A Doctor Answers

If you are having twins or more, there are a variety of issues involved. Mark Kan, MD, tells you about the risks.
The question
What are the risks of a multiple pregnancy?

The expert answers
The most important complication of multiple pregnancy is the risk of preterm labor and preterm delivery. Generally, a pregnancy with one baby lasts 37 to 42 weeks from the last menstrual period. Labor or delivery before this period of time frame is considered preterm. The incidence of preterm delivery increases as the number of babies inside the uterus increases. Infants who are born prematurely are at risk for problems stemming from organ systems that are not fully developed.

One of the most common problems is lung immaturity, however there can be many other complications. The good news is there are many treatments which can help patients in preterm labor, including medications that help the fetal lungs mature inside the womb. Irrespective of treatment success however, initial prevention of high-order multiples is always preferable.

Women with multiple gestations will often undergo treatment for commonly associated conditions. Bed rest and/or tocolytics (medicines which attempt to stop contractions) are often prescribed for preterm labor, however their efficacy remains debated among experts. Increased antepartum testing is often performed including fetal heart rate monitoring and periodic ultrasound examinations. When hospitalized, antibiotics may be administered, as are steroids which can improve fetal lung maturity and decrease the risk of intraventricular hemorrhage.PregnancyAndBaby.com


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