The prevalence of twin pregnancies is rising globally due to increased assisted conception and advanced maternal age in pregnancy. Twin pregnancies have 5-9 times higher frequencies of fetal chromosomal and structural abnormalities, often deliver preterm, and have high prevalence of gestational diabetes mellitus (GDM), preeclampsia (PE), and intrauterine growth restriction (IUGR) compared to singletons. Twins have special complications such as twins-to twin transfusion syndrome in mono chorionic (MC) twins. Consequently, more twins are born prematurely, suffer from low birth weight, cerebral palsy, etc., often requiring admission to newborn intensive care units, and develop motor and cognitive disorders for life. These impose a huge burden on individuals, families, and the society.