Robert Wood Johnson University Hospital

Care, Management of Multiple Pregnancy

Care and Management of Multiple Pregnancy

Management of multiple pregnancy:

Specific management for multiple pregnancy will be determined by your physician or midwife based on:

Management of multiple pregnancy may include the following:

How are multiple pregnancies delivered?

Delivery of multiples depends on many factors including the fetal positions, gestational age, and health of mother and fetuses. Generally, in twins, if both fetuses are in the vertex (head-down) position and there are no other complications, a vaginal delivery is possible. If the first fetus is vertex, but the second is not, the first fetus may be delivered vaginally, then the second is either turned to the vertex position or delivered breech (buttocks are presented first). These procedures can increase the risk for problems such as prolapsed cord (when the cord slips down through the cervical opening). Emergency cesarean birth of the second fetus may be needed. Usually, if the first fetus is not vertex, both babies are delivered by cesarean. Most triplets and other higher-order multiples are born by cesarean.

Illustration of a twin birth, head down/head down
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Illustration of a twin birth, head down/head up
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Illustration of a twin birth, head up/head down
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Vaginal delivery may take place in an operating room because of the greater risks for complications during birth and the need for cesarean delivery. Cesarean delivery is usually needed for fetuses that are in abnormal positions, for certain medical conditions of the mother, and for fetal distress.

Illustration of the delivery of the placenta
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Click here to view the
Online Resources of Pregnancy & Childbirth


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