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Twins-twice More Trouble?


Clinical Obstetrics and Gynecology: March 2012 - Volume 55 - Issue 1 - p 296–306
doi: 10.1097/GRF.0b013e3182446f51
Imaging in Obstetrics: State of the Art

Twin gestations are fascinating and are also high-risk pregnancies. They account for approximately 3% of all pregnancies in the United States. Major obstetrical complications associated with twin pregnancies include hypertensive disorders of pregnancy, gestational diabetes, and preterm delivery. In addition, the death rate for twins and the rate of severe handicap in very low birth weight survivors of twin pregnancies is greater than that for singleton pregnancies. Ultrasound allows for stepwise evaluations at any time during a twin gestation. Current evidence suggests that uncomplicated diamniotic twins with concordant and appropriate growth beyond 24 weeks’ gestation should be managed conservatively and the time and mode of delivery should be determined on the basis of obstetrical history and fetal presentations. Perinatal management of the remaining twin pregnancies depends on good clinical judgment, which is improved by the use of ultrasound imaging.

*Department of Obstetrics and Gynecology and Reproductive Sciences, Division of Maternal Fetal Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School

Department of Human Genetics, Rutgers University, New Jersey

The authors declare that they have nothing to disclose.

Correspondence: Joaquin Santolaya-Forgas, MD, PhD, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson St. Room 2151, New Brunswick, NJ 08901. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.