The Multiple Pregnancy

Perinatal mortality is very high in multiple pregnancy, and there are correspondingly greater losses in triplet and quadruplet pregnancies than in twins. It has been shown that even under the most favorable circumstances, fetal loss is still two or three times greater for multiple than for single births. Antepartum and intrapartum complications are quite common as immediate causes of death, but the greatest single threat to life appears to be prematurity. More than half the babies born in multiple pregnancies are premature by weight and are, therefore, subjected to the associated risks. It has been said that the judgment and technical skill of the obstetrician are particularly important in multiple pregnancy, and this undoubtedly applies especially for the unfortunate infants which follow the eldest in birth order. The excessive mortality of second twins over that of the first born has been adequately demonstrated.1 With reference to the matter of