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The effect is initially rather flat-footed, but when Padel gets stuck into the private tensions of Darwin's life – the religious belief of his wife Emma versus his own growing atheism; Emma's multiple pregnancies; the loss of his 10-year-old favourite daughter Annie; his decades-long illness – the poetry becomes much more absorbing, even moving.
Interestingly, after multiple pregnancies, the Nf2 defective mice develop myoepithelioma-like breast tumors at high frequency.
However, prolonged lactation, multiple pregnancies, the combined oral contraceptive, smoking and exercise are reported as protective factors [ 20].
To prevent multiple pregnancies the goal of ovulation induction by gonadotropins is to achieve only mono-follicular development.
To prevent multiple pregnancies the goal of ovulation induction by gonadotropins is to achieve only mono-follicular development and ovulation [ 3, 20, 22].
After exclusion of multiple pregnancies, the average crude incidence was 4.9% after spontaneous delivery, 7.4% after assisted vaginal delivery, 3.7% after elective CS and 2.4% after emergency CS.
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In the setting of a multiple pregnancy, the high risks associated with factors such as preterm delivery, intrauterine growth restriction, and the ill health of one twin affecting the other may all overshadow the genetic risk.
In the one published RCT (162 women) of specialised antenatal care for multiple pregnancy, the additional midwifery care and information trialled did not improve maternal or fetal morbidities [ 20].
Women were excluded if there was a known congenital anomaly, multiple pregnancy, the fetus required immediate delivery for abnormal fetal heart rate trace, maternal age was less than 16 years or they were unable to give informed consent.
Moreover, among women with preeclampsia in their first pregnancy, the presence of multiple pregnancies in the first pregnancy was associated with a lower preeclampsia recurrence rate in the second pregnancy, suggesting that preeclampsia in the presence of multiple pregnancies might be caused by the fetal multiplicity itself rather than by underlying constant maternal risk factors [ 23].
Objective: Our objective was to determine the incidence of spontaneous reduction in multiple pregnancies during the first 12 gestational weeks and determine the outcome of the surviving fetuses.
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