Clinical bedrest in twin pregnancies.

A retrospective study was made of 148 sets of twins born at the Wilhelmina Gasthuis between 1969 and 1979. From 1969 to 1974, clinical bedrest was prescribed on indication only. From 1975 to 1979, prophylactic clinical bedrest was advocated. The duration of the period of bedrest was longer in the second period than in the first: the mean for primiparae was 3 wk, and for multiparae 2 wk. Both periods were compared with respect to gestational age, birthweight, placental weight and survival. No effect of longer clinical bedrest on gestational age was found. In primiparae, a small significant increase of both birthweight and placental weight was found, possibly related to clinical bedrest. The improvement of survival observed could not be ascribed to bedrest. Obviously, clinical bedrest may, to a limited extent, improve conditions for intrauterine growth in twins. However, because of emotional and economic damage, clinical bedrest in twin pregnancies should be advocated on a more individualized basis.