The Epidemic of Twins: The Challenge in Obstetrics and Gynaecology

Abstract

In the past 50 years, the incidence of multiple pregnancy has increased dramatically due almost exclusively to two factors: delayed childbearing and assisted reproduction techniques (ARTs). Although the clinical guidelines and protocols currently endorsed by scientific societies have systematised the obstetric care required in multiple pregnancy, the effects of obstetric care beyond the perinatal period have seldom been evaluated. Twin deliveries also involve additional difficulties derived from the need for ‘simultaneous’ care of two fetuses during the expulsive period, during which the second twin is particularly vulnerable due to potential complications. Chorionicity, gestational age at birth, ART, birth order, and some parental variables, such as maternal age, have been studied as possible sources of neurodevelopmental delay in twins.

Keywords

• multiple pregnancy
• assisted reproduction
• perinatal outcomes
• preterm birth