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Chapter 1 - Epidemiology of Multiple Pregnancy

Published online by Cambridge University Press:  11 October 2022

Leanne Bricker
Corniche Hospital, Abu Dhabi
Julian N. Robinson
Brigham & Women's Hospital, Boston
Baskaran Thilaganathan
St George's Hospital Medical School, University of London
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The incidence of twin and higher order multiple pregnancies increased dramatically with the advent of Assisted Reproductive Technology (ART) in the 1970s, but practice guidelines have led to decreasing numbers from 2014 onwards. All types of twins have increased in incidence, but dizygous much more so than monozygous. Monochorionic placentation is peculiar to monozygotic pregnancies. Higher orders of chorionicity can occur in monozgotic pregnancies, but are much more common in gestations of plural zygosity. There are many factors that affect the incidence of multiple gestation: individual, genetic, and environmental. However, prudent ART management is the simplest and most effective way of reducing the incidence. Multifetal pregnancy reduction is an operative intervention that can reduce the unwanted medical and social sequelae of multiple pregnancy, counseling about such an intervention should be non-directional and carried out by a specialist.

Management of Multiple Pregnancies
A Practical Guide
, pp. 1 - 10
Publisher: Cambridge University Press
Print publication year: 2022

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