Twin Pregnancy : Symptoms, Complications, Factors and Diagnosis

Overview

It is always fascinating to see twins or triplets growing up together. Twin pregnancies are more common now as families often opt for fertility treatments. Pregnancies that occur with the help of fertility treatments tend to culminate into multiple pregnancies. 

This blog is a comprehensive guide to multiple pregnancies, focusing on twin pregnancies.

What is a twin pregnancy, and how does it happen?

A twin pregnancy is when the mother carries two babies at a time. A twin pregnancy can happen in two main ways.

• A fertilized ovum can split into two and get implanted in the uterine walls as two different embryos. These are called identical twins. They can look similar and be of the same sex since one ovum and sperm are involved.
• Two different sperms can fertilize two ova simultaneously, known as fraternal twins. The fetuses may not look identical and may not always be of the same sex since two different sperms are involved.

What are the factors that increase the chance of twin pregnancy?

Several factors may contribute to twin pregnancy.

1. Women above 30 years have a higher chance of conceiving multiple fetuses. The hormonal changes in adult women prepare their bodies to release more than one ovum a month. Therefore, the chances of all the released ova getting fertilised are high.
2. Genetics is another significant player in ensuring that women carry multiple fetuses. The chances of twin pregnancy drastically increase if the mother is a twin or has twins in the family. It may be due to passing down the gene of hyperovulation from parent to child.
3. Studies show that women with increased BMI and taller are more likely to have multiple pregnancies, even though the reason is unclear.
4. Modern fertility treatments have increased the number of twins and multiple pregnancies. In procedures such as IVF, the healthcare provider may place more than one egg to be fertilized into the mother’s system to increase the chance of successful pregnancy. All the zygotes may develop as babies leading to multiple pregnancies.

How to diagnose twin pregnancy?

Only an ultrasound examination can determine and confirm the number of babies inside the womb. The scan helps the healthcare provider to check the number of fetuses growing in the uterus. The healthcare providers may also suspect multiple pregnancies if more than one heartbeat is heard during a fetal Doppler scan.

What are the symptoms of multiple pregnancies?

Symptoms during a twin pregnancy may also differ slightly from a single pregnancy. The mothers may experience the following in greater severity :

• Morning sickness
• Severe vomiting and nausea
• Rapid weight gain
• Tender and sore breasts in the first trimester

What are the possible complications during twin pregnancy?

• Complications are common in all pregnancies, irrespective of the number of babies inside the womb. But multiple pregnancies are considered more complicated, and healthcare providers take extra precautions while handling such pregnancies.
• Pregnant women develop diabetes due to increased hormones from the placenta. As the number of placentae increases in multiple pregnancies, the risk of gestational diabetes may also shoot up. It may affect the baby’s health, and a dietitian may help the mother to manage the gestational diabetes .
• Premature labour and birth are the most common complication of twin or multiple pregnancies. The healthcare provider may recommend injections to prolong the gestational period for the babies to develop all their organs fully. Premature birth may cause vision, breathing, digestive difficulties, and infection in the newborn.
• Similar to diabetes, pregnant women may also get gestational hypertension. The complications double if the woman is carrying more than one fetus.
• The placenta may detach from the uterine walls in some women before delivery. This emergency situation is more common in women carrying multiples.
• More than half of the multiple pregnancy cases face complications with the growth of one of the babies. This condition is called intrauterine growth restriction. It may lead to premature delivery with low birth weight.
• Identical twins with the same placenta may develop the twin-twin-transfusion syndrome. In this condition, the babies share the blood resulting in one baby receiving more blood than the other. It can dangerously affect both babies.

How to stay healthy during a twin pregnancy?

A twin pregnancy demands more frequent antenatal visits than a single pregnancy. The calorie intake should be optimum for the growth and betterment of all babies and mothers. Studies show that an expectant mother should ideally consume an extra 300 calories for each baby. Along with food intake, following a low-impact workout to stay healthy is essential.

In a twin pregnancy, it is essential to hydrate oneself and get sufficient rest to handle stress and discomfort. Always choose a healthcare provider experienced in multiple births to make the process easier. Studies also indicate that the chances of postpartum depression are high in mothers with twin or multiple children. It is vital to take adequate care of the mother and the children. Always contact the healthcare provider for the mother’s and the baby’s needs and any medical emergencies.

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Conclusion

All pregnancies require attention and care. But multiple pregnancies require some extra care. With adequate care and medical attention, birthing multiple children become easier. The doctors must closely monitor complications of premature birth and fetal growth restrictions. Get personalised recommendations from the right healthcare provider to make the pregnancy journey smooth.

Frequently Asked Questions (FAQs)

What is vanishing twin syndrome?

Vanishing twin syndrome is a miscarriage of one of the babies in a twin pregnancy. It usually occurs in the first trimester when one of the embryos detected in the ultrasound stops developing.

Do twins share the same amniotic sac?

Some twins do share an amniotic sac and the placenta. But it is ideal if each baby has its amniotic sac and placenta for nutritional and protective purposes. Fetal complications such as umbilical cords tangling and nutrient imbalance may arise if the babies share the same amniotic sac.

Is a mother with multiple children more likely to have a C-section delivery?

Yes. The chances of having a cesarean are high in multiple births since they are more prone to complications.