Multiple pregnancy is highly fascinating. However it carries high risk both for the baby and the mother, It is a real challenge, both for the obstetrician and for the patient and of course to our sonologist also. There are some complications because of the multiple pregnancy. So let us consider in the first trimester that is in the first three months of the pregnancy there could be excess vomiting because of the extra production of the hormones, which can lead on to some nutritional deficiency and also dehydration and also there is risk of abortion in the multiple pregnancy Because of the increased chromosomal and also the congenital anomalies in the babies. In second trimester, there is increased risk of pregnancy induced hypertension and also excess water around the baby, call it as hydramnios and also there is increased risk of Iung and also there is abruption placenta, where there is a premature separation of the placenta and also because of the large size of the placenta, the placenta can also extend into the lower segment. The condition called as placenta previa is also more common in the multiple pregnancy and also multiple pregnancy is in the increased risk for diabetes and preterm delivery is one of the dreadful and one of the very common complication associated with the multiple pregnancy and following the delivery, there is increased risk for the bleeding, what we call it as a post-partum haemorrhage and they might have challenges with respect to the lactation and because of difficulties in handling two babies, there could be increased incidence of post-partum blues or the depression in Multiple pregnancy. In general there is increased incidence of caesarean in the case of multiple pregnancies. Under normal circumstances, each baby is surrounded by a membrane called as amnion and one more membrane called a chorion. So in twin pregnancies, what happens is there are two babies. If each baby is surrounded by its amnion and chorion, it is called as dichorioninc and diamnionotic. The beauty of that is that each baby has its own independent circulation and has its own placenta and because of which the complications are much lesser whereas if you consider the other types where the two embryos, each one has the amnion around it, but both together have a single chorion, what we call it as a monochorionic and diamniontic twin pregnancy. What happens here is that they may have two different placentas. But however there could be a vascular communication between the two placenta which can lead to special complications in these type of pregnancies or they may have a single placenta which might do a little bit of partiality for the blood supply for these two babies which in turn can lead to some special complications. That is why it is very important to identify, whether it is a monochorionic or a dichorionic, monoamniotic or a diamniotic in the initial stage of pregnancy so that we can lay down a specialised antenatal plan and also an antenatal scan modalities for the pregnancies and handle them accordingly.

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