Pregnancy and Birth › Multiple Pregnancy
Multiple Pregnancy
A multiple pregnancy differs from a singleton in more than the number of babies; the frequency of monitoring, the risks watched for and the birth plan are all different. Multiple pregnancies are therefore placed on a separate monitoring programme from the outset.
The first and most important question: how many placentas
In a twin pregnancy the most decisive piece of information is whether the babies have separate placentas. This is determined most accurately by ultrasound in the first three months and governs the whole of the subsequent plan.
Twins sharing a single placenta are monitored more frequently, because an imbalance in blood flow between them (twin-to-twin transfusion) can develop.
The monitoring programme
- Examinations and scans are more frequent than in a singleton pregnancy
- Twins sharing one placenta are usually scanned every two weeks
- The growth of each baby is followed and compared separately
- Cervical length is measured to assess the risk of preterm birth
- Blood pressure, anaemia and glucose are monitored more closely in the mother
Increased risks
- Preterm birth — the commonest problem in multiple pregnancy
- Pre-eclampsia
- Gestational diabetes
- Anaemia
- A difference in growth between the babies
- Postpartum haemorrhage
Advice for the mother
- Higher doses of iron and folic acid may be required
- Adequate protein and calorie intake matters
- Building rest periods into the daily routine
- Learning the signs of preterm labour: regular tightening, back pain, loss of fluid
- Limiting long journeys and heavy work
The birth plan
The mode and timing of birth are determined by the placentation, the position and growth of the babies and the mother's health. Birth in a multiple pregnancy is planned in a hospital with neonatal intensive care facilities.
