The incidence of multiple pregnancy and delivery has increased dramatically over the past 10–15 years in many developed countries of the world. Data for England and Wales show that between 1980 and 1993 the twin maternity rate increased by <“25% and the triplet and higher order maternity rate more than doubled. Similar trends have been reported from developing countries. The majority of these increases have been linked to the use of ovarian stimulants and assisted reproduction techniques, and multiple pregnancy must be considered to be one of the most important adverse outcomes in current methods of infertility treatment. Obstetric complications associated with multiple pregnancy include prenatal screening problems and increased incidence of pregnancy-induced hypertension, antepartum haemorrhage, preterm labour and assisted or surgical delivery. Neonatal problems include low birthweight and increased prevalence of congenital malformations. Compared with singletons, neonatal mortality is seven times higher in twins and >20 times higher in triplets and higher order births. Survivors also suffer higher rates of cerebral palsy and other neurological impairments.This article reviews neonatal complications and management of twins.

Keywords:  Twins; TTTS; TRAP; Thoracopagus.