Multiple pregnancy

There has been a consistent rise in multiple pregnancies over recent years. Such pregnancies are at increased risk of miscarriage, fetal abnormalities, preterm birth, complications specific to shared placentation including twin-to-twin transfusion syndrome, selective growth restriction, and twin anaemia–polycythaemia sequence. In addition, a woman with a multiple pregnancy is at a higher risk of maternal complications including pre-eclampsia and other hypertensive disorders of pregnancy, obstetric cholestasis, gestational diabetes, exaggerated maternal pregnancy symptoms, and postpartum haemorrhage. Antenatal care in a multiple pregnancy should ideally be offered in a dedicated setting, with increased contact with the healthcare professionals compared to a singleton pregnancy. Such pregnancies, especially when complicated, need support and appropriate counselling to prepare for an optimal outcome.