Chapters authored
Multiple Pregnancy: Boon or Bane – An Indian Perspective
In the era of rising multiple pregnancy, it is important for us to analyse the recent trends. Assisted reproductive technology has brought hope to many childless couples. But it comes with a price. The prevalence of multiple gestation globally at present is 32 per 1000 deliveries. Recent studies from India report an incidence of 30.5 per 1000 deliveries. The most important complication associated with multiple gestation is prematurity. From the neonatology point of view, the increase in multiple gestation has opened an additional opportunity for the neonatologists to see and manage more preterm babies. Infants born after a multifetal pregnancy are associated with an increased risk of prematurity, cerebral palsy, learning disabilities, slow language development, behavioural difficulties, chronic lung disease, developmental delay, and death. The relative risk of cerebral palsy in twins and triplets compared to a singleton is 4.9 and 12.7, respectively. Foetal reduction as a routine should be discussed with all couples with multiple gestation including twins, to improve the pregnancy and neonatal outcome. Any multifetal gestation is a high-risk pregnancy should be managed efficiently by a multidisciplinary team involving Senior Obstetricians, neonatologists, intensivists, anaesthesiologists, physicians and nursing team in a well-equipped centre.
Part of the book: Multiple Pregnancy