third IntroductionMultiple pregnancy poses particular problems over women, their infants,

third IntroductionMultiple pregnancy poses particular problems over women, their infants, and for their caregivers. Women are likely to experience the common, disagreeable symptoms of pregnancy, such as heartburn, backache, hemorrhoids, difficulty walking, and tiredness to a greater degree than women with a singleton pregnancy. They are more likely to suffer from anemia, hypertension, pre-eclampsia, preterm labor, and operative birth. The increased risks to the infants include congenital malformations, monochorionicity (both infants sharing single placenta), negative fetal growth, preterm birth, and perinatal death. For the survivors, in the long rehearse ace is a greater risk of cerebral palsy.2 Prenatal careA wide range of options for normal antenatal appearance are practised, ranging from modified common care between obstetrician and general practician to weekly visits from the 20th future of gestation onwards. There is no evidence to suggest that one chart of prenatal blame is better than another, because this important research question has never been properly addressed. Regular prenatal visits permit screening for hypertension and pre-eclampsia by careful determination of copper pressure, and, if elevated, checking for proteinuria. Care for girls ensconce a tortuous pregnancy who develop hypertension may be particularly important, and should ensue run-of-the-mill remedy recommendations.2.1 Advice and supportWomen salt away a multiple pregnancy rapture advice also support from caregivers to help them deal with the particular issues of multiple pregnancy and with the common, unpleasant signs of pregnancy, such as hemorrhoids, heartburn, besides backache (see Chapter 13). They may be especially anxious about the pregnancy, the birth, besides their ability to cope with the practical and financial demands of additional than one new baby. helping girls to find support, such due to a special antenatal class for women cloak a composite pregnancy or referring them to a multiple-birth help group, may help.2.2 NutritionFetal demands for inflexible and folate are increased credit multiple pregnancy and anemia is reported more frequently than in singleton pregnancies. Routine stiff and folate supplementation is often advised from the beginning of the second trimester, although this has not been proven to alter the clinical outcome of the pregnancy.

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