Multiple Pregnancy Clinics

Mary’s Hospital at Wythenshawe

The multiple pregnancy clinic is led by Consultant Obstetricians Dr Elaine Church and Dr Ghazia Saleemi, supported by Multiple Pregnancy Midwife Bev Carson.

All women booked at Wythenshawe with multiple pregnancies are offered care in this clinic including:

Dichorionic diamniotic (DCDA) – twins who are not usually identical and each has their own placenta and own amniotic sac.

Monochorionic diamniotic (MCDA) – identical twins who share a placenta but have separate amniotic sacs.

Monochorionic monoamniotic (MCMA) – identical twins who share a placenta and share the amniotic sac.

Triplets – there are different types of triplets (three babies in the womb), two or more of whom may share a placenta.

Higher order multiple pregnancies (such as quadruplets or more) would be advised to have care in the multiple pregnancy clinic at Saint Mary’s Oxford Road Campus.

St Mary’s Hospital Oxford Road Campus

The multiple pregnancy clinic is led by Consultant in Obstetrics and Fetal and Maternal Medicine, Dr Koon Loong Chan and Consultant Obstetricians, Dr Gillian Stephen and Dr Bindu Singhania.

All women with uncomplicated MCDA twins are looked after by Dr Bindu Singhania in the dedicated multiple pregnancy clinic, currently supported by midwife Fiona Prichard. Complicated monochorionic twins, triplets and higher order multiple pregnancies are looked after by Dr Koon Loong Chan and Dr Gillian Stephen in the Fetal Medicine Unit (FMU). DCDA twins are looked after by Consultant Obstetricians in their antenatal clinics.

Multiple Pregnancy Clinics

Being seen in a dedicated clinic provides continuity of care. Both hospital sites follow the same Manchester Foundation Trust guideline on Multiple Pregnancies which is based on the NICE Twin and Triplet Pregnancy Guideline published in 2019.

Women found to have a twin or triplet pregnancy on their dating scan will be referred to the multiple pregnancy clinic for an appointment with one of the consultants or senior registrars before 16 weeks gestation. This is an informative appointment where information about having a multiple pregnancy is shared. An individual plan of care for the pregnancy will be discussed. Women will have an opportunity to discuss obstetric and midwifery aspects of care, including infant feeding, safe sleeping and will be signposted to other information sources such as Twins Trust and this leaflet.

We also offer multiple pregnancy information evenings for parents expecting twins or triplets. These were temporarily paused during the covid-19 pandemic but will resume soon. Ask one of the team for the new dates.

Dichorionic twins have growth scans every 4 weeks from 24 weeks as a minimum to detect any issues with the growth of the babies (growth discordance or selective Fetal Growth Restriction). An individualised birth plan will be made, aiming for birth at 37 weeks. DCDA twins may be born by vaginally if the presenting twin is head first (cephalic) and the mother has no contraindications to a vaginal birth.

Monochorionic twins and triplets have scans every 2 weeks from 16 weeks to detect any issues with the growth of the babies (growth discordance or selective Fetal Growth Restriction) or any complications of sharing a placenta, such as Twin to Twin Transfusion Syndrome (TTTS).

If signs of TTTS are seen on ultrasound, and you are booked at Saint Mary’s @ Wythenshwe, the multiple pregnancy team at Wythenshawe would liaise with the multiple pregnancy consultants at Saint Mary’s Oxford Road Campus for a second opinion and ongoing care. Twins with TTTS who require treatment for this condition will be referred to Birmingham Women’s Hospital, which is our closest centre able to provide this very specialised treatment.

MCDA twins without complications will have an individualised birth plan made, aiming for birth at 36 weeks. MCDA twins may be born by vaginally if the presenting twin is head first (cephalic) and the mother has no contraindications to a vaginal birth.

MCMA twins without complications will have delivery planned at 32-34 weeks by caesarean section, due to the increased risks with this type of twins.

Triplets without complications will have delivery planned by 35 weeks, by caesarean section.

Research

We always want to improve the care we give to parents. Research studies are an important way in which we do this. Women attending the multiple pregnancy clinic on either site may be asked to participate in relevant research studies.

Clinics

The multiple pregnancy clinic at Saint Mary’s @ Wythenshawe is held every Wednesday morning.

The multiple pregnancy clinics at Saint Mary’s Oxford Road Campus is held every Wednesday morning in antenatal clinic and in the Fetal Medicine Unit.

Location

Wythenshawe Multiple Pregnancy Clinic – Antenatal Clinic, ground floor of the maternity unit, accessed via entrance 13 or 14, Wythenshawe Hospital.

Oxford Road Campus Multiple Pregnancy Clinic – Antenatal Clinic and Fetal Medicine Unit, Ground Floor, accessed via Saintt Mary’s Hospital entrance on Oxford Road.

How can I access this clinic?

You will be referred by your midwife if you have a multiple pregnancy at your dating scan at 10-14 weeks gestation.

Contact details

Antenatal Clinic reception at Saint Mary’s Hospital at Wythenshawe can be contacted on (0161) 291 2951 or 2959 Monday – Friday 08:00-17:00.

Antenatal Clinic at Saint Mary’s Oxford Road Campus can be contacted on (0161) 276 6409 Monday – Friday, 08:30 – 17:00