Description
The incidence of multiple pregnancies has increased with the increasing use of assisted reproductive techniques. This super-specialty title intends to cover basic epidemiology, associated complications and management of multiple pregnancy.The aim of this book is to provide a comprehensive, up to date and an evidenced-based discussion of multiple pregnancy and recent advances in its management. The chapters are divided in such a way that all three trimesters are discussed separately with all the relevant details. Pedagogical features like learning objectives, key learning points, text in highlighted boxes throughout the chapters provide the essential knowledge.Ideal for postgraduate students – MS and DNB, practitioner segment in obstetrics and gynaecology
Table of Contents
Section I: Background1. Epidemiology/Incidence of Multiple PregnancyTiran Dias and Amarnath Bhide1.1 Introduction1.2 Ethnic Variation1.3 Familial Tendency1.4 Geographical Variation1.5 Genetics of Twins1.6 Reproductive Age1.7 Assisted Reproductive Techniques2. Classification of Multiple PregnancyTiran Dias and Amarnath Bhide2.1 Introduction2.2 Classification of Multiple Pregnancy3. Mechanism of Multiple Pregnancy/AetiologyTiran Dias3.1 Introduction3.2 Zygosity3.3 Chorionicity and Amnionicity4. Placentation in Multiple PregnancyAAH Priyani4.1 Introduction4.2 Zygosity4.3 Placentation in Multiple Pregnancy4.4 Placental Growth During Pregnancy4.5 Twin Growth Discordance and Related Placental Characteristics4.6 Vascular Anastomoses and Related Complications4.7 Monoamniotic TwinningSection II: Antenatal Management of Multiple Pregnancy: Early Pregnancy5. Confirmation of Viability and Assessing Number of FetusesTiran Dias and Amarnath Bhide5.1 Introduction5.2 Confirmation of Viability and Assessing the Number of Fetuses5.3 Vanishing Twin6. Assessment of Gestational AgeTiran Dias and Amarnath Bhide6.1 Introduction6.2 Crown–Rump Length or Last Menstrual Period to Date the Pregnancy?6.3 Can Singleton Charts be Used Reliably to Date Twin Pregnancies?6.4 Should Pregnancy be Dated by Measurements of the Larger Twin,Smaller Twin or Their Average?6.5 Gestational Age Assessment After the First Trimester6.6 Gestational Age Assessment in IVF Multiple Pregnancy7. Assessment of ChorionicityTiran Dias and Amarnath Bhide7.1 Introduction7.2 Ultrasound Determination of Chorionicity8. Antenatal LabellingTiran Dias and Amarnath Bhide8.1 Introduction8.2 Antenatal LabellingSection III: Aneuploidy Risk Assessment in Multiple Pregnancy9. Principles of Aneuploidy Screening in Multiple PregnancyTiran Dias9.1 Introduction9.2 Assessment of the Aneuploidy Risk with Regard to Zygosity, Chorionicity and Maternal Age10. Aneuploidy Risk in Multiple Pregnancy and Assessment: Ultrasound and Serum BiochemistryTiran Dias10.1 Introduction10.2 First-Trimester Risk Assessment Using Nuchal Translucency in Twin Pregnancy10.3 First-Trimester Combined Screening10.4 Second-Trimester Maternal Serum Screening10.5 Integrated Screening for Chromosomal Aneuploidy in Twins10.6 Second-Trimester Ultrasound Screening for Aneuploidy in Twin Pregnancies11. Non-invasive Methods of Risk Assessment in TwinsTiran Dias11.1 Introduction11.2 Fetal Gender Determination in Twin Pregnancy11.3 Twin Zygosity Determination Using Maternal Plasma DNA Analysis11.4 Fetal Chromosomal Aneuploidy Detection Using Sequencing of Maternal Plasma DNA11.5 Prenatal Diagnosis of Pregnancy Complications11.6 Noninvasive Prenatal Diagnosis of Twins Using Circulating MicroRNAs in Maternal Plasma12. Invasive Methods of Screening in Multiple PregnancyTiran Dias12.1 Introduction12.2 Counselling in Invasive Testing12.3 Principles of Invasive Diagnostic Procedures12.4 Amniocentesis12.5 Chorionic Villus Sampling13. Managing Twins Divergent for Karyotypic AbnormalitiesTiran Dias13.1 Introduction13.2 Preliminary Counselling13.3 Selective Reduction of Multifetal PregnanciesSection IV: Antenatal Care in Multiple Pregnancy: Late Pregnancy14. Antenatal Fetal MonitoringTiran Dias14.1 Introduction14.2 Uncomplicated MCDA Twins14.3 Uncomplicated DCDA Twins14.4 Uncomplicated MCTA or DCTA Triplets14.5 Uncomplicated TCTA Triplets14.6 Assessments at Each Ultrasound Scan14.7 Nutritional Supplements14.8 Separate Growth Reference Ranges15. Perinatal Morbidity and Mortality in TwinsTiran Dias15.1 Introduction15.2 Potential Contributors for Morbidity15.3 Cerebral Palsy15.4 Cognitive Impairment15.5 Any Major Disability15.6 Early Pregnancy Loss in TwinsSection V: Planning of Delivery in Multiple Pregnancy16. Planning of Delivery in Multiple PregnancyTiran Dias16.1 Introduction16.2 Timing of Delivery17. Mode of DeliveryTiran Dias17.
