Multiple Pregnancy

What is a Multiple Pregnancy?

A pregnancy can be a singleton pregnancy, where you are pregnant with a single child, or a multiple pregnancy, where you are pregnant with two or more babies. Through a multiple pregnancy, you may have twins (2 babies), triplets (3 babies) or more.

Having three or more babies is called a higher order pregnancy and is rare.

How do Multiple Pregnancies Occur?

During fertilisation, a single egg is released, which fuses with a single sperm and gets implanted into the womb to develop into a foetus. In the case of multiple pregnancies, more than one egg is released. Each of the eggs fuse with a sperm and get implanted into the womb. They grow in a separate placenta and amniotic sac. In some cases, the egg splits after fertilising with a sperm to form two identical embryos. Hence, they look alike and are of the same sex and blood group.

Causes of Multiple Pregnancies

Multiple pregnancies are more likely to occur in women with late pregnancies because more than one egg might get released at a time as a result of hormonal disturbances.

Sometimes, multiple pregnancy may be expected when assistive reproductive techniques such as in vitro fertilisation have been used.

Identification of Multiple Pregnancies

It is important to identify a multiple pregnancy in its early stages. It may be suspected by your doctor if your uterus is growing fast and appears larger than normal and if there is more than one foetal heartbeat. Although some blood tests may suggest a multiple pregnancy, an ultrasound scan is ordered in the first trimester (12 weeks) to confirm the pregnancy and also determine the presence of multiple or single placenta and amniotic sacs.

Management of Multiple Pregnancies

During a multiple pregnancy, you need to take extra care of yourself and your babies. You should have:

  • Frequent check-ups: Frequent visits to the doctor are often recommended to monitor your babies’ growth, your health, and to check signs of preterm labour.
  • Healthy nutritious diet: You should increase the amount of folic acid, calcium, iron and proteins in your diet. You may take vitamin and iron supplements as per your doctor’s recommendation.
  • More weight gain: A gain of about 16 to 20 kilograms throughout your pregnancy is recommended if you have a multiple pregnancy. Gaining the appropriate weight helps support your babies’ health.
  • Precautions: As pregnancy progresses, you should refrain from certain activities which may cause strain such as excessive work, travel or strenuous exercise.

It is important that you remain aware of possible complications in a multiple pregnancy. High blood pressure is more likely and when it occurs in combination with proteinuria (protein in the urine), it is called preeclampsia, which is a serious complication. There is also an increased risk of pre-term labour which may lead to complications such as low birth weight, breathing difficulty, underdeveloped organs, learning and developmental problems in the babies. Most women having multiple pregnancies need a C-section delivery. Therefore, discuss with your doctor and get prepared mentally as well as physically for a C-section.

If you have a multiple pregnancy, regular medical visits, a proper diet and following the instructions of your obstetrician can help you have a safe and successful delivery.

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