Multiple pregnancy and solutions to the problem of its complications (a literature review)

Abstract

Currently, the number of multiple pregnancies has increased all over the world, and therefore it has become one of the urgent problems of modern obstetrics. The rise is due to both the widespread practical application of effective methods for infertility treatment in healthcare and the use of assisted reproductive technologies. This review presents an opinion of most researchers about an association between multiple pregnancy and a significant number of complications that accompany it from early gestational age. Notable amongst these are miscarriage at different gestational age and premature birth, as well as an increase in probability of preeclampsia, anemia, gestational diabetes, postpartum hemorrhage, low birth weight, neurological complications, and intrauterine fetal death. The main cause of perinatal losses in multiple pregnancies is very low gestational age and low birth weight and length, with prematurity ranking first among other reasons. Perinatal mortality in multiple pregnancies is more than 6 times as high as in singleton pregnancies. Thus, patients with multiple pregnancies constitute a high-risk group for the development of maternal and perinatal complications. In order to timely identify, prevent and reduce the severity of specific complications, it is necessary to know the features of multiple pregnancies course and the main risks associated with it. However, there are still no universal algorithms for determining proper follow-up, treatment and the choose of delivery mode among women with various variants of multiple pregnancies. In any single case, a personalized approach is needed to maintain and prolong pregnancy.

Keywords

• multiple pregnancy
• premature birth
• assisted reproductive techniques
• placental proteins
• placental hormones
• cervical cerclage