Complications in Multifetal Pregnancy

• Spontaneous abortion
- Monochorionic twins have a significantly greater risk
- <12 weeks AOG : one or more embryos died in 53% of triplet
pregnancies
Complications in Multifetal Pregnancy
• Congenital Malformations
- Monochorionic twins malformation rate was almost twice that of
dichorionic twin gestations
- 73% greater risk of congenital heart disease – substantially higher
among monochorionic
Fetal Demise in Multifetal Pregnancy
• Causes:
• related to
• zygosity,
• chorionicity, and
• growth concordance
• Higher in monochorionic multifetal pregnancies
Fetal Demise in Multifetal Pregnancy
• Vascular anastomoses
• Twin-twin transfusion syndrome
• Twin Anemia- Polycythemia Sequence
• Twin Reversed-Arterial-Perfusion Sequence