New research to help reduce the dangers of multiple births

Posted: 10/10/2016

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Each year in the UK, 9 – 15 October marks Baby Loss Awareness Week.  This week is designed to support charities that care for bereaved families and to raise awareness of the issues surrounding pregnancy and baby loss.  One such issue that has been investigated through research conducted by the British Medical Journal (BMJ) relates to the increased danger to twins in comparison with single babies during pregnancy and birth.

The research, published by the BMJ in August 2016, noted that since 2005 the number of patient safety incidents involving multiple pregnancies has risen by 419% in the UK. These ‘incidents’ include stillbirth and neonatal death (within the first month after birth). Indeed, multiple births are currently considered a major risk factor in high income countries like the UK. The report aimed to improve these worrying statistics by determining and minimising the risks of stillbirth and neonatal complications in twin pregnancies.

While it is well-known that difficulties are more likely to develop in multiple births, doctors are still unsure of the best time to deliver twin babies to reduce the risk of complications. Multiple babies are often delivered early in an attempt to prevent late stillbirth, as the risks of problems increase the longer they remain in the uterus. However, this of course needs to be balanced with the potential health problems that premature babies face after they have been delivered. The new study sought to establish the optimal time to deliver twin babies so that, in future, twins are safer and families are better informed.

The BMJ research compared monochorionic twins with dichorionic twins. Monochorionic twins share the same placenta so they are always identical. Dichorionic twins have a placenta each and can be identical or fraternal.  

Monochorionic twins are at a higher risk from a number of problems such as twin to twin transfusion while the risk of stillbirths is around 13 times higher than for single babies.  By collating a large number of smaller studies from around the world, the research balanced the risks of stillbirth or neonatal death in babies that were delivered at different stages during the final weeks of pregnancy.  While the average single pregnancy is usually delivered at around 40 weeks, twin babies are generally delivered earlier, at 37 or 38 weeks. The BMJ study examined statistics for deliveries at different weeks and concluded that, while uncomplicated dichorionic pregnancies should be delivered at 37 weeks, in monochorionic pregnancies delivery should be considered at 36 weeks. 

Camilla Wonnacott, an associate in the clinical negligence team at Penningtons Manches LLP, comments: “It is hoped that these research findings will enable medical professionals to advise expectant mothers and families more effectively on the management and planning of the pregnancy and birth, and in turn, reduce the risk of stillbirth and neonatal death in multiple pregnancies.

“If you would like to remember a little one who did not make it through pregnancy or the early months of life, you can get involved with Baby Loss Awareness Week online at www.babyloss-awareness.org.”

Penningtons Manches has an experienced clinical negligence team who can support and advise parents who have concerns that their child’s birth should have been managed differently. For further information on pursuing a claim in this area, please visit our obstetrics and gynaecology page.  

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