Multi Pregnant
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Multi Pregnant
Multiples Pregnancy: Twins, Triplets and More
You have just discovered that you are having a multiple pregnancy. Whether you are ecstatic, shocked, or overwhelmed, you may…
You have been told that you are expecting multiples and that you will need to gain more weight, eat more…
Twin to twin transfusion syndrome (TTTS) is a serious disorder that occurs in identical twins and higher-order multiples who share…
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A multiples pregnancy means having twins, triplets or multiples. It’s impossible to definitively know whether you are carrying twins (or multiple babies) by simply gauging how you feel or going off of what a home pregnancy test shows. In fact, only an ultrasound can confirm a twin or multiple pregnancy.
Many more women in America are having multiple pregnancies than ever before. According to the National Center for Health Statistics, the number of twin births increased 74% , and the number of higher-order multiples (twins, triplets, quadruplets, etc.) increased fivefold from 1980 to 2000. Most of this increase is due to women waiting to have children until their 30’s as well as the rise in the use of fertility treatments.
Moms with a multiples pregnancy may experience more morning sickness. But using the degree of morning sickness as an estimate that you are carrying twins isn’t necessarily very helpful.
Overall, 70% to 80% of women can experience some amount of nausea and vomiting with pregnancies, and up to 2% reportedly experience hyperemesis gravidarum , a form of severe morning sickness . At the same time, some moms of twins and triplets say they have no morning sickness.
The following links may also be helpful as you begin your journey of carrying multiples:
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A multiple pregnancy means being pregnant with more than 1 baby. It is often a happy
event for many couples. But multiple pregnancy has higher risks for complications.
The most common problems are listed below.
More than 3 in 5 twins and nearly all higher-order multiples are preterm (born before
37 weeks). The higher the number of babies in the pregnancy, the greater the risk
for early birth.
Preterm babies are born before their bodies and organ systems have fully matured.
These babies are often small, with low birth weights. This means less than 5.5 pounds (2,500
grams). They may need help breathing, eating, fighting infection, and staying warm.
Very preterm babies are those born before 28 weeks. They are more at risk. Many of
their organs may not be ready for life outside the mother's uterus and may be too
immature to work well. Many multiple birth babies will need care in a neonatal intensive
care unit (NICU).
Women pregnant with multiple babies are more than twice as likely to develop high
blood pressure of pregnancy. This health problem often starts earlier and is worse
than in pregnancy with one baby. It can also raise the chance of early detachment
of the placenta (placental abruption).
Women with a multiple pregnancy are more likely to get gestational diabetes.
Anemia is more than twice as common in women pregnant with more than 1 baby.
Multiple birth babies have about twice the risk for certain problems present at birth
(congenital). These include spina bifida and other neural tube defects, and problems
of the digestive tract and heart.
A phenomenon called vanishing twin syndrome is more likely in multiple pregnancies.
It's when more than 1 fetus is found, but vanishes (or is miscarried). This often
happens in the first trimester. This may come with bleeding. The risk of pregnancy
loss is higher in later trimesters as well.
Twin-to-twin transfusion syndrome (TTTS) is a condition of the placenta that develops
only with identical twins that share a placenta. Blood vessels connect within the
placenta and divert blood from 1 baby to the other. It happens in about 3 in 20 twins
with a shared placenta.
In TTTS, blood is shunted from 1 baby to the other through blood vessel connections
in a shared placenta. Over time, the recipient baby gets too much blood. This can
overload the cardiovascular system and cause too much amniotic fluid to develop. The
smaller donor baby does not get enough blood and has low amounts of amniotic fluid.
TTTS can be treated during pregnancy by withdrawing some of the extra fluid with a
needle or with surgery on the placenta. Sometimes, the twins may need to be delivered
early.
Amniotic fluid problems are more common in multiple pregnancies, especially for twins
that share a placenta.
The umbilical cord for the twins that share an amniotic sac can become tangled up.
In these cases, the babies may need to be monitored often in the third trimester.
Abnormal positions of babies in the womb raise the chances of a C-section.
A larger placenta and larger uterus due to more babies place a mother at risk for
bleeding after giving birth.
©2022 University of Rochester Medical Center Rochester, NY
The trusted provider of medical information since 1899
Professional
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Gynecology and Obstetrics
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Abnormalities and Complications of Labor and Delivery
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Multifetal Pregnancy
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Introduction to Abnormalities and Complications of Labor and Delivery
Prelabor Rupture of Membranes (PROM)
Last full review/revision Jul 2021| Content last modified Sep 2022
Complications
Diagnosis
Treatment
Key Points
Multifetal pregnancy is presence of > 1 fetus in the uterus.
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, MD, Children's Hospital of Philadelphia
Multifetal (multiple) pregnancy occurs in up to 1 of 30 deliveries.
Risk factors for multiple pregnancy include
Ovarian stimulation Treatment (usually with clomiphene or gonadotropins)
Multifetal pregnancy increases the risk of
Fetal presentation may be abnormal. The uterus may contract after delivery of the first child, shearing away the placenta and increasing risk for the remaining fetuses. Sometimes uterine distention impairs postpartum uterine contraction, leading to atony and maternal hemorrhage Postpartum Hemorrhage Postpartum hemorrhage is blood loss of > 1000 mL or blood loss accompanied by symptoms or signs of hypovolemia within 24 hours of birth. Diagnosis is clinical. Treatment depends on etiology... read more .
Some complications develop only in multifetal pregnancies. An example is twin-twin transfusion syndrome (when twins share the same placenta; this syndrome results in vascular communication between the two, which can lead to unequal sharing of blood).
Multifetal pregnancy is suspected if the uterus is large for dates; it is evident on prenatal ultrasonography.
In multifetal pregnancies, the overdistended uterus tends to stimulate preterm labor, resulting in preterm delivery.
Check for other possible complications, such as preeclampsia and gestational diabetes, and prepare for preterm delivery, cesarean delivery, and postpartum hemorrhage.
If the uterus is large for gestational age, do ultrasonography.
For most multifetal pregnancies, deliver by cesarean unless the presenting twin is in vertex presentation.
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