title: Management of multiple pregnancy: prenatal care--part II.
abstract: Over the past 20 years, the number and rate of multiple births have dramatically increased in the United States. The rise in multiple births is mainly attributable to the increased use of ovulation-inducing drugs and the newly developed assisted reproductive technologies such as in vitro fertilization. Multifetal gestation is associated with an increased risk of perinatal morbidity and mortality. Multiple births account for an increasing percentage of low-birth-weight infants, preterm births, and infant mortality. In this article, the unique complications of multiple gestation and their management are reviewed. Also, selective termination and multifetal reduction in multiple gestation are discussed.
  
  
  BACKGROUND
  Obstetricians & Gynecologists, Family Physicians
  
  
  OBJECTIVE
  After completion of this article, the reader should be able to describe the effects of the rising rate of multiple pregnancies on perinatal morbidity and mortality, to recall the complications of diagnosing and treating abnormalities of multiple pregnancies, to list the multiple severe complications associated with multiple gestations, and to describe the difficulty in managing these complications.
authors.affiliation: Department of OB/GYN Naval Medical Center Portsmouth, MFM Division, Norfolk, Virginia 23511, USA. mfmayres@cox.net
authors.forename: Allen
authors.initials: A
authors.lastname: Ayres
authors.forename: Timothy R B
authors.initials: TR
authors.lastname: Johnson
mesh_terms: D000025:Abortion, Eugenic; D000328:Adult; D002490:Central Nervous System / Q000196:embryology; D000013:Congenital Abnormalities / Q000209:etiology*; D003937:Diagnosis, Differential; D004200:Diseases in Twins; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D011272:Pregnancy, Multiple