In homosapiens normally one ova is fertilized by a single sperm for the propagation of generation. Many sperms are required to dissolve the zona pellucida. Due to some unknown etiology and due to the increased induction of ovulation in assisted reproductive technology (ART), the incidence of multiple pregnancies is increasing not only in the developed world, but also in developing countries like India. When we deviate from the nature, artificial technologies have their own hazards, so do with multiple gestations.
Multiple gestations are at higher risk of maternal complications. Walker et al 2004 [1] studied more than 44,000 multiple gestations and found that compared to singleton, risks for pre-Eclampsia, postpartum haemorrhage and maternal death increased by two fold. Moreover, chances of …show more content…
There is now evidence that incidence of zygote splitting is increased following ART. In contrast dizygotic twin is influenced by race, heredity, maternal age, parity and fertility treatment.
Vanishing twin
Sonographies done at first trimester have shown that one twin is lost or vanishes before the second trimester in up to 20 to 60% of spontaneous twin conception (Dickey 2000) [3]
A vanishing twin may cause an elevated maternal serum alpha protein. So, diagnosis of vanishing twin should be excluded to avoid confusion during maternal serum screening for Down syndrome or neural tube defects. Similarly, a vanishing twin can cause a discrepancy between the karyotype of a surviving twin when a tissue from a vanished twin is inadvertently sampled. For these reasons amniocentesis for karyotype may be preferable if a vanishing twin is suspected. (Reddy associates 1991) [4].
Complications of twin pregnancy can be divided into maternal and fetal
Maternal
• Hyperemesis gravidarum results from high levels of
Multiple gestations are at higher risk of maternal complications. Walker et al 2004 [1] studied more than 44,000 multiple gestations and found that compared to singleton, risks for pre-Eclampsia, postpartum haemorrhage and maternal death increased by two fold. Moreover, chances of …show more content…
There is now evidence that incidence of zygote splitting is increased following ART. In contrast dizygotic twin is influenced by race, heredity, maternal age, parity and fertility treatment.
Vanishing twin
Sonographies done at first trimester have shown that one twin is lost or vanishes before the second trimester in up to 20 to 60% of spontaneous twin conception (Dickey 2000) [3]
A vanishing twin may cause an elevated maternal serum alpha protein. So, diagnosis of vanishing twin should be excluded to avoid confusion during maternal serum screening for Down syndrome or neural tube defects. Similarly, a vanishing twin can cause a discrepancy between the karyotype of a surviving twin when a tissue from a vanished twin is inadvertently sampled. For these reasons amniocentesis for karyotype may be preferable if a vanishing twin is suspected. (Reddy associates 1991) [4].
Complications of twin pregnancy can be divided into maternal and fetal
Maternal
• Hyperemesis gravidarum results from high levels of