Multiple Pregnancy / Twin Pregnancy – Management

Antenatal management

The essence of successful outcome of a diagnose it at the earliest period of gestation. This will help the mother to take additional care not only for her own benefit but also for the fetuses.

Advice:

¨     Diet increased dietary supplement is needed for increased energy supply to the extent of 300 K cal per day.

¨     Supplement therapy (i) iron therapy is to be increased to the extent of 60-80 mg per day. (ii) additional vitamins, calcium and folic acid (1 mg) are to be given, over and above those prescribed for a singleton pregnancy.

¨     Increased rest to prevent preterm labour and other complications.

¨     Interval of antenatal visit should be more frequent to detect at the earliest, the evidence of anemia, preterm labour or pre-eclampsia.

¨     Fetal growth assessment should be done by ultrasound at every 2-3 weeks interval.

 

Hospitalization

¨     Elective;in an uncomplicated twin pregnancy routine admission for bed rest is not essential. However, the patient may be admitted around 32^nd week if she requests it for bed rest.

¨     Emergency: development of complicating factors necessitates urgent admission irrespective of the period of gestation.