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Chapter 13 - Multiple Gestation

from Part II - INTRAPARTUM AND POSTPARTUM

Published online by Cambridge University Press:  07 May 2010

John Patrick O'Grady ,
Martin L. Gimovsky ,
Lucy A. Bayer-Zwirello  and
Kevin Giordano
By
V. Ravishankar  and
J. Gerald Quirk
John Patrick O'Grady
Affiliation:
Tufts University, Massachusetts
V. Ravishankar
Affiliation:
Clinical Assistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences State University of New York at Stony Brook Stony Brook University School of Medicine Stony Brook, New York
J. Gerald Quirk
Affiliation:
Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Medicine State University of New York at Stony Brook
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Summary

This chapter explores the maternal and fetal complications, advances in prenatal diagnosis, and management of complications unique to multiple gestations. Tidal volume and oxygen consumption in multiple gestations are increased, as is the normal alkalosis seen in singleton pregnancy. Hypertensive disorders increase by at least twofold in twin gestations. Hemorrhagic complications occur more frequently with twins. Growth of singletons and twins is comparable until 27 weeks gestation. The uterus accommodates the larger volume imposed by twins by overdistension, and beyond a certain limit, premature labor can result. Preterm deliveries (less than 37 weeks' gestation) occurred in 10.6% of singleton pregnancies against a phenomenal rate of 61.2% of live births in multiple gestations. Diagnosis of multiple gestations, establishing chorionicity, identifying anomalies, foreseeing possible maternal and fetal complications, prevention and treatment of preterm labor, and management of growth restriction are some of the areas of medicolegal concerns in multiple gestations.

Keywords

congenital anomaliesfetal complicationshypertensive disorderspreterm deliverysingleton pregnancypreterm labormultiple gestationspreterm deliveriestwin gestationsweeks' gestation

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Operative Obstetrics , pp. 322 - 347
Publisher: Cambridge University Press
Print publication year: 2008

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  • Multiple Gestation
    • By V. Ravishankar, Clinical Assistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences State University of New York at Stony Brook Stony Brook University School of Medicine Stony Brook, New York, J. Gerald Quirk, Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Medicine State University of New York at Stony Brook
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book: Operative Obstetrics
  • Online publication: 07 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511580987.015
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  • Multiple Gestation
    • By V. Ravishankar, Clinical Assistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences State University of New York at Stony Brook Stony Brook University School of Medicine Stony Brook, New York, J. Gerald Quirk, Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Medicine State University of New York at Stony Brook
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book: Operative Obstetrics
  • Online publication: 07 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511580987.015
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Multiple Gestation
    • By V. Ravishankar, Clinical Assistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences State University of New York at Stony Brook Stony Brook University School of Medicine Stony Brook, New York, J. Gerald Quirk, Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Medicine State University of New York at Stony Brook
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book: Operative Obstetrics
  • Online publication: 07 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511580987.015
Available formats
×