Multifetal Pregnancy Clinical Presentation

1. Malone FD, D'Alton ME. Multiple gestation: clinical characteristics and management. Creasy RK, Resnik R. Maternal Fetal Medicine, Principles and Practices. Sixth edition. Philadelphia, PA: Saunders; 2009. 454-476.

2. Schieve LA, Peterson HB, Meikle SF, Jeng G, Danel I, Burnett NM, et al. Live-birth rates and multiple-birth risk using in vitro fertilization. JAMA. 1999 Nov 17. 282(19):1832-8. [QxMD MEDLINE Link].

3. Nylander PP. The factors that influence twinning rates. Acta Genet Med Gemellol (Roma). 1981. 30(3):189-202. [QxMD MEDLINE Link].

4. Soma H, Takayama M, Kiyokawa T, Akaeda T, Tokoro K. Serum gonadotropin levels in Japanese women. Obstet Gynecol. 1975 Sep. 46(3):311-2. [QxMD MEDLINE Link].

5. Benirschke K, Kim CK. Multiple pregnancy. 1. N Engl J Med. 1973 Jun 14. 288(24):1276-84. [QxMD MEDLINE Link].

6. Martin JA, Hamilton BE, Osterman MJ. Three decades of twin births in the United States, 1980-2009. NCHS Data Brief. 2012.

7. Lambalk CB, De Koning CH, Braat DD. The endocrinology of dizygotic twinning in the human. Mol Cell Endocrinol. 1998 Oct 25. 145(1-2):97-102. [QxMD MEDLINE Link].

8. Ettner SL, Christiansen CL, Callahan TL, Hall JE. How low birthweight and gestational age contribute to increased inpatient costs for multiple births. Inquiry. 1997-1998 Winter. 34(4):325-39. [QxMD MEDLINE Link].

9. Grether JK, Nelson KB, Cummins SK. Twinning and cerebral palsy: experience in four northern California counties, births 1983 through 1985. Pediatrics. 1993 Dec. 92(6):854-8. [QxMD MEDLINE Link].

10. Committee on Practice Bulletins—Obstetrics., Society for Maternal–Fetal Medicine. Practice Bulletin No. 169: Multifetal Gestations: Twin, Triplet, and Higher-Order Multifetal Pregnancies. Obstet Gynecol. 2016 Oct. 128 (4):e131-46. [QxMD MEDLINE Link].

11. Shetty A, Smith AP. The sonographic diagnosis of chorionicity. Prenat Diagn. 2005 Sep. 25(9):735-9. [QxMD MEDLINE Link].

12. Evans MI, Dommergues M, Wapner RJ, Goldberg JD, Lynch L, Zador IE. International, collaborative experience of 1789 patients having multifetal pregnancy reduction: a plateauing of risks and outcomes. J Soc Gynecol Investig. 1996 Jan-Feb. 3(1):23-6. [QxMD MEDLINE Link].

13. Haas J, Hourvitz A, Dor J, et al. Pregnancy outcome of early multifetal pregnancy reduction: triplets to twins versus triplets to singletons. Reprod Biomed Online. 2014 Dec. 29(6):717-21. [QxMD MEDLINE Link].

14. Shinagawa S, Suzuki S, Chihara H, Otsubo Y, Takeshita T, Araki T. Maternal basal metabolic rate in twin pregnancy. Gynecol Obstet Invest. 2005. 60(3):145-8. [QxMD MEDLINE Link].

15. Weight gain during pregnancy: reexamining the guidelines. Institute of Medicine of the National Academies. May 28, 2009.

16. Goodnight W, Newman R,. Optimal nutrition for improved twin pregnancy outcome. Obstet Gynecol. 2009 Nov. 114(5):1121-34. [QxMD MEDLINE Link].

17. Blake GD, Knuppel RA, Ingardia CJ, Lake M, Aumann G, Hanson M. Evaluation of nonstress fetal heart rate testing in multiple gestations. Obstet Gynecol. 1984 Apr. 63(4):528-32. [QxMD MEDLINE Link].

18. Lodeiro JG, Vintzileos AM, Feinstein SJ, Campbell WA, Nochimson DJ. Fetal biophysical profile in twin gestations. Obstet Gynecol. 1986 Jun. 67(6):824-7. [QxMD MEDLINE Link].

19. Rouse DJ, Caritis SN, Peaceman AM, Sciscione A, Thom EA, Spong CY, et al. A trial of 17 alpha-hydroxyprogesterone caproate to prevent prematurity in twins. N Engl J Med. 2007 Aug 2. 357 (5):454-61. [QxMD MEDLINE Link].

20. Caritis SN, Rouse DJ, Peaceman AM, Sciscione A, Momirova V, Spong CY, et al. Prevention of preterm birth in triplets using 17 alpha-hydroxyprogesterone caproate: a randomized controlled trial. Obstet Gynecol. 2009 Feb. 113 (2 Pt 1):285-92. [QxMD MEDLINE Link].

21. Minakami H, Sato I. Reestimating date of delivery in multifetal pregnancies. JAMA. 1996 May 8. 275(18):1432-4. [QxMD MEDLINE Link].

22. Hack KE, Derks JB, Elias SG, Franx A, Roos EJ, Voerman SK. Increased perinatal mortality and morbidity in monochorionic versus dichorionic twin pregnancies: clinical implications of a large Dutch cohort study. BJOG. 2008 Jan. 115(1):58-67. [QxMD MEDLINE Link].

23. Lee YM, Wylie BJ, Simpson LL, D'Alton ME. Twin chorionicity and the risk of stillbirth. Obstet Gynecol. 2008 Feb. 111(2 Pt 1):301-8. [QxMD MEDLINE Link].

24. Glinianaia SV, Obeysekera MA, Sturgiss S, Bell R. Stillbirth and neonatal mortality in monochorionic and dichorionic twins: a population-based study. Hum Reprod. 2011 Jul 4. [QxMD MEDLINE Link].

25. Hogle KL, Hutton EK, McBrien KA, Barrett JF, Hannah ME. Cesarean delivery for twins: a systematic review and meta-analysis. Am J Obstet Gynecol. 2003 Jan. 188(1):220-7. [QxMD MEDLINE Link].

26. Chasen ST, Spiro SJ, Kalish RB, Chervenak FA. Changes in fetal presentation in twin pregnancies. J Matern Fetal Neonatal Med. 2005 Jan. 17(1):45-8. [QxMD MEDLINE Link].

27. Chauhan SP, Roberts WE, McLaren RA, Roach H, Morrison JC, Martin JN Jr. Delivery of the nonvertex second twin: breech extraction versus external cephalic version. Am J Obstet Gynecol. 1995 Oct. 173(4):1015-20. [QxMD MEDLINE Link].

28. Glinianaia SV, Rankin J, Wright C. Congenital anomalies in twins: a register-based study. Hum Reprod. 2008 Jun. 23(6):1306-11. [QxMD MEDLINE Link].

29. Cameron AH, Edwards JH, Derom R, Thiery M, Boelaert R. The value of twin surveys in the study of malformations. Eur J Obstet Gynecol Reprod Biol. 1983 Feb. 14(5):347-56. [QxMD MEDLINE Link].

30. Meyers C, Adam R, Dungan J, Prenger V. Aneuploidy in twin gestations: when is maternal age advanced?. Obstet Gynecol. 1997 Feb. 89(2):248-51. [QxMD MEDLINE Link].

31. Garchet-Beaudron A, Dreux S, Leporrier N, Oury JF, Muller F, ABA Study Group, et al. Second-trimester Down syndrome maternal serum marker screening: a prospective study of 11 040 twin pregnancies. Prenat Diagn. 2008 Dec. 28 (12):1105-9. [QxMD MEDLINE Link].

32. Curnow KJ, Wilkins-Haug L, Ryan A, et al. Detection of triploid, molar, and vanishing twin pregnancies by a single-nucleotide polymorphism-based noninvasive prenatal test. Am J Obstet Gynecol. 2015 Jan. 212(1):79.e1-9. [QxMD MEDLINE Link].

33. Committee Opinion No. 640: Cell-Free DNA Screening For Fetal Aneuploidy. Obstet Gynecol. 2015 Sep. 126 (3):e31-7. [QxMD MEDLINE Link].

34. Narang K, Szymanski LM. Multiple gestations and hypertensive disorders of pregnancy: what do we know?. Curr Hypertens Rep. 2020 Nov 18. 23 (1):1. [QxMD MEDLINE Link].

35. Sibai BM, Hauth J, Caritis S, Lindheimer MD, MacPherson C, Klebanoff M. Hypertensive disorders in twin versus singleton gestations. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol. 2000 Apr. 182(4):938-42. [QxMD MEDLINE Link].

36. Roach VJ, Lau TK, Wilson D, Rogers MS. The incidence of gestational diabetes in multiple pregnancy. Aust N Z J Obstet Gynaecol. 1998 Feb. 38(1):56-7. [QxMD MEDLINE Link].

37. Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Consens Statement. 1994 Feb 28-Mar 2. 12(2):1-24. [QxMD MEDLINE Link].

38. Mauldin JG, Newman RB. Neurologic morbidity associated with multiple gestation. Female Pat. 1998. 23(4):27-8, 30, 35-6, passim.

39. Roberts D, Neilson JP, Kilby M, Gates S. Interventions for the treatment of twin-twin transfusion syndrome. Cochrane Database Syst Rev. 2008 Jan 23. CD002073. [QxMD MEDLINE Link].

40. Whitworth NS, Magann EF, Morrison JC. Evaluation of fetal lung maturity in diamniotic twins. Am J Obstet Gynecol. 1999 Jun. 180(6 Pt 1):1438-41. [QxMD MEDLINE Link].

Asha J Heard, MD, MPH, FACOG Assistant Professor of Obstetrics and Gynecology, Associate Residency Director, Director of Clinical Ultrasound, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center

Asha J Heard, MD, MPH, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, Society for Maternal-Fetal Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ronald M Ramus, MD Professor of Obstetrics and Gynecology, Director, Division of Maternal-Fetal Medicine, Virginia Commonwealth University School of Medicine

Ronald M Ramus, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, Medical Society of Virginia, Society for Maternal-Fetal Medicine

Disclosure: Nothing to disclose.

Jordan G Pritzker, MD, MBA, FACOG Adjunct Professor of Obstetrics/Gynecology, Hofstra North Shore-LIJ School of Medicine at Hofstra University; Attending Physician, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center; Medical Director, Aetna, Inc; Private Practice in Gynecology

Disclosure: Nothing to disclose.

Steven J Ralston, MD Associate Professor of Obstetrics and Gynecology, Harvard Medical School; Consulting Staff in Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center

Steven J Ralston, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Society of Law, Medicine & Ethics, Association of Professors of Gynecology and Obstetrics, Society for Maternal-Fetal Medicine

Disclosure: Nothing to disclose.

• Print this section
• Print the entire contents of
• Print the entire contents of article