Multiple Births Clinical Presentation

Updated: Dec 20, 2019
  • Author: Garth E Fletcher, MD; Chief Editor: Dharmendra J Nimavat, MD, FAAP  more...
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History and Physical Examination


Most multifetal pregnancies are prenatally diagnosed.

Maternal complaints of excessive weight gain, hyperemesis gravidarum, the sensation of more than one moving fetus, the use of ovulation-inducing drugs, or a family history of dizygotic twins should alert caregivers to the possibility of a multifetal pregnancy.

Physical Examination

Women with multifetal pregnancies may have a uterine size that is inconsistently large for dates and may experience accelerated weight gain. Upon auscultation, more than one fetal heart rate may be heard.



Risk factors for multifetal pregnancy can be divided into natural and induced.

Risk factors for natural multifetal pregnancy include advanced maternal age, family history of dizygotic twins, and race.

Induced multifetal pregnancies occur following infertility treatment via the use of ovulation-inducing agent or multiple gamete/zygote transfer.