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Twin Pregnancy

Overview

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Twin pregnancy occurs when a woman carries two fetuses simultaneously. It can happen with identical twins (monozygotic), formed from a single fertilized egg that splits into two, or fraternal twins (dizygotic), resulting from two separate eggs fertilized by two sperm. Twin pregnancies can lead to increased risks and complications for both the mother and the babies.

It can happen with identical twins (monozygotic), formed from a single fertilized egg that splits into two, or fraternal twins (dizygotic), resulting from two separate eggs fertilized by two sperm. Twin pregnancies can lead to increased risks and complications for both the mother and the babies.

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Symptoms
  • Increased Weight Gain: More pronounced than in a singleton pregnancy.
  • Greater Abdominal Size: A visibly larger belly earlier in the pregnancy.
  • More Pronounced Pregnancy Symptoms: Such as nausea, fatigue, and mood swings.
  • Increased Fetal Movements: Mothers may feel more movement due to two active fetuses.
  • Shortness of Breath: As the uterus expands, it can put pressure on the diaphragm.
Complications
  • Preterm Birth: Higher likelihood of delivering before 37 weeks.
  • Gestational Diabetes: Increased risk during pregnancy.
  • Preeclampsia: A condition characterized by high blood pressure and potential organ failure.
  • Placenta Previa: A condition where the placenta covers the cervix, leading to complications during delivery.
  • Low Birth Weight: Twins are often born with lower weights than singletons, increasing health risks.
  • Twin-to-Twin Transfusion Syndrome (TTTS): A condition in identical twins where blood flow is unbalanced, leading to complications.
Causes

Several Factors can Increase the Likelihood of Having Twins, Including

  • Family History: A genetic predisposition to hyperovulation can increase the chances of fraternal twins.
  • Age: Women over 30, particularly those in their 30s and 40s, have a higher chance of conceiving twins.
  • Previous Pregnancies: A history of twins increases the likelihood in future pregnancies.
  • Fertility Treatments: Use of medications or assisted reproductive technologies can increase the chances of multiple births."
Prevention
  • There is no Reliable Way to Prevent a Twin Pregnancy, as it is Largely Influenced by Genetic and Biological Factors. However, Maintaining Overall Reproductive Health and Discussing Any Concerns with a Healthcare Provider can be Beneficial.
Risk Factors
  • Genetic Factors: A family history of twins, particularly on the mother’s side.
  • Increased Maternal Age: Older women have a higher chance of producing multiple eggs.
  • Obesity: Higher body mass index (BMI) can be associated with an increased likelihood of twin pregnancies.
  • Certain Ethnic Backgrounds: Some populations have higher rates of twinning (e.g., African descent).
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How is it treated?

Management Of Twin Pregnancies Typically Involves

  • Regular Monitoring: More frequent prenatal visits and ultrasounds to monitor fetal growth and development.
  • Nutritional Support: Emphasis on a balanced diet rich in nutrients to support two growing fetuses.
  • Monitoring for Complications: Close observation for signs of preterm labor, gestational diabetes, and other potential complications.
  • Planning for Delivery: Discussions about delivery options, as twins can be delivered vaginally or via cesarean section depending on their position and health.
  • Early prenatal care and regular monitoring are crucial for optimizing outcomes in twin pregnancies, ensuring both maternal and fetal health are prioritized throughout the pregnancy.
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How is it Diagnosed?

Twin pregnancy is commonly diagnosed during prenatal care, with early detection often occurring through routine ultrasonography. The first indication may arise from clinical suspicion when the uterus appears larger than expected for gestational age during physical examination. Confirmation is typically achieved through a transvaginal or abdominal ultrasound, which can detect the presence of two gestational sacs, embryos, or fetal heartbeats as early as 6 weeks of gestation.

Ultrasound also helps determine chorionicity (number of placentas) and amnionicity (number of amniotic sacs), which are vital in managing twin pregnancies. Monochorionic twins share one placenta, increasing the risk of complications such as twin-to-twin transfusion syndrome. Serial ultrasounds are performed throughout the pregnancy to monitor fetal growth, development, and amniotic fluid levels.

Blood tests, including elevated human chorionic gonadotropin (hCG) and alphafetoprotein (AFP), may also suggest multiple gestation but are nonspecific. Doppler ultrasound and fetal echocardiography may be used in high-risk cases to assess fetal well-being. In later stages, maternal symptoms like excessive weight gain, severe nausea, or feeling multiple fetal movements may prompt further investigation. Early diagnosis is critical for planning appropriate antenatal care, timing of delivery, and managing potential complications.

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I have twins. Dr. Payal Modi's support and diagnosis have been great. She has been very supportive for 9 months. She is no less than God for me.

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Best maternity hospital....Dr. Nishi Makhija is my doctor for both the deliveries...n she is world's best doctor .....Thanks Tirath ram hospital for the beautiful lifetime memories....

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