Multifetal Gestations

In recent years, multiple pregnancy rates have increased significantly. Twin pregnancy rate increased by 76% between 1980 and 2009, from 18.9 to 33.3 in 1000 births. Triplets and high-order multiple pregnancies have increased by 400% in the 1980s and 1990s. Two main reasons of this increase in the incidence of multiple pregnancies are: (1) maternal age at the time of conception, shifting to advanced ages where multiple pregnancies are more common and (2) a more common use of assisted reproductive techniques. The main problem in multiple pregnancies is spontaneous preterm delivery and associated neonatal morbidity and mortality. Although numerous attempts have been made to prolong the gestation period and improve outcomes, none of them have been effective. In this article, the complications encountered in multiple pregnancies will be summarized and evidence-based approaches that can be used in their management will be reported.