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I gemelli: eterogeneità clinica e approccio multidisciplinare [Twins: Clinical heterogeneity and multidisciplinary approach]


The incidence of multiple pregnancy has increased during the last 15 years, particularly in relation to the advances in assisted reproductive technologies. Twins are conceived in about 1 in 80 pregnancies. Multiple gestations are high risk pregnancies, which may be complicated by pre-eclampsia, anemia, postpartum hemorrhage, pre-maturity, intrauterine growth restriction (IUGR), small for gestational age (SGA) newborn, neonatal morbidity and high perinatal, neonatal and infant mortality. Main complication is the twin-to-twin transfusion syndrome (TTTS) in monochorionic twin gestations; it is associated to high perinatal mortality and increased neurological, cardiovascular and renal dysfunctions or defects. An accurate long-term developmental surveillance program is particularly indicated for at-risk twins