Kathleen Minor, Samantha Do, Yair J. Blumenfeld
The rate of twin births has recently decreased in the United States; however, multifetal gestations continue to contribute to the burden of prematurity and very-low-birthweight neonates. We review the embryology, diagnosis, and management, including surveillance and delivery strategies for multifetal gestations. Special attention is paid to addressing evidence-based prediction and prevention of preterm birth to reduce neonatal morbidity and mortality. Additionally, we review the diagnosis and management of unique complications associated with monochorionic pregnancies including twin-to-twin transfusion syndrome, twin-anemia-polycythemia sequence, selective fetal growth restriction and single twin demise.