- Multiple pregnancies are more common, with twins occurring in 1 in 73 pregnancies in the UK in 1995. Chorionicity affects pregnancy risks like fetal loss and cerebral palsy rates.
- Twin-twin transfusion syndrome occurs in 25% of monochorionic twins and can have high mortality rates if severe. Fetoscopic laser ablation has better outcomes than serial amnioreduction.
- There is controversy around optimal delivery methods for twins regarding vaginal delivery versus C-section and timing between twin deliveries. Factors like chorionicity, presentation, and growth need to be considered.
5. Fetal and Perinatal Mortality Fetal Loss (<24 weeks) Perinatal Loss (>24 weeks) Sebire N et al. BrJOG 1997 12.1% 1.8% 2.8% 1.6% Monochorionic Dichorionic
35. Presentations of twins FIRST TWIN SECOND TWIN Percentage of presentation combinations in labour Cephalic Breech Other Cephalic 38.6 13.1 0.6 Breech 25.5 9.2 0.6 Other 8.0 3.9 0.5
36.
37. Weight difference in twins Audit data SHH 1998 N=45 Twin 1 is not usually bigger than twin 2
Note: isolated case reports publication bias: unsuccessful attempts are not published. Measures employed: antibiotics cerclage tocolysis + cerclage cerclage, antibiotics + tocolysis Clearly should be limited to dichorionic pregnancies only.