What is multiple pregnancy?

A pregnancy with more than one baby at the same time is called as a multiple pregnancy. This includes women pregnant with twins, triplets, and four or more babies.   

Babies born from a twin pregnancy are commonly fraternal twins. It means two embryos had developed from fertilization of two different ova or eggs. Identical twins are rare, in which the fertilized ovum splits into two giving rise to two identical embryos.

Getting to know about atwin pregnancy is exciting news for would-be parents and family. However, twin pregnancy carries significant risks for the health of both, the mother and babies.

Recently the chances of twin pregnancy have increased due to the following:

• Many couples opting for assisted reproductive technology like in vitro fertilization (IVF), medicines to induce ovulation, etc. for treating infertility.
• Late pregnancy in women beyond 30 to 33 years of age.

Twin pregnancy has long-term effects on the mother’s health as the body has to adjust to the two babies growing in the womb. In the absence of proper management, there is equal risk of complications to the babies.

How is twin pregnancy different from a single pregnancy?

First of all, how do you know if you are pregnant with twins?

An ultrasound scan plays a key role in diagnosing a twin pregnancy. At 12 weeks, the ultrasound scan can detect the growing twins. Number of amniotic sacs, whether twins share it or have separate placenta and chorion (membrane covering the embryo that forms the placenta) are also detectable on an ultrasound scan. Other tests include the foetal doppler study, which detects two different heart beats.

What to expect during twin pregnancy?

Body changes related to twin pregnancy are different as compared to single baby pregnancy.

Common symptoms of twin pregnancy include the following:

Early signs of twin pregnancy include rapid weight gain, especially in the first 3 months of pregnancy. Women with twin pregnancies also experience morning sickness with a higher intensity as compared to those with a single pregnancy. The size of the uterus exceeds the expected size for the duration of pregnancy.

Things to know about a twin pregnancy

Twin pregnancy complications have significant effects on the mother’s health. Knowledge about the difficulties that might arise helps the would-be parents and family to get ready for a twin pregnancy.

1. Women with a twin pregnancy have two times more chances of developing high blood pressure (pre-eclampsia) and diabetes during pregnancy, which can cause serious post-delivery health problems.
2. Labour in twin pregnancy starts early as compared to pregnancy with a single baby.
3. Need for delivery by caesarean section increases in twin pregnancyto ensure safety of both the mother and babies.
4. Anaemia, post-delivery bleeding, premature rupture of membranes and post-caesarean section complications are high in twin pregnancy.
5. Severe complications can also lead to mother’s death.

Babies conceived in twin pregnancy too are at risk of developing health issues as follows:

1. Preterm delivery or delivery of the babies before the due date is common in twin pregnancy.
2. As a result, premature birth of babies as early as 28 weeks is a frequently occurring serious complication of twin pregnancy.
3. One of the twins or both babies could be small with a low birth weight.
4. The overall growth may be restricted leading to learning disabilities, delayed milestones, stunted growth, etc. in both or one of the twins.
5. Chances of brain damage or bleeding in the brain are high in preterm babies, particularly in twin pregnancy. Cerebral palsy in the surviving twin is very common when the co-twin in unable to thrive the complete duration of pregnancy.
6. Twin-twin transfusion syndrome (TTTS) is a one of the serious twin pregnancy complications. Imbalance of blood circulation occurs due to sharing of one placenta among the twins. This causes insufficiency in one and excessive blood supply to the other twin, which affect the growth and development of both babies.
7. Mono-amniotic and mono-chorionic is a rare occurrence in which twins share the amniotic sac as well as the placenta. This condition can be harmful for both the babies as the two umbilical cords can get entangled.

Twin pregnancy care

• It is essential that the mother receives nutrition sufficient for the growth of two babies during twin pregnancy. A balanced diet with high nutrition value and adequate quantity helps in the healthy growth of babies.
• Doctors usually double the dose of folic acid in twin pregnancy.
• Because there is easy and rapid weight gain in twin pregnancy, it is necessary that weight gain be closely monitored to prevent excessive weight gain, which could cause problems for the mother and foetus.
• Regular mild to moderate exercise such as walking, prenatal yoga, swimming is required to remain active during twin pregnancy.
• Getting the required tests done for checking birth defects is crucial as there are high chances of birth defects in a twin pregnancy.
• Regular check-up as advised by the doctor is important to monitor the various developmental milestones of the  babies in twin pregnancy.
• Bed rest is recommended only in cases of anticipated complications.

Disclaimer: The information in the article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor.

Also read: Twin Pregnancy: Cesarean Birth or Vaginal Birth?

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