**Diagnosis**

**Chapter 4**

**Provisional chapter**

**Early Pregnancy Ultrasound Assessment of Multiple**

**Early Pregnancy Ultrasound Assessment of Multiple** 

As the frequency of multiple pregnancies is increasing, every obstetrician has to know that the correct, accurate, and timely determination of gestational age, chorionicity, and amnionicity has significant importance in the management of a multiple pregnancy. Surveillance, complications, outcome, morbidity, and mortality are totally different in a monochorionic and a dichorionic pregnancy. In this chapter, we will present the sonographic figures that are visualized in the first trimester in a multiple pregnancy and help us define the gestational age, chorionicity, and amnionicity. We will classify them into two periods: the early first trimester, including the 10 first weeks of gestation and the late first trimester including the period between the 10th and 14th week of gestation. Finally, we will review some interesting, although infrequent, cases from the literature, showing that pitfalls in the determination of both chorionicity and amnionicity exist and

highlighting the importance of being aware of their subsistence.

**Keywords:** multiple pregnancy, early ultrasound assessment, gestational age,

It is a well-established fact that multiple pregnancies occur more commonly nowadays than a few decades ago. The progress of reproductive technologies and *in vitro* fertilization has played a major role in this increase. In fact, twins comprise about 3% of all live births in the United States [1]. As we speak about history, the vast majority of multiple pregnancies that occurred

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.81498

**Pregnancy**

**Pregnancy**

George Daskalakis

**Abstract**

George Daskalakis

Panagiotis Antsaklis, Maria Papamichail, Marianna Theodora, Michael Syndos and

Panagiotis Antsaklis, Maria Papamichail, Marianna Theodora, Michael Syndos and

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.81498

chorionicity, amnionicity

**1. Introduction**

#### **Early Pregnancy Ultrasound Assessment of Multiple Pregnancy Early Pregnancy Ultrasound Assessment of Multiple Pregnancy**

DOI: 10.5772/intechopen.81498

Panagiotis Antsaklis, Maria Papamichail, Marianna Theodora, Michael Syndos and George Daskalakis Panagiotis Antsaklis, Maria Papamichail, Marianna Theodora, Michael Syndos and George Daskalakis

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.81498

#### **Abstract**

As the frequency of multiple pregnancies is increasing, every obstetrician has to know that the correct, accurate, and timely determination of gestational age, chorionicity, and amnionicity has significant importance in the management of a multiple pregnancy. Surveillance, complications, outcome, morbidity, and mortality are totally different in a monochorionic and a dichorionic pregnancy. In this chapter, we will present the sonographic figures that are visualized in the first trimester in a multiple pregnancy and help us define the gestational age, chorionicity, and amnionicity. We will classify them into two periods: the early first trimester, including the 10 first weeks of gestation and the late first trimester including the period between the 10th and 14th week of gestation. Finally, we will review some interesting, although infrequent, cases from the literature, showing that pitfalls in the determination of both chorionicity and amnionicity exist and highlighting the importance of being aware of their subsistence.

**Keywords:** multiple pregnancy, early ultrasound assessment, gestational age, chorionicity, amnionicity
