ArticlesAmbulatory Management of Multiple GestationGALL, STANLEY A. MDAuthor Information University of Louisville, Louisville, Kentucky Correspondence: Stanley A. Gall, MD, Department of Obstetrics and Gynecology, University of Louisville, 550 South Jackson Street, Louisville, KY 40292. Clinical Obstetrics and Gynecology: September 1998 - Volume 41 - Issue 3 - p 564-583 Buy Abstract The management of multiple gestation presents a challenge to the obstetrician. The challenge is to attempt to achieve outcome results in patients with multiple gestation that are equivalent to those attained in a singleton gestation. This challenge is made more evident because of the current epidemic of multiple gestations. There is hardly a day that a busy labor and delivery unit will not have a patient with a multiple gestation. The patient's euphoria after the diagnosis of a multiple gestation must be modified by a realistic discussion by the obstetrician of the risks and potential problems that may be encountered. The increased use of assisted reproductive techniques has led to the current increase in multiple gestation. The use of assisted reproductive techniques is not the root cause of the problem; rather, the inappropriate use of these techniques is the cause. Uncontrolled hyperstimulation of the ovary to produce excessive follicles and ova to the replacement of an excessive number of embryos, either through ignorance or intentionally attempting to inflate the pregnancy rate, have plagued those practicing assisted reproduction. It is time for the realization that more is not necessarily better. © 1998 Lippincott Williams & Wilkins, Inc.