Which aspect of antenatal management is particularly important in a twin pregnancy?

Answer: C. Early booking, nutritional supplementation (increased calories/protein, iron, calcium, folic acid, vitamins) and serial fetal growth monitoring

Antenatal management of twins

Twin pregnancies require enhanced antenatal care because of the higher maternal and fetal risks.

Key elements

• Early booking visit (and early determination of chorionicity).
• Nutritional supplementation: increased calories and proteins; iron, calcium, folic acid and vitamins (higher demand, anaemia risk).
• Serial fetal growth monitoring (IUGR and growth discordance, especially in monochorionic twins; TTTS surveillance).
• Advise to avoid heavy work and have adequate rest.

Why C

Early booking, nutritional supplementation and growth monitoring are the cornerstones.

Why the others are wrong

Twin pregnancy needs increased (not reduced) calories/protein, more (not fewer) scans for growth/chorionicity monitoring, and adequate rest - not discouraging rest.