Multiple Pregnancies: Optimal Follow-Up, Early Detection and Management of Complications, and Appropriate Mode and Time of Delivery

Dear Colleagues,

The frequency of multiple pregnancies has risen, primarily attributed to factors such as postponed parenthood and the increased age of mothers at the time of conception, along with the prevalent use of assisted reproductive technologies. Additionally, compared to singleton gestations, multiple pregnancies carry a higher risk of perinatal mortality and morbidity. For instance, the occurrence of preterm births—defined as births before 37 weeks of gestation—is seen in up to 60% of multiple pregnancies. This significantly contributes to the heightened risk of neonatal mortality. Moreover, multiple pregnancies face a higher risk of iatrogenic preterm delivery compared to singleton gestations, due to the more frequent occurrence of complications affecting the mother and fetus. This risk is notably greater in monochorionic pregnancies than in dichorionic ones.

Ultrasound serves as a crucial instrument enabling clinicians to monitor multiple pregnancies effectively. International guidelines address the optimal follow-up of multiple pregnancies and the role of ultrasound in the early detection of pregnancy complications. Nonetheless, further research is needed regarding the management of specific pregnancy complications, such as selective fetal growth restriction or twin anemia-polycythemia sequence (TAPS), and concerning the appropriate mode and time of delivery. Thus, this Special Issue aims at gathering the latest insights on the management, follow-up, and delivery strategies for both uncomplicated and complicated multiple pregnancies.

Dr. Alicia Martínez-Varea
Guest Editor

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• multiple pregnancy
• twin pregnancy
• triplet pregnancy
• monochorionic pregnancy
• monochorionic twins
• monochorionic monoamniotic pregnancy
• monochorionic diamniotic pregnancy
• dichorionic diamniotic pregnancy
• quadruplet pregnancy
• chorionicity
• amnionicity
• conjoined twins
• in vitro fertilization
• assisted reproductive techniques
• advanced maternal age
• natural conception
• pregnancy dating
• aneuploidy screening
• twin-to-twin transfusion syndrome (TTTS)
• fetal growth restriction (FGR)
• selective fetal growth restriction (sFGR)
• twin anemia-polycythemia sequence (TAPS)
• twin reversed arterial perfusion sequence (TRAP)
• fetoscopy
• laser ablation
• fetal laser therapy
• laser therapy
• bipolar cord coagulation
• radiofrequency ablation
• selective feticide
• elective fetal reduction
• elective termination of pregnancy
• discordant fetal anomaly
• structural abnormalities
• single intrauterine fetal demise
• cerclage
• threatened preterm labor
• preterm birth
• preeclampsia
• gestational hypertension
• gestational diabetes
• fetal ultrasound
• fetal therapy
• delivery
• vaginal delivery
• operative vaginal delivery
• cesarean section
• adverse perinatal outcomes