Management of twin pregnancies: Remaining challenges and unanswered questions.

Abstract

Several professional societies have published guidelines on twin pregnancies over the past few years. These documents provide recommendations on antenatal surveillance and management of twin pregnancies. At the same time, these guidelines identify several key areas where evidence is limited and additional research is needed. In the present review, we summarize available evidence regarding some of these key areas, including the screening and prevention of preterm birth, the definition and management of fetal growth restriction, the diagnosis and management of gestational diabetes, the optimal maternal gestational weight gain, and the mode and timing of delivery. In addition, we describe several online tools related to these areas that can empower individuals with twin pregnancies and assist care providers in counseling these patients.