Twin & Multiple Pregnancy Care in Delhi
Specialised monitoring for twin pregnancies, which carry distinct risks.
What twin & multiple pregnancy care involves
Twin pregnancies need more frequent scanning than singletons, because of the risks of growth discordance, preterm birth and, in identical twins sharing a placenta, twin-to-twin transfusion syndrome.
The single most important early step is determining chorionicity — whether the twins share a placenta — which is best done before 14 weeks and determines the entire monitoring schedule.
Who this is for
- Twin or triplet pregnancy, spontaneous or after fertility treatment
- Monochorionic twins requiring intensive surveillance
- Previous preterm delivery with a current multiple pregnancy
- Growth discordance identified on scan
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
Chorionicity
Determined before 14 weeks, ideally at the dating scan.
Scan schedule
Fortnightly from 16 weeks for monochorionic twins, four-weekly for dichorionic.
Preterm prevention
Cervical length measurement, with progesterone or cerclage where indicated.
Delivery planning
Timing and mode planned in advance with neonatal support arranged.
Your results, in writing
Whatever the outcome of twin & multiple pregnancy care, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: Chorionicity at 12 weeks changed everything
32, Dwarka · twins after IVF · referred at 12 weeks
What she came in with
A twin pregnancy after a double embryo transfer at another centre. She had been booked for routine four-weekly antenatal visits, as for a singleton.
What the workup showed
The 12-week scan showed a T-sign at the membrane insertion — monochorionic diamniotic twins sharing one placenta, despite two embryos having been transferred. Monochorionic twins carry a 10–15% risk of twin-to-twin transfusion syndrome and need fortnightly surveillance, not four-weekly visits.
What we did
The schedule was changed immediately to fortnightly scans from 16 weeks with amniotic fluid and bladder assessment in both twins, plus cervical length monitoring.
Outcome
Discordant fluid volumes appeared at 22 weeks — early-stage TTTS. Referred the same week for fetal therapy assessment, monitored closely, and delivered both twins in good condition at 34 weeks.
The point of this case
Chorionicity is easy to determine before 14 weeks and almost impossible afterwards. It is the single most important piece of information in a twin pregnancy, and it decides the entire monitoring plan.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
Chorionicity established early, as it changes everything that follows
Fortnightly surveillance for monochorionic pregnancies
Cervical length monitoring to anticipate preterm birth
Delivery at a unit with neonatal intensive care available
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
Questions about twin & multiple pregnancy care
When are twins usually delivered?
Around 37–38 weeks for dichorionic twins and 36–37 weeks for monochorionic diamniotic twins, earlier if complications arise.
Can twins be delivered vaginally?
Yes, when the first twin is head-down and both are growing well. Many twin pairs deliver vaginally safely.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.