Twin Pregnancy – Signs, Complications, Tips, and More

Does your baby bump look bigger than others? Well, you may be carrying twins (or even multiples)!

Being pregnant with more than one baby brings you a lot of excitement and pleasure, but it also puts you and your babies at higher risk of certain pregnancy-related complications. However, with proper prenatal care and adequate knowledge related to delivering twins, you can significantly increase your chances of enjoying a safe and healthy twin pregnancy.

If you’re having twins or multiples, here’s everything you wanted to know about twin pregnancy, including its reasons, signs, ways to confirm, complications, and tips to stay healthy.

Let’s start by finding out how multiple pregnancies occur.

What Factors Increase the Chances of Twin Pregnancy?

While sometimes a twin pregnancy just “happens,” a few of the likely factors that could increase your chances of having twins or multiples are:

#Fertility Treatments

Assisted Reproductive Techniques (ART), such as IVF, GIFT, ZIFT, and multiple embryo transfer, may lead to twins.

#Maternal Age:

After 30 years of age, the likelihood of releasing more than one egg from the ovary increases, maximizing the chances of twin pregnancy.

#Higher Body Mass Index (BMI):

An over-average height with a BMI above 25 or higher increases the probability of getting pregnant with twins.

#Family History

Having “the twin gene” or being already a mom to twins makes you more susceptible to having a fraternal twin birth.

#Conception While Breastfeeding or On Contraceptive Pills

Hormone imbalance may increase the odds of twin pregnancy.

Top 5 Weird Signs of Twin Pregnancy

In addition to common early pregnancy signs and symptoms, women who are pregnant with twins or multiples may experience the following symptoms:

#Uterus Larger Than Date

If your uterus is stretching and expanding more rapidly than expected, twin gestation may be suspected. Also, you’re likely to gain more weight because having multiple babies in the womb has a significant impact on a woman’s body. Consequently, you tend to outgrow your regular clothes and require maternity wear soon.

#Elevated β-hCG or AFP Levels

The abnormally increased or accelerated levels of β-hCG, a hormone produced during pregnancy, in the blood or urine, are one of the early signs of multiple pregnancies. Besides, if your AFP (Alpha-fetoprotein) test is positive or unusually high, your chances of having more than one baby are significantly higher.

#Severe Morning Sickness

Because of rising levels of several pregnancy hormones, you may experience Hyperemesis Gravidarum, the most severe form of morning sickness, during the first two weeks of pregnancy. Several studies show that women with multifetal gestation usually experience extreme morning sickness than women with a singleton pregnancy.

#Extreme Breast Tenderness

A significant soreness and tenderness in your breasts is another common sign of a twin pregnancy. Around the sixth week, you may also experience an increased pigmentation of the areolas, around the nipples. This happens due to elevated levels of pregnancy hormones because your breasts are working overtime to get prepared for feeding two babies rather than just one.

#Frequent Urination

Although this is a common early sign of pregnancy, carrying twins can cause you to pass urine a lot more frequently due to rising levels of the β-hCG hormone. When you have a twin pregnancy, the pressure exerted by the abnormally growing uterus on the bladder increases your need to go to the bathroom.

How to Confirm Your Twin Pregnancy?

While you can always look for signs and symptoms (like the ones listed above) for a twin pregnancy, you can also take advantage of different medical technologies to confirm a twin pregnancy:

#Ultrasound Scan

An ultrasound scan is the most reliable way to confirm a twin or multiple pregnancies. The optimal time for diagnosis is during the early second trimester.

#Clinical Evaluation

Careful examination with a stethoscope or fetoscope can identify two distinct heartbeats between 18 and 20 weeks of pregnancy. Palpating (examining by touch) two fetal heads can also confirm twins.

#Doppler Heartbeat Count

Towards the end of the first trimester, your doctor may carry out Doppler ultrasonography to detect more than one heartbeat. However, results generated by a Doppler system are less accurate than ultrasound as it is difficult to distinguish individual heartbeats.

#Magnetic Resonance Imaging (MRI)

In rare circumstances, your doctor can use MRI in case the diagnosis is not possible through an ultrasound scan. Since an MRI uses a magnetic field, it may not be advisable in pregnancy, and you must consult your doctor about any possible side effects.

Twin Pregnancy and Its Complications

No pregnancy is entirely free of risks, and the same applies to twin pregnancy. With twins, you’re at higher risk for:

#Premature Delivery:

Over 60% of twins and almost all higher-order gestations are premature. Usually, the higher the fetus’s count in the uterus, the greater the risk of preterm birth.

#Low Birth Weight (LBW):

More than half of twins and multiples are born with low birth weight, weighing on average 5.1 pounds. They are at increased risk of health issues and may need help feeding, breathing, staying warm, and fighting infection after birth.

#Growth Problems in the Fetus:

In a twin pregnancy, one baby could be smaller than the other. This is called Intrauterine Growth Restriction (IUGR) and affects the growth rate of the smaller baby.

#Congenital Disabilities:

In multiple pregnancies, babies are at increased risk of congenital anomalies like spina bifida, heart, and gastrointestinal disabilities.

#Twin to Twin Transfusion Syndrome (TTTS):

It’s a condition in which two babies share a placenta, allowing one baby to get too much blood while the other gets too little. TTTS affects about 15% of identical twins.

#Neonatal Death:

Preterm twins are likely to die within the first month of their birth, and they often need neonatal intensive care unit (NICU) to survive.

#Intrauterine Fetal Loss:

It refers to the death of one of the two fetuses inside the uterus. The doctor then removes the demised fetus from the womb surgically.

#Anemia:

A lack of healthy red blood cells due to the shortage of iron in the body leads to anemia. The doctor usually adds iron supplements to your diet in such a case.

#Too Much or Too Little Amniotic Fluid:

Polyhydramnios (excess amniotic fluid) and oligohydramnios (too amniotic fluid) are common problems faced by moms carrying multiples, especially twins with TTTS.

#Gestational Diabetes:

Due to increased insulin resistance by the placenta, the risk of gestational diabetes is also higher with twins or multiples.

#Cesarean Delivery:

Abnormal fetal positions increase your risk of complications during labor, requiring you to deliver by Cesarean section.

#Postpartum Hemorrhage and Depression:

Over-distended uterus, large placental area, and hectic post-birth schedule increase the chances of heavy bleeding and depression after childbirth.

Tips for Healthy Twin Pregnancy

#Find the Right Healthcare Provider

First of all, it’s crucial to find a healthcare provider with profound experience and expertise in delivering twins and multiples. They’ll be able to answer your all twin pregnancy-related questions and also offer the appropriate advice and care.

#Eat Healthy and Eat for Three

When you’re carrying twins, your nutritional needs are quite different from having a single baby. You need to follow a nutritious pregnancy diet and drink plenty of fluids to ensure your little ones are getting all the essential nutrients required for healthy growth and development.

#Stay Active as Much as You Can

Rest is essential when you’re pregnant with twins, but staying active throughout the pregnancy will reduce your risk of gestational diabetes and prepare your body to combat labor pain. To keep your muscle toned and keep them ready for labor, you can try pregnancy-friendly exercises such as prenatal yoga and swimming.

#Prepare Well in Advance

Given that 60% of women having twins deliver before 37 weeks, you should get ready early because you may go into labor earlier. Once you’re over 30 weeks, make a hospital bag checklist and have your cell phone at arm’s length. Factually, the more babies you carry, the earlier you’re likely to deliver.

#Stay Positive

Having twins does not necessarily mean twice the worry, hence stay positive to keep up your energy. Read self-help books offering plenty of tips and advice regarding twin pregnancy. Talk with other moms who have twins learn from their experiences. A twin pregnancy can make you anxious, but with intelligence, you can overcome stress.