Pregnant With Twins Or Triplets? Here’s Everything You Need To Know About Their Health & Yours

Posted: September 7, 2017

If you are pregnant with twins or triplets, it adds another layer of worry for new parents. Here is an overview of what you need to know.

Congratulations! You are going to be a mother soon. However, you then find out that you are carrying twins. Or even triplets! Whether your pregnancy is planned or unplanned, finding out that you are going to have twins or triplets, can be scary. You may worry about the difficulties of managing two babies at once and the increased financial responsibility. But long before the babies emerge from the the womb, you as the mother, need to be alert, aware of possible complications, and take good care of yourself.

Read on to find out more.

Why do twins or triplets (multiples) happen?

Two ways in which multiples can happen

  1. One fertilized egg may split up in to two or more embryos. Then you have identical twins or triplets, all boys, or all girls, with the same blood type.
  2. If there happens to be more than one egg, and each egg is fertilized by a different sperm, then you get fraternal twins or triplets. These multiples may be of different sex and have no more in common than siblings with the same parents.

Factors that increase the probability of having multiples

  • Couples with family histories of many multiples are more likely to have multiples.
  • If you are in your thirties or forties, you are more likely to have multiples, because your as you get older you may ovulate two follicles simultaneously resulting in twins.
  • Fertility treatments also increase the likelihood of multiples.

What should you expect with multiples?

There is no denying, that pregnancies with multiples are riskier than single pregnancies. But don’t lose perspective. Remember, that a great majority of multiple pregnancies result in healthy babies, and all you have to do is make sure you go for regular check ups, and follow your doctor’s advice.

Special Prenatal Care

Picking the right doctor

Carrying twins and triplets can put a lot of stress on your body, and you may face a few bumps along the way. So it is vital to choose a doctor you are comfortable with. Choose someone with whom, you can openly discuss any discomfort you are experiencing.

Pick some one close to home, because you will be visiting your doctor very often to monitor the progress of the babies as well as your own health. Regular check ups will ensure, that any complication is detected early, and dealt with effectively in a timely manner.

Regular checkups and proper prenatal care

  • Folic acid is essential to stave off birth defects. You need to have more of it if you are carrying twins or triplets. So be sure to take the proper dose of folic acid prescribed by your doctor.
  • Twin pregnancies are at higher risk of miscarriages, pre-term labour, and placenta pervia, so follow your doctor’s recommendations for reduced activity or bed rest.
  • Healthy diet and appropriate weight gain, in case of multiples, is very important to reduce the chances of pre-term labour. If you are carrying twins you need to gain about 16 to 20 kgs, and if you are carrying triplets, you need to gain 23 to 27 kgs. Weight gain is particularly important between 20 and 24 weeks of pregnancy.

Possible complications during pregnancy

You may have a completely uneventful pregnancy, and that will be great. However, in case of pregnancies with multiples, the following complications are more likely, so ask your doctor if you are showing early symptoms for any these, and what you can do to overcome the problem.

Gestational diabetes

Gestational diabetes, occurs when your pancreas cannot keep up with the increased need for insulin during pregnancy. It is usually a temporary condition, and is more common with twins or triplets. Regular visits to the doctor helps to detect this early, so it can be managed with diet and exercise and medicine if necessary.

Pre-eclampsia

Pre-eclampsia is a condition marked by high blood pressure and presence of protein in urine. It prevents the placenta from receiving enough blood, and often causes of premature birth. It occurs in about 10-15% of pregnancies with twins or triplets. Sometimes, pre-eclampsia may not present any early symptoms, so it is essential to regularly monitor blood pressure and do urine tests.

Placenta problems

With two or more babies the uterus gets very crowded. Sometimes babies share a placenta and sometimes they have separate placentas. Either way the placentas take up a lot of space, and the uterus is stressed. As a result, the following problems may occur.

Sometimes a part of the placenta covers the cervix. This is called placenta pervia, and may cause vaginal bleeding at any time of the pregnancy. Bed rest helps, but in extreme cases blood transfusion may be necessary.

Sometimes, as a result of high blood pressure, which is more common in case of twins or triplets, the placenta detaches from the wall of the uterus prematurely. This is called abruptio placentae, and in extreme cases the babies need to be delivered by C-section right away.

Intrauterine growth restriction

Intrauterine growth restriction is a condition in which a baby does not grow sufficiently in the womb. It affects 25% of multiple pregnancies, and results in one or both twins or triplets being smaller than normal. Sometimes one twin gets much less blood and nutrients than the other resulting in that twin being much smaller. Usually, doctors can spot this problem during check ups, and take steps to reduce the impact on you and the babies.

Namrata, a mother of twins, says that she encountered this problem and it wasn’t detected till the babies were born, but now at the age of 4 they are both doing fine.

Vanishing twin syndrome

Vanishing twin syndrome is when one twin survives and suffers a miscarriage. So when you go for your first ultrasound, your doctor may tell you, you are having twins, but then only detect one heart beat on your next visit. This occurs in about 21-30% of pregnancies with multiples. You may also experience some symptoms of a miscarriage, even though you are still carrying one baby.

Twin to twin transfusion syndrome

Twin-to-twin transfusion syndrome is a rare condition in 10 o 15 % of identical twins. This occurs when blood flows from one baby to the other through the shared placenta. But don’t worry, laser surgery can be used to seal off the connection between the blood vessels and treat it effectively.

Possible problems during delivery of twins or triplets

Needing a C-section

C-sections are common with multiples, so it is good to discuss this with your doctor in advance. Depending on the position of the babies, a normal delivery may or may not be possible.

Possibility of birth injuries

In case of twins or triplets, birth injuries are more common, and while one twin may be born perfectly healthy, the other may not. Sometimes, one or both babies, may need to spend time in an incubator or at the Neonatal Intensive Care Unit. Again, this might happen, so just be prepared for the possibility – remember that most twins come out of this to lead healthy lives.

Premature deliveries

On average, twin pregnancies last 35 weeks, which means, on average, twins are born prematurely. Premature babies born after 34 weeks usually do very well. If you go in to labour before 34 weeks, ask your doctor if it is possible to delay labour for a few days with medication.

Post delivery problems

Premature birth

Babies born before 28 weeks usually need medical attention at a NICU. Premature birth may cause long-term health problems, including, hearing, vision and dental problems as well as, cerebral palsy or autism. Some of these conditions may be mild, and specialists and counsellors can help deal with these problems.

Low birth weight

Birth weight under 2.5 kgs is considered low and is a common problem for multiples. Babies with low birth weight are at risk for health problems, like breathing on their own, fighting infections and controlling body temperature, even if they are not born prematurely.

Higher chances of postpartum depression

A study in John Hopkins found, that women who deliver multiples are significantly more likely to suffer moderate to severe depression within 9 months after delivery. So if you are feeling depressed talk about it with friends and family, and know that it is not unusual. In extreme cases do not hesitate to sought professional help.

No shame in asking for help

Caring for one new baby is a tough job for an inexperienced mother. Caring for two or three simultaneously seems like a herculean task. So don’t be shy to ask for help. Discuss how you will share baby care duties with your spouse or other family members.

Enjoy your motherhood!

Image source: By MultipleParent (Image:TwinsTwins.JPG) [GFDL, CC-BY-SA-3.0 or CC BY-SA 2.5-2.0-1.0], via Wikimedia Commons, for representational purposes only.

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