Specializing in Multiple Pregnancies
A multiple pregnancy occurs when a woman is carrying at least two fetuses at once. Multiple pregnancies may result when more than one egg is fertilized and each egg implants itself in the uterus. In other cases, one egg is fertilized and divides into two or more embryos, producing multiple babies that will be completely identical. Most commonly, these pregnancies result in the birth of twins, although some women carry several fetuses to term during the same pregnancy.
Nearly all multiple pregnancies are diagnosed during the first trimester. Multiple pregnancies pose a variety of serious health risks and complications, for both the mother and babies. One of the biggest concerns for multiple pregnancies is premature birth, which increase the children’s risk of birth defects as well as cognitive or medical issues in the future. Because of the potential health issues associated with multiple pregnancies, they are always considered high risk and require proper prenatal care and close monitoring.
Symptoms of Multiple Pregnancies
Many women begin to suspect that they are pregnant with more than one baby, especially if they have previously been pregnant. While the specific symptoms that may occur during a multiple pregnancy will vary by the individual, many women experience the following symptoms:
- Increased morning sickness
- Noticeable fetal movements from different areas of the abdomen at the same time
- Excessive weight gain, especially during the early stages of pregnancy
- Increased appetite
Causes of Multiple Pregnancies
Multiple pregnancies have been linked to a variety of factors:
- A family history of multiple pregnancies
- Maternal age, especially if the mother is over the age of 30
- Reproductive technologies such as in vitro fertilization (IVF), which can produce multiple eggs that, if fertilized, result in multiple fetuses
- Ovulation or fertility-stimulating medications, such as serophene or clomifene citrate, which may produce multiple eggs at once
Risks of Multiple Pregnancies
Multiple pregnancies are typically considered high risk, due to the many health issues and complications these pregnancies can present. Some common risk factors that may be associated with multiple pregnancies include:
- Premature labor and birth
- Gestational diabetes
- Low birth weight
- Preeclampsia, or pregnancy-induced hypertension
- Miscarriage or fetal loss
- Underdeveloped lungs in the infant
- Abnormal discharge of amniotic fluid
- Birth defects
- Emergency cesarean delivery
- Postpartum hemorrhage
- Heavy blood loss
- Urinary tract infection
Management of Multiple Pregnancies
Multiple pregnancies can be well managed through frequent prenatal visits to monitor health and check for complications. In addition, lifestyle changes such as improvements to nutrition and increased rest are often very helpful. Generally, women who are carrying multiples are advised to gain between 35 and 45 pounds during pregnancy, which is approximately 10 pounds more than the recommendations for a single pregnancy. Testing is required throughout the pregnancy to monitor the health of the fetuses, and may become more frequent if any complications develop.
Premature labor is often a concern for multiple pregnancies. For women beginning to exhibit signs of going into premature labor, medications may be administered in order to stop or slow contractions. These medications can be either taken orally or injected. Corticosteroid injections may also be necessary to promote the maturing of the babies’ lungs if preterm labor occurs.
The approach to delivering multiples will depend on the number of fetuses being carried as well as the overall health of the mother. If the labor cannot be slowed or stopped, an emergency cesarean delivery may be required. If there are no signs of complications, twins can often be delivered vaginally. However, when a woman is delivering more than two babies at once, a caesarean section is almost always necessary.
Risks for Children of Multiple Pregnancies
Multiple pregnancies can impact the health of the babies in a variety of ways. In some cases, the medical issues it causes are permanent, but in other instances they may resolve as the child grows up. Among the chief concerns during a multiple pregnancy is delivering the babies prematurely. Infants born prior to 32 weeks of gestation typically face more substantial risks than those carried closer to full term. Children of multiple pregnancies who have been born prematurely often suffer from low birth weight, and are at a higher risk for breathing problems, cerebral palsy, learning disabilities and developmental delays. Multiples born prematurely typically must remain in a neonatal intensive care unit for some time after birth to receive specialized care.