Twin Pregnancy FAQ

Discovering that you're pregnant with twins is exciting but also quite overwhelming. Because twin pregnancies carry additional risks and precautions, you likely have many questions.

What's different about a twin pregnancy?

The experience of a twin pregnancy can be very different for some women. In some cases, women who are pregnant with twins experience enhanced pregnancy symptoms such as nausea, fatigue, or edema (swelling). A a woman who is pregnant with twins is at greater risk for some medical complications, such as preterm labor, preeclampsia, pregnancy induced hypertension (PIH) and gestational diabetes.
What are the signs of twin pregnancy?

While some women report drastic differences in a twin pregnancy, others report no differences from a singleton pregnancy. Some of the most common indicators of multiple births are weight gain, measuring large for gestational age, severe morning sickness, early detection of fetal movement, abnormally High Results on an AFP or Triple Screen Test, extreme fatigue and elevated HcG Levels.

How can I find out if I am having twins?

Ultrasound remains the most reliable way to detect and monitor a multiple pregnancy. The routine use of ultrasound in prenatal care has reduced the number of surprise appearances by twins in the delivery room; most multiples are discovered during the first half of pregnancy. If you have a hunch or suspect that you are carrying twins or more, discuss your feelings with your doctor.

Will I have to go on bed rest?

Bed rest is prescribed in multiple pregnancy as a preventative and precautionary tool. It can provide benefits for both mom and babies, prolonging a pregnancy in danger of preterm labor to a woman whose body is under stress. In 1992, a survey by the National Organization of Mothers of Twins Clubs showed that 70 percent of women expecting multiple births experienced bed rest at some point in their pregnancy. However, times have changed and doctors have become less rigid about sentencing women to bed.

Can there be a hidden twin?

Nearly every pregnant woman considers the possibility that she may be carrying more than one baby. The only way to confirm a twin or multiple pregnancy is by visually identifying the multiple fetuses with ultrasound. If your doctor or caregiver can only see one baby, you're not having twins or multiples. There are some very rare exceptions. Ultrasound provides a picture of the womb, but sometimes the picture can be misleading or misinterpreted, particularly if performed very early in the pregnancy or by an incompetent technician. At twenty weeks, a second fetus would be clearly visible on ultrasound, and the likelihood that there is another baby hidden in the womb is extremely small.

What is vanishing twin syndrome?

Vanishing Twin Syndrome occurs when one of a set of twin fetuses apparently disappears from the womb during pregnancy, usually resulting in a normal singleton pregnancy. One of the fetuses in a twin pregnancy spontaneously aborts, usually during the first trimester; the fetal tissue is absorbed by the other twin, the placenta, or the mother, thus giving the appearance that the twin "vanished." In recent years, enhanced use of ultrasound early in pregnancy has increased the frequency of diagnosis of twin pregnancy. As a result, there has been a heightened awareness of vanishing twin syndrome.

How much weight will I gain?

Women are always worried about how much weight they will gain with any pregnancy, singleton or multiple. Now that you're having twins, the thought of extra weight gain seems scary. Generally, a healthy pregnancy requires that a woman gain 25 to 30 pounds during the nine month gestation period, depending on her body type. But that's for just one baby. Like everything about having multiples, more is required. Doctor recommendations vary, but most women tend to gain about 35 to 45 pounds during a twin pregnancy, with about 10 additional pounds for every additional baby in a higher order multiple pregnancy. However, this is just a guideline so be sure to speak to your doctor about what is appropriate for your body type.

What is the typical gestation for a twin pregnancy?

Generally, twins and other multiples are born earlier than singletons. Research from the National Organization of Mothers of Twins Clubs (NOMOTC) indicates that about half of multiples are born before 36 weeks gestation. There's no way to know exactly when your babies will be born. In some cases, a premature birth can not be avoided. Some doctors feel that thirty-seven or thirty-eight weeks should be considered full-term for twins and will seek to prompt the delivery of the babies at that time.

Are my twins identical or fraternal?

This is one of the first things people want to know about a twin pregnancy. Here are some ways to discover is you're twins are identical or fraternal:

* If you're twins are the same gender, they are identical.
* If you're twins have been diagnosed with Twin-to-Twin Transfusion Syndrome (TTS), they are identical. TTS does not affect fraternal twins.
* If there is a single, shared placenta, it is more likely you're twins are identical.
* If you're twins have been identified as monoamnionic, they are identical. Only identical twins develop with a single, shared amnion.

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