Multiple Pregnancies: Complications and Management – A Brief Review

Review Article

Abstract

Multiple pregnancies, defined by the simultaneous presence of two or more fetuses, represent a high‑complexity obstetric challenge whose incidence has been rising worldwide. This increase is driven mainly by delayed childbearing and the expanded use of assisted reproductive technologies. Maternal physiological overload and competition for nutrients among fetuses elevate the frequency of complications, notably gestational hypertension, pre‑eclampsia, gestational diabetes, and anemia. In addition, venous thromboembolism and postpartum hemorrhage occur more often. From the fetal standpoint, prematurity and intrauterine growth restriction are the principal threats, contributing substantially to neonatal morbidity and mortality. Management strategies include more frequent prenatal visits, serial ultrasound monitoring, and interventions such as antenatal corticosteroids and laser photocoagulation for twin‑to‑twin transfusion syndrome. This review demonstrates that multidisciplinary teams combining nutritional support, hemodynamic surveillance, and psychological care reduce complications. It concludes that intensive monitoring and evidence‑based protocols are fundamental to improving maternal and perinatal outcomes in multiple pregnancies.