Complications of multiple pregnancies. Overwiew

Abstract

Multiple gestations are high risk pregnancies which may be complicated by prematurity,low birthweight, preeclampsia, anaemia, postpartum haemorrhage, intrauterine growth restriction, neonatal morbidity and high neonatal and infant mortality. Preterm labor and birth represent the greatest risk to a multiple pregnancy. Sixty percent of multiples are born prematurely (<37 weeks) compared to about 10% of singleton pregnancies. Placental function is more likely to be abnormal in a multiple pregnancy. Another placental problem is twintwin transfusion, a life-threatening condition in identical twins. Preeclampsia, also known as toxemia, occurs 2 to 5 times more often in multiple pregnancies. Fifteen percent to 20% of women with twin pregnancies will experience preeclampsia, and an even higher percentage is preeclamptic in triplet or high-order pregnancies. Preterm labor and birth pose the greatest risk to a multiple pregnancy. Sixty percent of multiples are born prematurely (<37 weeks) compared to about 10% of singleton pregnancies. Fetal and Newborn complications such as preterm delivery, respiratory distress syndrome, brain damage are responsible for almost 10% of premature newborn deaths. Birth defects and stillbirths account for about 30% of the deaths in twins and multiple pregnancies. Low birth weight of less than 5.5 pounds (lb.) [2,500 grams] occurs in over half of twins..

Comparison of the survival outcomes of laparoscopy versus laparotomy in treatment of early-stage ovarian cancer: a systematic review and meta-analysis

“…In 1994 Querleu and Leblanc created a precedent of surgical staging procedure for patients with ovarian or fallopian tube malignancies by using laparoscopic technique [ 5 ]. In the area of gynecologic oncology, laparoscopic surgery had been widely accepted by more and more surgeons and patients due to its advantage of minimal trauma and rapid recovery [ 17 , 18 ]. However, its application still remained controversial because of the unpleasant complications such as the unexpected tumor rapture or spillage, instrumental thermal injury, difficulty in tumor extraction and port-site metastasis etc., which were of enormous importance to patients’ prognosis.…”

Neonatal Outcomes of Very Preterm or Very Low Birth Weight Triplets

“…Multiplegestation pregnancies are associated with preterm birth. 6,7 More than 90% of multiples are born preterm compared with 6% to 10% of singletons, 2,8 and very preterm birth is especially high for pregnancies with triplets and higher-order multiples when compared with singleton pregnancies. 9 In turn, preterm birth is associated with complications that have individual, family, societal, and financial implications.…”

“…9 In turn, preterm birth is associated with complications that have individual, family, societal, and financial implications. 10,11 In previous work, researchers evaluated outcomes of triplets 6, 12 -15 and reported higher risks of mortality, 2 respiratory distress syndrome, 3,7,8,12 retinopathy of prematurity (ROP), 3,16 and intraventricular hemorrhage (IVH) 3,7 in triplets who were very preterm than in singletons. However, authors of other studies reported no difference in outcomes between triplets and singletons.…”

The impact of a three-phase education–support–follow-up program on the mothers' perceptions of the needs of their multiple infants: A protocol study for a clinical trial

“…Maternal complications include cardiovascular risk, metabolic disorders, preeclampsia, placental abruption, urinary tract infection, and preterm delivery. [ 8 ] Fetal complications include prematurity, intrauterine growth retardation, congenital anomalies, and twin-to-twin transfusion syndrome. [ 9 ] Neonatal complications and outcomes include neonatal death, prematurity, low birth weight, respiratory distress, hypocalcemia, and hypoglycemia, which increase compared to singleton pregnancies.…”