Twin pregnancy: What multiples mean for mom

Twin pregnancy? Taking good care of yourself is the best way to take care of your babies. Here's what you need to know.

Would you be surprised to learn that you're carrying twins or even triplets? It happens to an estimated three in every 100 pregnant women in the United States. Worldwide rates of twin pregnancy vary. One thing is certain, however: Twin pregnancy rates are on the rise.

What's driving the twin pregnancy trend?

Many women are delaying pregnancy well into their 30s and beyond — when age-related hormonal changes may cause more than one egg to be released at a time. This boosts the odds of conceiving nonidentical (fraternal) twins.

Because of their decreased fertility, older women are also more likely to use assisted reproductive technologies — such as in vitro fertilization — to conceive. Since these procedures typically involve implanting more than one fertilized egg in the uterus, they're more likely to result in twins or other multiples.

How multiples are made

Fraternal twins — the most common kind — occur when two separate eggs are fertilized by two different sperm. Each twin has his or her own placenta and amniotic sac. The twins can be two girls, two boys, or a boy and a girl. Genetically, they're no more alike than any other siblings.

Identical twins occur when a single fertilized egg splits and develops into two fetuses. Identical twins may share a placenta, but each baby usually has a separate amniotic sac. Genetically, the two babies are identical. They'll be the same sex and look exactly alike. Rarely, identical twins fail to completely separate into two individuals. These babies are known as conjoined twins.

Triplets and other higher order multiples can be identical, fraternal or a combination of both.

Diagnosing a twin pregnancy

Typically, a twin pregnancy is diagnosed before delivery. The first clue is often a uterus that's larger than normal or more than one fetal heartbeat. Certain blood tests may suggest twins or other multiples as well.

A suspected twin pregnancy is often confirmed with an ultrasound. During this exam, sound waves are used to create images of your uterus and baby — or babies.

Sometimes a seemingly normal twin pregnancy is later found to have only one baby. This is known as vanishing twin syndrome. Such an episode can be heartbreaking, frustrating and confusing. Often, there's no clear explanation for the loss.

What twin pregnancy means for mom

Taking good care of yourself is the best way to take care of your babies. During pregnancy, you can expect:

More side effects. Carrying multiples may intensify common pregnancy complaints, such as nausea, vomiting, heartburn, insomnia and fatigue. Abdominal pain, shortness of breath and pressure on the pubic bone are common as well.
More frequent checkups. You'll see your health care provider often to track your babies' growth and development, monitor your health, and watch for signs of preterm labor. You may need frequent ultrasounds or other tests. Your health care provider may recommend every-other-week visits during the second trimester and once-a-week visits during the third trimester.
More emphasis on certain nutrients. You'll need more folic acid, calcium, iron, protein and other essential nutrients. If you're already eating healthfully, keep it up — and be sure to take a daily prenatal vitamin. Your health care provider may recommend an iron supplement as well.
More weight gain. Gaining the right amount of weight can support your babies' health. It also makes it easier to shed the extra pounds after delivery. For twins, the recommendation is often 35 to 45 pounds. This may sound like a lot, but it only takes about 300 extra calories a day. Work with your health care provider to determine what's right for you.
More precautions. Your health care provider may ask you to limit some of your activities — such as work, travel and exercise — as your pregnancy progresses.

Consider complications

Healthy multiples are born every day. But it's important to be aware of possible complications. For example:

Preterm labor. Most pregnancies last 38 to 42 weeks. For a twin pregnancy, 37 to 39 weeks is optimal. Preterm labor refers to contractions that begin to open the cervix before week 37. Sometimes contractions can be stopped with fluids or medication. Although bed rest hasn't been proved an effective way to prevent preterm labor, it's often prescribed as a safeguard.
Preterm birth. If preterm labor can't be stopped, your babies may be born too early — the most serious risk for multiples. You may be given injections of a steroid medication to speed your babies' lung development. Even then, the smallest preemies may fight to survive. Complications may include low birth weight, breathing and digestive difficulties, underdeveloped organs, learning disabilities, and developmental problems.

Rarely, one baby is born prematurely while the other baby or babies are able to continue developing in the womb. This is known as a delayed-interval delivery.
High blood pressure. Mothers of multiples are more likely to develop high blood pressure during pregnancy. When high blood pressure is combined with protein in the urine, the condition is known as preeclampsia. Careful management is needed to prevent serious complications for both mother and baby.
Gestational diabetes. Mothers of multiples are more likely to develop gestational diabetes, a type of diabetes that occurs only during pregnancy. Gestational diabetes may damage the placenta and increase the risk of breathing problems at birth. Although gestational diabetes may cause single babies to grow too large, that effect is often blunted in twins.
Twin-twin transfusion. With identical twins, it's possible for a blood vessel in the placenta to connect the babies' circulatory systems. This causes one baby to receive too much blood and the other too little. Often, babies in this situation are delivered as soon as the benefits of early birth outweigh the potential problems of prematurity.
C-section delivery. It's possible to deliver multiples vaginally. C-section deliveries are common for twin pregnancies, however — especially if the babies aren't in a head-down position. In some cases, complications after the vaginal delivery of the first twin may require a C-section delivery for the second twin. C-sections are usually considered the safest option for triplets and higher order

Caring for multiples

Healthy multiples have the same needs as other newborns. Yet with twins, you'll have a double dose. You may need more rest and support than you imagined. Take time to enjoy your babies — and ask friends, loved ones and others for help when you need it.

Source:

http://www.mayoclinic.com

Posted by Ashiya Mizuki