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Maternal-Fetal MedicineSociety
SG-006GuidelineMultiple pregnancy

Management of multiple pregnancy

Determining chorionicity, monitoring schedules by type, TTTS screening, and choosing the timing and mode of delivery.

Version 2.034 pagesUpdated 20 July 2025Perinatology Working Group

Key recommendations

  • Chorionicity must be determined before 14 weeks
  • Monochorionic pregnancies monitored fortnightly from 16 weeks
  • Dichorionic twins delivered at 37–38 weeks
  • Monochorionic diamniotic twins at 36–37 weeks

Multiple pregnancy carries a substantially higher risk of complications, which is why intensive monitoring is required.

TTTS

Screening for twin-to-twin transfusion syndrome is performed by assessing amniotic fluid volume and bladder visualisation at every visit.

Note: A guideline is a recommendation and does not replace the clinician's professional judgement in an individual case. Departing from it is acceptable where the reasoning is documented.