ABSTRACT
As is the case in singleton pregnancies, Uteroplacental bleeding disorders can occur in twin gestations as well. Indeed, in certain clinical situations, it may occur more frequently. Uterine bleeding during the second and third trimesters is relatively common and occurs in approximately 6-8% of all pregnancies1. Regardless of etiology, bleeding is associated with an increased risk of preterm births and perinatal deaths1. Whereas up to 20% of bleeding episodes are attributed to placenta previa and 30% to abruptio placentae2, at least half are of unknown etiology. In twin pregnancies, both placenta previa and placental abruption account for the majority of Uteroplacental bleeding disorders. Other causes may include premature labor, genital tract trauma, carcinoma of the cervix or vagina, coagulation defects and hemorrhagic cystitis. The management of such bleeding disorders requires consideration of both maternal and fetal conditions, an understanding of the maternal pathophysiology and natural fetal outcomes and careful formation of a therapeutic plan. This chapter discusses placenta previa and abruption and the management of these disorders in twin gestations.
