Gestation of delivery of twins - influence on perinatal mortality and morbidity and childhood educational outcomes. (360G-Wellcome-104490_Z_14_Z)

The purpose of this work is to guide clinicians on the optimum timing of the elective delivery of twins. This information is crucial in attempting to reduce perinatal mortality and morbidity in twin pregnancies. The following specific research aims will be investigated in this study: 1. To determine the gestation specific perinatal and neonatal mortality and morbidity in twins following (i) spontaneous delivery and (ii) elective delivery in the absence of maternal or fetal complications. T his research aim has been prompted by NICE following the multiple pregnancy guideline which acknowledges a lack of evidence to support its current recommendation on elective delivery of twins. 2. To determine the perinatal risk index in twin pregnancies according to gestation at delivery. Calculating this risk index for twin pregnancies will be useful in guiding the optimum timing of delivery of twins 3. To determine the long term educational outcomes of twin deliveries by gestational age The above questions have been answered in singletons and I believe that it is essential that similar data are available for women with twin pregnancy.