دانلود کتاب راهنمای عملی مدیریت حاملگی های چند قلو

From the introduction of modern record-keeping in the early 1900s until the 1970s, the combined incidence of multiple births in the United States was stable at around 2%. Of these, twins occurred in 18.9 per 1,000 live births and higher-order multiples (triplets and above) in 32.3 per 100,000 births.1 In the 1980s, the widespread introduction of assisted reproductive technologies (ART) and shifting maternal demographics led to a steady increase in multiple pregnancies. From 1980 to 2009, twin births in the United States rose 76% to 33.2 per 1,000 births among women of all ages. Higher-order multiples increased 400%, peaking at 193.5 per 100,000 births in 1998.2 In the late 1990s, concerns over the rising rates of multiple pregnancies led to the introduction of professional societal guidelines to reduce the number of multifetal gestations attributable to ART. Higher-order multiple pregnancy rates began to fall shortly thereafter and, in 2018, higher-order multiples occurred in only 93.0 per 100,000 births, a 52% decrease from 1998, but still nearly threefold higher than during the pre-ART era.3 The twin birth rate was slower to stabilise, settling at around 33 per 1,000 births between 2007 and 2014. In 2014, for the first time in three decades, the twin birth rate began to decline and, in 2018, represented 32.6 out of 1,000 live births