Management of Multiple Pregnancies. A Practical Guide

1. Epidemiology of multiple pregnancy Hong-Thao Thieu and Errol R. Norwitz
2. Assisted conception and multiple pregnancy: strategies to reduce rates Mariano Mascarenhas and Adam Balen
3. Zygosity, chorionicity and amnionicity Waldo Sepulveda and Amy E. Wong
4. Multifetal pregnancy reduction Simi Gupta Talati and Andrei Rebarber
5. Gestational dating in multiple pregnancy Pierre Mace, Houman Mahallati and Laurent J. Salomon
6. Screening for fetal aneuploidy in multiple pregnancy Maria del Mar Gil and Kypros Nicolaides
7. Screening for fetal abnormality in multiple pregnancy Carolina Bibbo, Julian N. Robinson and Beryl Benacerraf
8. Screening and diagnosis of complications of shared placentation Caitlin D. Baptiste and Lynn Simpson
9. Invasive prenatal diagnosis in multiple pregnancy Ranjit Akolekar
10. Conjoined twinning: diagnosis and management Alice King and Michael A. Belfort
11. Management of discordant fetal anomaly Rajit Narayan and Jon Hyett
12. Single and double fetal loss in twin pregnancy Mark Kilby, Leo Gurney, Janice L. Gibson and R. Katie Morris
13. Management of twin-twin transfusion syndrome Christian Bamberg and Kurt Hecher
14. Management of twin anemia-polycythemia sequence Liesbeth Lewi and Enrico Lopriore
15. Management of Twin Reversed Arterial Perfusion (TRAP) sequence Werner Diehl
16. Management of fetal growth pathology in multiple pregnancy Nikolaos Antonakopoulos and Asma Khalil
17. Management of monoamniotic twins Vagisha Pruthi, Shiri Shinar, Johannes Keunen, Greg Ryan and Tim van Mieghem
18. Maternal complications in multiple pregnancy Sarah Rae Easter and Mike Foley
19. Risk-assessment and screening for preterm birth in multiple pregnancy Amanda Roman Alexandra Ramirez, Guillermo Gurza and Vincenzo Berghella
20. Prevention of preterm birth in multiple pregnancies Abdallah Adra
21. Optimal antenatal care in multiple pregnancy Leanne Bricker
22.Triplet and higher order pregnancy: special considerations Ann McHugh and Fergal Malone
23. Timing of delivery in multiple pregnancy Laure Noel and Basky Thilaganathan
24. Mode of delivery in multiple pregnancy Amir Aviram, Jon FR Barret, Elad Mei-Dan and Nir Melamed
25. Practical management of vaginal birth in multiple pregnancy Julian Robinson
26. Neonatal care aspects of multiple pregnancy Alejandra Barrero-Castillero and DeWayne M. Pursley
27. Lifestyle considerations for multiple pregnancy Nathan S Fox
28. Emotional and mental wellbeing in multiple pregnancy Lala Langtry White
29. New frontiers in multiple pregnancy management Caroline Shaw and Christoph Lees
30. Multiple pregnancy resources for professionals and public Natasha Fenwick and Jane Gorringe
31. Obstetric anaesthesia in multiple pregnancy Tarek Ansari.

Multiple pregnancies are associated with higher risks for both mother and babies. Women with multiple pregnancies have an increased risk of miscarriage, anemia, hypertensive disorders, haemorrhage, and postnatal illness. These pregnancies are more likely to need an operative delivery, and maternal mortality is generally 2.5 times that of singleton births. Fetuses are at increased risk for anatomic and genetic anomalies, growth abnormalities, prematurity, and several physiological problems related to monochorionicity. This book provides a much needed, up-to-date guide to the management of multiple pregnancies. Presented with a uniform approach to all chapters, information is easily navigable, evidence-based, and highly practical. Heavily illustrated, particularly with ultrasound images – the cornerstone of management of multiple pregnancies - this book will appeal to obstetricians and specialists in maternal-fetal medicine, midwives and ultrasonographers and will improve outcomes for mothers and babies.

• Maternal mortality associated with multiple births is 2.5 times that for singleton births – this book will provide a much-needed, up-to-date practical guide to the management of multiple births
• Heavily illustrated – particularly with ultrasound images, which are the cornerstone of management of multiple pregnancies
• Written in a uniform way to ease navigation for the reader; chapters are practical and evidence-based with key points and management flow-charts

Editors

Leanne Bricker, Corniche Hospital, Abu Dhabi
Leanne Bricker undertook undergraduate training in South Africa and then in the UK specialised in OBGYN and subspecialised in Fetomaternal Medicine. She was Director of Fetal Medicine at Liverpool Women's Hospital in the UK (2003–2014) and served on the British Maternal and Fetal Medicine Society executive committee (2009–2014). Since 2014 she has been Chair of Fetal Medicine at Corniche Hospital, Abu Dhabi, UAE. She has published over sixty papers, abstracts and book chapters. She is an expert in the management of multiple pregnancy and was involved in the development of the UK NICE guidelines for the management of multiple pregnancy and the RCOG green top guideline for the management of monochorionic twin pregnancy.

Julian N. Robinson, Brigham & Women's Hospital, Boston
Julian N. Robinson is the Chief Medical Officer at Newton Wellesley Hospital, where he was also the Medical Director of Maternal Fetal Medicine for nine years before serving eight years as Chief of Obstetrics at the Brigham and Women's Hospital. He is an Associate Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School. His professional interests include Quality and Safety and his clinical and research interests include Obstetrics, Prenatal diagnosis, and multiple pregnancy. He is a Diplomate of the American Boards of Obstetrics and Gynecology and Maternal Fetal Medicine and a Fellow of American College of Obstetrics and Gynecology.

Baskaran Thilaganathan, St George's Hospital Medical School, University of London
Basky Thilaganathan was appointed Director of Fetal Medicine at St George's Hospital in 1999. He has authored over 300 peer-reviewed publications in indexed journals. His major research interest is placental dysfunction leading to pre-eclampsia, fetal growth restriction and stillbirth (TED talk: http://bit.ly/2i1SqDk). He has led on the implementation of algorithm-based screening at St Georges which has led to an 80% reduction in preterm pre-eclampsia – the severest form of the disease (https://vimeo.com/rcog/authorinsights16361). He is the Clinical Director of the Tommy's National Centre for Maternity Improvement (https://vimeo.com/638468663/23d205d029) located at the RCOG and is Editor Emeritus of Ultrasound in Obstetrics and Gynaecology, the medical journal affiliated to ISUOG. He is a Council Member on the Royal College of Obstetrics and Gynaecology (RCOG) and represents the RCOG on the UK National Screening Committee and the DH Saving Babies Lives Care Bundle oversight committee. He is also the Clinical Lead for the first dedicated high-throughput cfDNA screening NHS lab to undertake cfDNA aneuploidy screening (NIPT) in pregnancy (www.theSAFEtest.co.uk).

Contributors

Hong-Thao Thieu, Errol R. Norwitz, Mariano Mascarenhas, Adam Balen, Waldo Sepulveda, Amy E. Wong, Simi Gupta Talati, Andrei Rebarber, Pierre Mace, Houman Mahallati, Laurent J. Salomon, Maria del Mar Gil, Kypros Nicolaides, Carolina Bibbo, Julian N. Robinson, Beryl Benacerraf, Caitlin D. Baptiste, Lynn Simpson, Ranjit Akolekar, Alice King, Michael A. Belfort, Rajit Narayan, Jon Hyett, Mark Kilby, Leo Gurney, Janice L. Gibson, R. Katie Morris, Christian Bamberg, Kurt Hecher, Liesbeth Lewi, Enrico Lopriore, Werner Diehl, Nikolaos Antonakopoulos, Asma Khalil, Vagisha Pruthi, Shiri Shinar, Johannes Keunen, Greg Ryan, Tim van Mieghem, Sarah Rae Easter, Mike Foley, Amanda Roman Alexandra Ramirez, Guillermo Gurza, Vincenzo Berghella, Abdallah Adra, Leanne Bricker, Ann McHugh, Fergal Malone, Laure Noel, Basky Thilaganathan, Amir Aviram, Jon FR Barret, Elad Mei-Dan, Nir Melamed, Julian Robinson, Alejandra Barrero-Castillero, DeWayne M. Pursley, Nathan S. Fox, Lala Langtry White, Caroline Shaw, Christoph Lees, Natasha Fenwick, Jane Gorringe, Tarek Ansari