Multiple gestations, including twins, triplets or more, are often considered higher-risk pregnancies, as they account for a disproportionate share of both maternal and fetal complications and adverse pregnancy outcomes.
Caring for Multiple Pregnancies
Due to the increased maternal and fetal risks for multiple pregnancies, we have developed a multiple gestations clinic. In addition to providing consultations, the clinic provides multidisciplinary care in a coordinated and convenient manner, with the overall goal of improving both maternal and fetal outcomes. We focus on individualized counseling about each woman’s risk factors and management with the goal of achieving the best possible maternal and neonatal outcomes. This includes providing the most favorable and safest environment for delivery. We also have a state-of-the-art neonatal ICU (NICU), if needed, to provide excellent care for the babies after delivery.
The clinic is staffed with experienced maternal-fetal medicine specialists, or perinatologists, who have a special interest in caring for women with multiple gestations. These dedicated caregivers are experienced in managing the numerous potential complications encountered in the prenatal management and delivery of multiple gestations. Our team also includes genetic counselors from our Prenatal Diagnosis and Treatment Center. Other integral personnel include a dedicated nursing team, nutritionists, lactation consultants and social workers.
A variety of prenatal screening and diagnostic tests are available, and a state-of-the-art ultrasound unit is on-site. When indicated or requested, our physicians perform chorionic villus sampling (CVS) and amniocentesis. We also offer counseling to women with higher-order multiple gestations on management options, such as multifetal pregnancy reduction. All care, including specialized ultrasound, fetal testing, nutrition and lactation consultations, is scheduled during the prenatal visit to increase convenience for the patient.
Specialized, coordinated care for multiple gestations includes early ultrasound to determine the type of placentation (if fetuses share the same placenta or amniotic sac), as this impacts the risk of complications and may lead to needing more frequent prenatal visits. Ultrasounds for growth are typically performed monthly. In certain situations, ultrasounds are performed every other week or more frequently. Fetal surveillance, including fetal echocardiography, biophysical profiles and various Doppler measurements, are available when indicated.
If complications occur, we coordinate and refer patients to the appropriate consultants who will ultimately care for the baby, including pediatric cardiologists, surgeons, neurosurgeons, urologists and neonatologists. If needed prior to delivery, consultations with anesthesiologists or other medical specialists are coordinated.