Multiple births
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Follow the links below to find trusted information about multiple births.
Last reviewed: May 2018
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Multiple birth - triplets or more
If you are pregnant with triplets or more, the birth will need careful planning. The main risk is that they will be born prematurely. Find out more here.
Read more on Pregnancy, Birth & Baby website
Types of multiple pregnancy
Multiple pregnancies, including triplets and more, are rare but require lots of support. Find out about the different types of multiple pregnancy here.
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Multiple pregnancy (triplets or more)
Learning you're pregnant with triplets or more can be a shock, but overall, most parents find having multiple babies to be a positive experience.
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Pregnant with twins
If you're pregnant with twins, a healthy lifestyle and diet will help you cope with your pregnancy and give your babies the best start in life.
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Raising multiple babies
Raising multiple babies - triplets or more - involves planning, hard work, and well designed routines. But with support, raising multiples does get easier.
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Feeding multiple babies
Feeding multiple babies, such as triplets or more, can be challenging at first, but even breastfeeding is possible with some expert help.
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Giving birth to twins
Twins are more likely to be born early, often before 38 weeks, so it's important to understand your birth options.
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Twins, triplets and multiples
If you are having twins, triplets or more, find out everything you need to know about your pregnancy, the birth, feeding and raising your babies.
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Raising twins
Find out more on how to get your twins to sleep, what the 'twin bond' is and dealing with sibling rivalry.
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Types of twins
There are two types of twins - fraternal twins and identical twins.
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Top results
Elective birth of women with an uncomplicated twin pregnancy from 37 weeks' gestation | Cochrane
The optimal timing of birth for women with a twin pregnancy is uncertain, with clinical support for both elective delivery at 37 weeks' gestation (either by induction of labour or caesarean birth), and for waiting for labour to start spontaneously (expectant management).
Read more on Cochrane (Australasian Centre) website
Nutritional advice for improving outcomes in multiple pregnancies | Cochrane
In multiple pregnancies (twins, triplets and more), the metabolic rate of the mother is greater than in women who are carrying a single baby so that a high-calorie diet may also help maintain the mother's nutritional state. Multiple pregnancies have a higher risk of complications for women and their babies than do single pregnancies. In particular, poor growth of the babies in the womb, premature birth, and low birthweights are more common.
Read more on Cochrane (Australasian Centre) website
Surgery for choanal atresia | Cochrane
Congenital (present from birth) choanal atresia is a rare abnormality characterized by narrowing or blockage of one or both sides of the nasal airway. It has an incidence of between 1 in 5000 and 1 in 8000 births and is two times more common in females. Choanal atresia is treated by surgery, which aims to open the nasal airway sufficiently, avoid harm to any structure in development and result in a low rate of restenosis (renarrowing) after the operation. The procedure should ideally enable the shortest possible surgery and hospitalization time, and minimize morbidity and mortality. Many different techniques and approaches have been described.
Read more on Cochrane (Australasian Centre) website
Folic acid supplements before conception and in early pregnancy (up to 12 weeks) for the prevention of birth defects | Cochrane
Read more on Cochrane (Australasian Centre) website
Plastic and Reconstructive Surgery
Plastic & Reconstructive Surgery
Read more on RACS – Royal Australasian College of Surgeons website
High versus low dose of initial thyroid hormone replacement for congenital hypothyroidism | Cochrane
Congenital hypothyroidism is a condition that affects infants from birth and results from a missing or abnormally developed thyroid gland, abnormal production of thyroid hormones or a failure of the pituitary gland to stimulate thyroid hormone production. It affects approximately 1 in 3000 to 4000 newborn infants and early diagnosis and treatment is very important to achieve a good outcome.Treatment of congenital hypothyroidism consists of a daily dose of thyroid hormone (thyroxine). However, the initial dose of thyroxine required to improve outcomes for infants with this condition is unclear and has been the subject of several studies. Some studies have suggested that when infants with congenital hypothyroidism are treated with a higher dose of thyroxine compared with the standard dose, this results in earlier normalisation of the their thyroid hormones and leads to better developmental outcome and intelligence.
Read more on Cochrane (Australasian Centre) website
Prevention of transmission of cytomegalovirus from mother to fetus during pregnancy | Cochrane
There is insufficient evidence from randomised controlled trials to recommend use of any particular intervention to prevent the transmission of cytomegalovirus (CMV) from mother to fetus during pregnancy (congenital CMV infection). CMV is a herpesvirus and is the most common cause of congenital infection in developed countries. Some 40% of women who acquire the infection during pregnancy transmit the virus to their fetus. The fetus can have serious health problems as a result of this infection, including growth restriction and the risk of late miscarriage. While 90% of infants with congenital CMV infection display no manifestations at birth, the remaining 10% do have signs and are at risk of life-long neurological consequences, including cognitive and motor deficits, hearing and visual impairments. Maternal education and behavioural modification are used to limit women acquiring CMV in pregnancy (for example by improved hand hygiene). Drug interventions include antiviral treatment, immunoglobulin therapy (for example CMV hyperimmune globulin) and the possibility of anti-CMV vaccination. There is currently no licensed vaccine against CMV. Antiviral therapy, such as ganciclovir, can be given to the newborn infant to prevent or reduce any consequences of congenital infection. Interventions differ in their efficacy, risks to the baby, possible side effects (such as nephrotoxicity, bone marrow suppression, and emergence of resistant CMV strains) and acceptability of use.
Read more on Cochrane (Australasian Centre) website
Treatments for coarctation of the thoracic aorta | Cochrane
Coarctation of the aorta (CoA) is a congenital narrowing of the lumen in a section of the aorta. The narrowing is most commonly in the upper thoracic aorta but can occur in the abdominal aorta. It is present at birth and males are more often affected than females. Clinical symptoms are variable and depend on the position, degree and extent of the narrowed segment of the aorta. Other congenital heart abnormalities may also be present. In general, the diagnosis is made by finding a difference in pulsations and blood pressure between the upper body and arms and the lower body and legs. If left unrepaired, average survival is 31 years. The treatment of CoA is intended to improve life expectancy and quality of life by reducing the incidence of aortic and cardiac disabling conditions such as aneurysm (dilation) of the ascending aorta, coronary artery disease, high blood pressure, and aortic and mitral valvular disease. The treatment of CoA consists of enlarging of the narrowed segment. Traditionally this required open heart surgery. Balloon angioplasty became available as an alternative treatment in the 1980s but recurrence, aneurysm and aortic dissection (a tear in the inner wall of the aorta causing blood to flow between the layers of the blood vessel wall) remained disadvantages of both treatments. In the early 1990s, endovascular stents were introduced and have become an alternative approach to surgical repair. The present review looked at the available evidence for the effectiveness of open surgery compared with placing a stent in the coarctation of the thoracic aorta. The review authors searched the medical literature but they did not found any studies that compared open surgery and stent placement for the treatment of coarctation of the thoracic aorta. The treatment of CoA is a challenging procedure and the centers that perform this treatment have a well-established strategy for patients with CoA; the strategy is in accordance with the experience of involved professionals and local resources. In both situations experience and resources have improved the results of the treatment. However a more concrete and long-term analysis of these strategies is needed.
Read more on Cochrane (Australasian Centre) website
Planned caesarean section for a twin pregnancy | Cochrane
Read more on Cochrane (Australasian Centre) website
Planned early delivery versus expectant management for twins who are in the same amniotic sac during pregnancy (monoamniotic twins) | Cochrane
Read more on Cochrane (Australasian Centre) website
