Three pairs of monozygotic twins were ascertained during a general survey of language disabilities conducted among schoolchildren of Porto Alegre, Brazil. Two of them were concordant for dysgraphia, dysorthographia, dyslexia, and speech defects, while the other was concordant for dysorthographia and dyslexia, but discordant for dysgraphia. Two of the mothers and two sibs also presented language problems, but of a type that was not completely similar to those of the twins. Concomitant neurological and psychological studies, as well as the family histories, helped to understand the similarities and dissimilarities observed.

A specific prenatal care program is proposed to prevent preterm deliveries in twin pregnancies, with ultrasound scanning, early work leave and home visits by midwifes. A four-year study has been conducted on 197 pregnancies (160 early followed and booked and 37 late referred). It can be shown that early preterm births and very low birth weights are less frequent in the followed group than in published data, as well as in the late referred pregnancies. The total perinatal mortality rate is 25.6 per 1000 total births.

One of twins was bom with prune belly syndrome and congenital heart defect following exposure to Bendectin and Tigan. Red cell antigens and HLA typing were compatible with monozygosity. The possible associations of the prune belly syndrome to monozygotic twinning or to teratogenic agents is considered in light of this patient and review of the literature.

We have compared breech twins and breech single births in a population recorded between 1974 and 1978 in 10 Belgian maternity centers. In 190 twin pregnancies, 38 first and 65 second twins were delivered in breech presentation. These twins were compared to 853 singleton breeches, of which 95 delivered by cesarean section were excluded. Data were stratified according to birthweight. No significant difference between twins and singletons was found in terms of perinatal mortality rates. However, Apgar scores below 7 at 5 minutes were significantly less numerous among first twins than among singletons. Therefore, first twins in breech presentation might be at lower risk of fetal distress. This difference should be taken into account in the management of first twins presenting by the breech.

A study of 111 mothers of twins in Nottinghamshire, England, in 1981-82 showed that at least 12 had used ovulation stimulants, compared to 2 of 102 mothers of singletons. Thus, the use of ovulation stimulants increased the twinning rate of this population by about 10 percent; this may explain the recently noted levelling off in the secular decline in twinning rates. In contrast to a recent study in France, no association between twinning and prior use of oral contraceptives was seen.

A simple program for management of term twin delivery in the second stage of labor is presented. Provided that given selection criteria are met, twins at term are delivered by the vaginal route

In a sample of 63 like-sex dizygotic twins, red blood ceE and plasma magnesium and red blood cell zinc concentrations were analyzed for linkage to each of 23 genetic systems by estimating correlation between proportion of genes identical by descent and biological resemblance for the trait. The results suggest possible linkage of red blood cell magnesium with the HLA locus and of red blood cell zinc with the GLO1 locus. However, studies applying more powerful tests are needed to confirm such conclusions.

An epidemiological study of all primigravid twin pregnancies delivered in Aberdeen between 1950 and 1969 was performed to determine the pattern of arterial blood pressure changes. There is a greater fall from non-pregnant levels in diastolic blood pressure by mid pregnancy and a greater rise of diastolic pressure by delivery. These changes are independent of age, body size and rate of weight gain during pregnancy. The expected increased incidence of proteinuric pre-eclampsia is also independent of rate of weight gain when defined for twin pregnancies.

No significant difference has been found in either stroke volume or cardiac output between twin pregnancies and singleton pregnancies. Cardiac output is less in preeclamptic twin pregnancies.

A BASIC computer program designed to facilitate analysis of twin data is presented. The program estimates genetic parameters and tests their statistical significance based on the genetic and environmental hypothesis.

In recent years, it has been realized that some infants of frankly alcoholic mothers escape the stigmata of fetal alcohol syndrome (FAS) and others have only a few of the characteristics. These infants are thought to display fetal alcohol effects (FAE). The controversy regarding the amount of alcohol a woman can safely drink during pregnancy and the effects of timing and individual physiology on producing FAS vs FAE in the infant are important questions which can perhaps be partially answered through examining twin pregnancies and offspring. Data are presented regarding the long-term growth and development of a set of dizygotic twins, one with FAS and one with FAE, delivered to a mother who drank moderate amounts of alcohol during pregnancy. The variation in the degree of abnormality found in dizygotic twins exposed to similar amounts of alcohol at the same time during gestation indicates that differences in fetal susceptibility to ethanol dysmorphogenesis are of prime importance to the expression of the fetal alcohol syndrome.

Continuous wave Doppler ultrasound was used to study the twin fetus in 76 multiple pregnancies. The technique is not difficult and allowed the identification of the small for gestional age twin in both intrauterine growth failure and twin to twin transfusion syndrome.