Multiple pregnancy – overview

Introduction Pregnancy with more than one fetus in uterus is not a physiological phenomenon for a woman. The risk of most of pregnancy complications is higher and there is a possibility of abnormalities, which are not met in singleton pregnancy, caused by having two or more fetuses supplied by one placenta. Aim Author analyzed recent literature regarding up-to-date management of multiple pregnancy and recommended time and mode of delivery. Material and methods Recommendations regarding management of multiple pregnancy in available guidelines of gynecological societies and national healthcare institutions were analyzed. Latest articles from Pubmed describing current views on multiple pregnancy management and delivery options were also reviewed. Results and discussion Guidelines for multiple pregnancies management, including delivery time and mode planning, were analyzed and compared. Most of them are very consistent, there are only few differences in recommended pregnancy management. Diagnosing pregnancy complications as early as it is possible and adequate treatment is the aim of pregnancy management, and as multiple pregnancies have higher risk of all complications, they have to be monitored very closely. Diagnosis of type of pregnancy, routine follow-up visits schedule and ultrasound scan scheme are discussed as well as the recommended time and mode of delivery. Vaginal delivery for well defined group of patients should be considered, while cesarean section seems safer for some women. Conclusions Multiple pregnancies, as high risk pregnancy, require more frequent visits and ultrasound scans depending on chorionicity and amnionicity. Close monitoring and careful qualification for vaginal delivery improves pregnancy outcome.