title: Maternal physiology and complications of multiple pregnancy.
abstract: Approximately 1% to 3% of all pregnancies in the United States are multiple gestations. The vast majority (97-98%) are twin pregnancies. Multiple pregnancies constitute significant risk to both mother and fetuses. Antepartum complications-including preterm labor, preterm premature rupture of the membranes, intrauterine growth restriction, intrauterine fetal demise, gestational diabetes, and preeclampsia-develop in over 80% of multiple pregnancies as compared with approximately 25% of singleton gestations. This article reviews in detail the maternal physiologic adaptations required to support a multiple pregnancy and the maternal complications that develop when these systems fail or are overwhelmed.
authors.affiliation: Department of Obstetrics, Gynecology & Reproductive Sciences, Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT 06520, USA. errol.norwitz@yale.edu
authors.forename: Errol R
authors.initials: ER
authors.lastname: Norwitz
authors.forename: Valentine
authors.initials: V
authors.lastname: Edusa
authors.forename: Joong Shin
authors.initials: JS
authors.lastname: Park
mesh_terms: D005260:Female; D005313:Fetal Death / Q000503:physiopathology; D006801:Humans; D009099:Multiple Birth Offspring; D007752:Obstetric Labor, Premature / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011272:Pregnancy, Multiple / Q000502:physiology*