TwinsorTripletsPregnancy—MultipleGestationCare
Written & medically reviewed by Dr. Shaivalini Kamarapu
MBBS · MS (Obstetrics & Gynaecology) · Fellowship in Reproductive Medicine · 20+ years of clinical experience
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Twinsortriplets—multiplegestationcare
Multiple pregnancy usually happens when more than one egg is fertilized by a man's sperm. But it can also happen when one egg is fertilized and then splits into two or more embryos that grow into two or more babies.
Twins are called identical when one fertilized egg splits into two — identical twins look almost exactly alike and share the exact same genes. Twins are fraternal when two separate eggs are fertilized by two separate sperm — fraternal twins don't share the same genes and are no more alike than any brothers and sisters from different pregnancies with the same mother and father.
Typesofmultiplepregnancies
Howaremultiplesborn?
If you're pregnant with multiples, you're more likely to have a cesarean birth (C-section) than if you're pregnant with one baby. A C-section is surgery in which your baby is born through a cut your doctor makes in your belly and uterus. Most triplets and higher-order multiples are born by C-section.
With twins, a vaginal birth may be possible if:
Both babies are in the head-down position and you have no other complications
The lower twin is in the head-down position, even if the higher twin isn't
If you're pregnant with twins, you may need a C-section if neither baby is in the head-down position or if you have other complications. Vaginal birth is the way most babies are born — during vaginal birth, the uterus contracts to help push the baby out through the vagina.
Signsofamultiplepregnancy
The only way to know if you're pregnant with more than one baby is through an ultrasound exam with your healthcare provider — during this test, your provider can look at images inside your uterus and confirm how many babies are there. Apart from an ultrasound, your provider might also suspect multiples if more than one heartbeat is detected during a fetal Doppler scan. Multiple pregnancies can also bring more intense versions of typical pregnancy symptoms.
Whatcomplicationsarelinkedtomultiplebirths?
Premature labour and birth
Pre-eclampsia or gestational hypertension (high blood pressure)
Gestational diabetes
Placental abruption
Fetal growth restriction
Anaemia
Miscarriage
Howcanbeingpregnantwithmultiplesaffectyourbabies'health?
Premature birth
Birth defects
Growth problems
Low birthweight (LBW)
Twin-twin transfusion syndrome (TTTS)
Neonatal death
Diagnosisofmultiplepregnancies
The following tests help confirm and monitor a multiple pregnancy, and help avoid complications at the time of delivery:
HCG testing
Ultrasound
Alpha-fetoprotein