Book contents
- Management of Multiple Pregnancies
- Management of Multiple Pregnancies
- Copyright page
- Contents
- Editors
- Contributors
- Chapter 1 Epidemiology of Multiple Pregnancy
- Chapter 2 Assisted Conception and Multiple Pregnancy
- Chapter 3 Zygosity, Chorionicity and Amnionicity
- Chapter 4 Multifetal Pregnancy Reduction
- Chapter 5 Gestational Dating in Multiple Pregnancy
- Chapter 6 Screening for Fetal Aneuploidy in Multiple Pregnancy
- Chapter 7 Screening for Fetal Abnormality in Multiple Pregnancy
- Chapter 8 Screening and Diagnosis of Complications of Shared Placentation
- Chapter 9 Invasive Prenatal Diagnosis in Multiple Pregnancy
- Chapter 10 Conjoined Twinning
- Chapter 11 Management of Discordant Fetal Anomaly
- Chapter 12 Single and Double Fetal Loss in Twin Pregnancy
- Chapter 13 Management of Twin–Twin Transfusion Syndrome
- Chapter 14 Management of Twin Anaemia-Polycythaemia Sequence
- Chapter 15 Management of Twin-Reversed Arterial Perfusion (TRAP) Sequence
- Chapter 16 Management of Fetal Growth Pathology in Multiple Pregnancy
- Chapter 17 Management of Monoamniotic Twins
- Chapter 18 Maternal Complications in Multiple Pregnancy
- Chapter 19 Risk Assessment and Screening for Preterm Birth in Multiple Pregnancy
- Chapter 20 Prevention of Preterm Birth in Multiple Pregnancies
- Chapter 21 Optimal Antenatal Care in Multiple Pregnancy
- Chapter 22 Triplet and Higher-Order Pregnancy
- Chapter 23 Timing of Delivery in Multiple Pregnancy
- Chapter 24 Mode of Delivery in Multiple Pregnancy
- Chapter 25 Practical Management of Vaginal Delivery in Multiple Pregnancy
- Chapter 26 Neonatal Care Aspects of Multiple Pregnancy
- Chapter 27 Lifestyle Considerations for Multiple Pregnancy
- Chapter 28 Emotional and Mental Well-Being in Multiple Pregnancy
- Chapter 29 New Frontiers in Multiple Pregnancy Management
- Chapter 30 Multiple Pregnancy Resources for Professionals and the Public
- Chapter 31 Obstetric Anaesthesia in Multiple Pregnancy
- Index
- Plate Section (PDF Only)
- References
Chapter 23 - Timing of Delivery in Multiple Pregnancy
Published online by Cambridge University Press: 11 October 2022
- Management of Multiple Pregnancies
- Management of Multiple Pregnancies
- Copyright page
- Contents
- Editors
- Contributors
- Chapter 1 Epidemiology of Multiple Pregnancy
- Chapter 2 Assisted Conception and Multiple Pregnancy
- Chapter 3 Zygosity, Chorionicity and Amnionicity
- Chapter 4 Multifetal Pregnancy Reduction
- Chapter 5 Gestational Dating in Multiple Pregnancy
- Chapter 6 Screening for Fetal Aneuploidy in Multiple Pregnancy
- Chapter 7 Screening for Fetal Abnormality in Multiple Pregnancy
- Chapter 8 Screening and Diagnosis of Complications of Shared Placentation
- Chapter 9 Invasive Prenatal Diagnosis in Multiple Pregnancy
- Chapter 10 Conjoined Twinning
- Chapter 11 Management of Discordant Fetal Anomaly
- Chapter 12 Single and Double Fetal Loss in Twin Pregnancy
- Chapter 13 Management of Twin–Twin Transfusion Syndrome
- Chapter 14 Management of Twin Anaemia-Polycythaemia Sequence
- Chapter 15 Management of Twin-Reversed Arterial Perfusion (TRAP) Sequence
- Chapter 16 Management of Fetal Growth Pathology in Multiple Pregnancy
- Chapter 17 Management of Monoamniotic Twins
- Chapter 18 Maternal Complications in Multiple Pregnancy
- Chapter 19 Risk Assessment and Screening for Preterm Birth in Multiple Pregnancy
- Chapter 20 Prevention of Preterm Birth in Multiple Pregnancies
- Chapter 21 Optimal Antenatal Care in Multiple Pregnancy
- Chapter 22 Triplet and Higher-Order Pregnancy
- Chapter 23 Timing of Delivery in Multiple Pregnancy
- Chapter 24 Mode of Delivery in Multiple Pregnancy
- Chapter 25 Practical Management of Vaginal Delivery in Multiple Pregnancy
- Chapter 26 Neonatal Care Aspects of Multiple Pregnancy
- Chapter 27 Lifestyle Considerations for Multiple Pregnancy
- Chapter 28 Emotional and Mental Well-Being in Multiple Pregnancy
- Chapter 29 New Frontiers in Multiple Pregnancy Management
- Chapter 30 Multiple Pregnancy Resources for Professionals and the Public
- Chapter 31 Obstetric Anaesthesia in Multiple Pregnancy
- Index
- Plate Section (PDF Only)
- References
Summary
Multiple pregnancies are at higher risk of stillbirth, spontaneous or elective preterm delivery and neonatal death. These risks vary with gestation and are further increased for monochorionic pregnancies, and therefore accurate assessment of both gestational age and chorionicity is mandatory to plan further delivery. The risk of stillbirth per ongoing pregnancies increases with advancing gestational age, whereas the risk of neonatal death per livebirth decreases. The optimal timing of birth in uncomplicated multiple pregnancies is not well established and recommendations for timing of birth vary between institutions and countries. The latest evidence supports scheduled birth at 37 weeks for dichorionic diamniotic twins, at 36 weeks for monochorionic diamniotic, at 32-34 weeks for monochorionic monoamniotic twins, at 35 weeks for trichorionic triamniotic and dichorionic triamniotic triplets. For monochorionic triplets and higher order multiples there is no evidence to guide recommendations, but it seems reasonable to aim for delivery after 32 weeks gestation if possible.This chapter discusses timing of birth in uncomplicated multiple pregnancies, namely pregnancies without evidence of fetal anomaly, fetal growth discordance, preeclampsia or complications related to monochorionicity such as twin-to-twin transfusion syndrome. The management of the latter are reviewed in the corresponding individual chapters covering such pregnancy complications.
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- Management of Multiple PregnanciesA Practical Guide, pp. 241 - 248Publisher: Cambridge University PressPrint publication year: 2022