The incidence of twin pregnancy has risen substantially over the past decade, likely largely as a consequence of artificial reproductive technologies. The perennial dilemmas that apply to any singleton delivery, such as intrapartum monitoring and operative interventions are compounded by the presence of the second fetus. There is no doubt that the conduct of a twin delivery remains one of the most challenging events in the daily practice of obstetrics.

Endothelial cell proliferation and survival require continuous low levels of vascular endothelial growth factor (VEGF). The bioavailability of this angiogenic factor appears to be regulated by anti-angiogenic factors, including the soluble form of VEGF receptor 1 (sFlt-1) in the non-pregnant and pregnant states. During pregnancy a VEGF antagonist (sFlt-1) and other anti-angiogenic factors, including soluble endoglin (s-Eng), are produced by the human placenta and released into the maternal circulation; an excess of these anti-angiogenic factors can lead into angiogenic imbalances and pregnancy complications. This is important because regulation of VEGF action on angiogenic balances appears to be essential for a successful pregnancy.

Spatio-temporal image correlation (STIC) is a feature of four-dimensional ultrasonography (4D US) that allows the acquisition of volume datasets akin to blocks of pathological specimens, where all the anatomical information is contained in the block and the information displayed depends on the level at which the block is cut. STIC has the additional advantages that these planes can be assessed in a virtual beating heart, and that rendering techniques can be used to gain additional insight into the structure and function of the fetal heart.

Preterm birth (PTB) has a global prevalence of 11.1% accounting for almost 15 million babies born each year before 37 weeks of gestation. It is a risk factor in over 50% of all neonatal deaths, which amounts to 1.1 million deaths annually. Preterm birth, especially at early gestational ages is associated with a high risk of long-term morbidity in survivors. Despite much research effort, PTB rates continue to rise, placing immense financial and emotional burden on society. In the US, the annual societal economic cost associated with PTB is $26.2 billion with an average of $51,600 being spent per infant born preterm. Preterm labour (PTL) accounts for 70% of these births, of which 25% are preceded by preterm pre-labour rupture of membranes (PPROM).