Multiple pregnancies refer to instances where a pregnancy has more than a single live foetus. The most common cause of multiple pregnancies is the use of IVF treatments or fertility drugs, but can also occur from natural conception. Since the mother is called upon to care for the well being all the babies in the pregnancy, complications can arise and often this can lead to issues like high blood pressure, miscarriages, premature delivery, diabetes etc. In some instances, one or perhaps all the babies in multiple pregnancies may experience congenital defects.
The best way to avoid complications with multiple pregnancies is to take utmost care. It should also be emphasized that many babies are born as twins or multiple siblings without any health issues mainly because there were no complications when these babies were conceived, and the mother was also very careful with her health and the pregnancy throughout the tenure.
What are the symptoms of multiple pregnancies?
The following are broadly the symptoms of multiple pregnancies:-
-Higher level of hCG
-Abnormal results from AFP test
-Larger measurement for the gestational age
-Enhanced morning sickness
-Frequent or early movement of the foetus
While you can use a pregnancy test kit at home to confirm pregnancy, you will need the services of an obstetrician to confirm whether you are carrying multiple pregnancies or not.
Ultrasound test helps the doctor check the number of babies in the uterus and the condition of the babies. The doctor may also advise more ultrasounds to track the development of the babies. It is safer to get an ultrasound test done during the early days of pregnancy itself so that the mother can take all the additional precautions if it is detected that she is carrying multiple pregnancies.
Your obstetrician can detect the heartbeat of the babies with the help of a foetal Doppler. This is done during the fag end of the first trimester. A heart beat monitor is helpful in detecting the condition of the babies.
Human chorionic gonadotrophin or hCG level
Pregnant women are expected to have an enhanced level of hCG across the nine months before the baby is delivered. The blood, as well as the urine of a pregnant woman, will carry this hormone. While the presence of the hormone is not a definite pointer towards multiple pregnancies, it serves as a signal to see your obstetrician/gynaecologist.
The distance between the pubic bone of the mother and the top edge of her uterus is referred to as the fundal height. In multiple pregnancies, it is expected that the uterus will be more stretched to accommodate the additional foetus and thus increase the fundal height.
When a pregnant woman has twins in the uterus, an additional 10 pounds of weight is usually expected for the stretched uterus. This additional weight is higher compared to a woman with a single baby in the uterus. However, during pregnancy, weight gain can also happen due to a variety of other factors.
Causes of multiple pregnancies
Multiple pregnancies can be caused by a single egg cell or different egg cells. Babies coming from the same egg (fertilized by a singular sperm cell) are known as identical twins. In this case, the fertilized ovum has multiplied into two zygotes. Identical twins can also be all males or females. The genes and physical characteristics of this type of twins tend to be same. They will also look very similar though they would still have features that distinguish them from one another. Their fingerprints too would be different.
Fraternal twins, on the other hand, come from two different egg cells with different sperm cells fertilizing them. Fraternal twins can either be both male and both female or one male and one female.
Multiple pregnancies can also mean more than two foetuses. In such an instance, three foetuses would be called triples, quadruplets meaning 4, quintuplets denoting five, and the list goes on. While more than two foetuses are rare, there are indeed instances of even six babies in a single delivery and the coming of fertility drugs is often reckoned as a major cause of multiple pregnancies with more than two healthy foetuses.
Most multiple pregnancies also tend to complete the full term of 39 weeks, and most of the twin babies are delivered around the 37th week or earlier.
Some of the major causes that lead to multiple pregnancies include:-
-Above 35 years of age
-Taking fertility drugs prescribed by your doctor
-In vitro fertilization
-Family tradition of twins
-Withdrawing birth control pills
Fertility drugs, in particular, induce production of more eggs before the start of ovulation increasing chances of multiple eggs being fertilized. Similarly, in the case of in-vitro fertilization, the woman may receive more fertilized eggs in her uterus to enhance the chances of having one or perhaps more offsprings
Risks and challenges associated with multiple pregnancies
Some of the challenges and risks associated with multiple pregnancies include:-
-Miscarried or vanishing twin
-Low birth weight
-IUGR or intrauterine growth restriction
Carrying multiple pregnancies can be pretty overwhelming. It would also mean twice the challenge as well as fun. Pregnancy is also the best time to keep yourself healthy. You should also remember that including you, the well being of three or more lives is dependent on your nourishment.
The following are some of the measures that will keep you in good stead:-
1. Balanced diet: consume more fruits and vegetables including food rich in iron, folic acid, and calcium. These are important nutrients essential for the development of your babies.
2. Stay free from all vices including alcohol, drugs and cigarettes
3. Do devote attention to adequate rest, but don’t forget the importance of some exercise at intervals
4. Do not skip your appointment with the doctor
5. According to Dr Shelley (maternal fetal medicine specialist), always rely on medicines prescribed by your obstetrician and avoid OTC drugs
6. Take your doctor into confidence and always seek his/her opinion even on small issues like a specific food, an unusual uneasiness etc.