Management, Delivery Costs Pegged at $30,000 per Twin.

VAIL, COLO. -- Current approaches to managing twin pregnancies are both extremely expensive and not very successful at avoiding problem births, according to Dr. John C. Hobbins.

Moreover, the incidence of twin pregnancies has doubled in recent decades as a result of assisted reproductive technologies. And these twin pregnancies are associated with more problems than twin births of earlier times. Today, twins account for 3% of all deliveries but 21% of low-birth-weight deliveries and 13% of total infant mortality.

Although only 1% of singletons deliver before 32 weeks' gestation--the threshold below which profound damage becomes most likely--that's the case for 1 in 20 sets of dichorionic twins, 1 in 10 sets of monochorionic twins, and 1 in 4 sets of triplets, Dr. Hobbins said at a conference on obstetrics and gynecology sponsored by the University of Colorado.

The cost of care in twin pregnancies, he added, is "extremely expensive and perhaps out of control." Data from Brigham and Women's Hospital, Boston, in the mid-1990s showed that hospital charges for twin deliveries averaged almost fourfold greater than for singleton births. Charges for triplets were 11-fold greater.