and Society for Pediatric Research

Disclosure: Nothing to disclose.

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Diamniotic/dichorionic placentation.
Diamniotic/monochorionic placentation.
Monoamniotic/monoamniotic placentation.
 
 
 
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