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Maternal Complications Associated
with Multiple Gestation
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Placental abnormalities associated with maternal hemorrhage
are more likely to occur
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Gestational diabetes, anemia, and polyhydramnios (excess amniotic
fluid) occur more frequently
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Cesarean section (C-section) is often needed for twin pregnancies
and almost always for triplets and beyond
Other Considerations
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Multiple gestation is associated with more nausea and vomiting,
anemia, fatigue, weight gain, heartburn, lack of sleep, financial
difficulties, depression, and marital discord
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Multifetal reduction may be advised for the health of the
mother and to improve survival of the pregnancy. However, it
is unclear how effective it is in reducing the rate of many
of the above problems. Couples contemplating this option should
consider counseling
Prevention of Multiple Gestation
-
Careful monitoring during treatments with fertility drugs
-
Limit the number of embryos transferred during in-vitro fertilization
(IVF).
Transfer of multiple embryos may not improve delivery rates
but clearly increases the risk of multiple pregnancy. The Society
for Assisted Reproductive Technology (SART)
and the American Society for Reproductive Medicine (ASRM)
have published guidelines recommending an optimal number of
embryos for transfer based on a woman's age, embryo quality,
and other criteria
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