TWINS: CLINICAL HETEROGENEITY AND MULTIDISCIPLINARY APPROACH

The incidence of multiple pregnancy has increased during the last 15 years, particularly in relation to the advances in assisted reproductive technologies. Twins are conceived in about 1 in 80 pregnancies. Multiple gestations are high risk pregnancies, which may be complicated by pre-eclampsia, anemia, postpartum hemorrhage, pre-maturity, intrauterine growth restriction (IUGR), small for gestational age (SGA) newborn, neonatal morbidity and high perinatal, neonatal and infant mortality. Main complication is the twin-to-twin transfusion syndrome (TTTS) in monochorionic twin gestations; it is associated to high perinatal mortality and increased neurological, cardiovascular and renal dysfunctions or defects. An accurate long-term developmental surveillance program is particularly indicated for at-risk twins.