11. What are the most common complications and maternal risks of a multiple pregnancy?

Complications can occur during any pregnancy, but a higher incidence of complications occurs during higher-order multiple pregnancies, and the number and nature of the complications typically depend on gestation (the number of weeks pregnant).

Not all expectant mothers of multiples experience complications, but the vast majority of mothers expecting triplets or more experience some complications, and the most common is preterm labor.

For respondents to the MOST Medical Birth Survey, the most common complications during their higher-order multiple pregnancy were:

  • 55% preterm labor
  • 29% hypertension related complications (pregnancy-induced hypertension (PIH), toxemia, preeclampsia, etc.)
  • 23% vaginal bleeding
  • 18% anemia
  • 18% carpal tunnel syndrome
  • 14% gestational diabetes
  • 13% infection
  • 12% prolonged rupture of membranes
  • 11% severe itching (PUPPPS, cholestasis, rash)

Other possible complications in a higer-order multiple pregnancy can include HELLP Syndrome, Twin-to-Twin Tansfusion Syndrome, Intrauterine Growth Restriction, unequal sharing of the placenta, and others. See statistics from the MOST Medical Birth Survey for more information.



For specific resources on pregnancy complications (such as cancer during pregnancy or cardiomyopathy), visit the MOST Pregnancy Resource Listing.

Additional information about possible pregnancy complications is available in the MOST book Expecting Multiples: A Comprehensive Guide.

The MOST Birth Survey statistics on pregnancy provides more data from the MOST Birth Survey on pregnancy complications.

Sonography of Multiple Gestations by Jacqueline Reyesó, MD, Luís Flávio de Andrade Gonçalvesõ, MD, Sandra Rejane Silvaö, MD, Philippe Jeantyò, MD, PhD (article from The Fetus)

WebMD's Risk of Multiple Pregnancy

Childbirth Education for Multiple Pregnancy

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