Multiple pregnancy

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What is multiple pregnancy?

A pregnancy with more than one fetus is called a multiple pregnancy. A pregnancy carrying two fetuses is called twins. A pregnancy carrying three fetuses is called triplets.

How common is multiple pregnancy?

Multiple births have become more common in recent years because more people are using fertility drugs and procedures, such as IVF, to help conceiving a baby.

What complications are linked to multiple pregnancy?

There are typically more risks linked to a multiple pregnancy than a singleton (carrying only one baby) pregnancy.

Higher order the pregnancy, higher is the risk. Monochorionic (one placenta) pregnancy has higher risk than dichorionic (two placenta) pregnancy. Chorionicity could be found out by ultrasound scan in early pregnancy. Identical twins could be monochorionic (70%) and dichorionic ( 30%). Non-identical twins are dichorionic.

Pregnant with multiple pregnancy might have more severe morning sickness , GI upset or breast distension or musculoskeletal pain.

Possible complications include:

Fetal risks

  •  Miscarriage
  •  Fetal anomaly
  •  Premature labor and birth i.e. birth before 37 weeks of pregnancy
  •  Low birth weight
  •  Fetal growth restriction
  •  Still birth

Maternal risks

  •  Preeclampsia or gestational hypertension (high blood pressure)
  •  Gestational diabetes
  •  Anemia

Obstetric risks

  •  Placenta abruption
  •  Placenta previa

Risk specific for monochronic twins

  •  Selective fetal growth restriction (one twin grows well, whereas the co-twin does not experience much growth)
  •  Twin–twin transfusion syndrome (TTTS)
  •  Cord complication
  •  Twin reversed arterial perfusion sequence (TRAPs)

Pregnant with multiple pregnancy are generally at higher risks. It is recommended to start early antenatal checkup and under care with experienced obstetrician or fetal maternal medicine professionals.