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Diagnosis and Treatment of Twin Pregnancy

Published online by Cambridge University Press:  01 August 2014

Per-Håkan Persson  and
Lars Grennert
Per-Håkan Persson
Affiliation:
Diagnostic Ultrasound Laboratory, Department of Obstetrics and Gynecology, University Hospital, Malmö, Sweden
Lars Grennert
Affiliation:
Diagnostic Ultrasound Laboratory, Department of Obstetrics and Gynecology, University Hospital, Malmö, Sweden

Abstract

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Early detection is a prerequisite for the active management of twin pregnancy. Detection rate was not, or was only slightly, increased by improved anamnesis or more alert physical examination. General placental lactogen screening selected 95% of the twins but implied a subsequent ultrasonic screening examination of 16% of the pregnant population for the definitive diagnosis. A general screening programme with ultrasound detected 90% of the twin pregnancies (methodological error 1.7%; not participating 8%) in the mid-trimester. Extensive restriction of maternal physical activity from the 29th to the 36th gestational week by bed rest in hospital reduced perinatal mortality to the level of singletons and also decreased the incidence of neurological and mental handicap among the surviving twins. For the supervision of twin pregnancy, urinary estriol estimates predict birth weight rather than fetal distress. Monitoring with repeated ultrasonic biparietal diameter measurements seem limited in value; even large intertwin BPD differences are not indicators of fetal distress in the smallest twin. The decrease of perinatal mortality and morbidity among twins subjected to special antenatal supervision suggests that large gains can be made by early detection and antenatal hospitalization. The earlier finding that impairment of the intrauterine supply line is closely associated with neurological sequelae gives added importance to the reduction of CNS handicap and of growth-retarded fetuses observed during such a programme.

Keywords

Twin pregnancyUltrasoundEarly diagnosisMonitoringTreatment
Type
Session III: Management of Twin Pregnancy
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 28 , Issue 4 , October 1979 , pp. 311 - 317
Copyright
Copyright © The International Society for Twin Studies 1979

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