title: Twins prematurity--the influence of prenatal surveillance.
abstract: OBJECTIVE
  To evaluate the influence of the local prenatal surveillance of twin pregnancies in the obstetrical results.
  
  
  METHODS
  A prospective cohort study of multiple pregnancies delivered over a period of 16 years in a tertiary centre was conducted. In this study 861 twin pregnancies were included. They were compared for obstetric complications, gestational age at delivery, mode of delivery and birthweight, according to the place of the surveillance.
  
  
  RESULTS
  Of the 861 cases examined, the following obstetric complications were significantly different: metrorrhagia (p = 0.039), infections (p < 0.001), HELLP (p = 0.007), PROMPT (p < 0.001) and fetal death (p = 0.024). The mode of delivery was similar but occurred mostly ≤32 weeks (p < 0.001), the birthweight was mostly <2000 g and occurred more NICU admission (p < 0.001) when surveillance was outside the MPC-MDM.
  
  
  CONCLUSIONS
  Our results demonstrate the crucial importance of prenatal surveillance be carried in a differentiated referral centers with specific/strict protocols or the urgent implementation of same protocols in all other places of surveillance, since this straight surveillance greatly reduces the occurrence of prenatal complications, mainly PROMPT, PTD.
authors.affiliation: Obstetrics A Department, Maternidade Dr Daniel de Matos, Centro Hospitalar e Universitário de Coimbra , Portugal .
authors.forename: Ana Patrícia
authors.initials: AP
authors.lastname: Domingues
authors.forename: Etelvina
authors.initials: E
authors.lastname: Fonseca
authors.forename: Adriana
authors.initials: A
authors.lastname: Belo
authors.forename: Paulo
authors.initials: P
authors.lastname: Moura
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D011174:Portugal / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D059285:Pregnancy, Twin / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011446:Prospective Studies
keywords: Reducing twins prematurity; twins obstetrical complications; twins prenatal surveillance