Maternal mortality in multiple pregnancy

The combination of physiological changes and perinatal pathologies certainly inerease the maternal risk for serious morbidity associated with multiple pregnancies. A recent review cited mortality cases attributed to beta-mimetic tocolysis, 1:6 deaths from eclampsia, and delivery-related mortality attributed to blood loss.
In France, the maternal mortality was 10.2 vs. 4.4. per 100,000 live birth in multiples vs. singletons, and for the entire Europe, the corresponding figures were 14.9 vs. 5.2.
In a database from Latin America the adjusted relative risks for pre-eclamptic toxemia. eclampsia, preterm labor, anemia, post-partum hemorrhage, and endometrilis were 2.2, 3, 3.9, l.S, 2, and 1.8, respectively. These risks were mainly associated with nulliparity, but the risk of death tor the multipanı was twice in a multiple pregnaney than in a singleton gestation.
Admittedly, the true incidence of maternal mortality in multiple pregnancies is unknown, merely because death is registerecl by the prime cause (e.g., eclampsia) but not altributed to what increased the risk for eclampsia (i.e., a twin pregnaney). With the inereasing numbers of multiple births, it is important to register all mortalities by plurality in order to realize the risk of maternal death in multiple pregnancies.