ABSTRACT
The problems that can be anticipated with multiple pregnancy rise steeply with increasing numbers and were highlighted, with tragic outcome, during the period when there was no control over the number of embryos placed back in the uterus after assisted conception procedures. Women carrying triplets and above should be warned to expect an exhausting pregnancy and premature delivery; it is also necessary to be frank about the risks of perinatal loss and damage. Although, theoretically, a vaginal delivery could be planned, a caesarean section will be a great deal safer. Many women may wish to consider reducing the number of fetuses by selective pregnancy termination; such a request must be considered sympathetically, especially for quadruplets and above.
