[Can the high percentage of premature twins be reduced? Thoughts based on an analysis of 243 twin births].

243 twinpregnancies of the university hospital at Hamburg between 1960 to 1969 have been analysed retrospectively (1960 to 1964 = Group A, 1965 to 1969 = Group B). It was found that the main risk factors of gemellary gravidity are the high rate of born before term babies the high rate of EPH-gestosis, and the high rate of perinatal mortality. 57 respectively 65% of all gemellipara had one or more symptoms of EPH-gestosis. Measured by birth weight (less than 2500 g = pre-term and small for gestational age infants) greater than 50% of the twins of group A and B were of low birth weight. The perinatal mortality of multiple pregnancy of all groups of birth weight was 11.6% in group A and 13.3% in group B. The perinatal mortality of not premature newborn with greater than 2500 g was 10 times lower and has been corrected from 1.1% (group A) to 0.5% (group B). Gemellipara, younger than 20 and elder than 30 years of age, show the maximum rate of perinatal mortality. Twins should be diagnosed in time of pregnancy. This allows pre-term hospitalisation with routine testing of placental function and if necessary prophylactic therapy of immature labour. This offers more promise to prevention of prematurity and leads to progress satisfactorily with multiple pregnancy.