05 Aug Twin pregnancy Q&A’s

I am pregnant and my doctor has just diagnosed on ultrasound that I am carrying twins! I am excited but also a little nervous as I have heard that extra care is needed to have healthy babies in twin pregnancies?

A twin pregnancy is a double blessing, but it can also carry greater risks than singleton pregnancies.Achieving optimal and good pregnancy outcomes in a twin pregnancy are the desired goals of antenatal programmes worldwide. The best thing that the pregnant woman can do is to take care of herself to stay healthy. We recommend that you

• Go for your obstetrician appointments at regular & frequent intervals.
• Get the antenatal blood & urine tests done regularly for early detection of problems and their appropriate management.
• Eat a healthy diet and the iron, calcium and vitamin supplements as prescribed by your obstetrician.
• Take plenty of rest and talk to your doctor about what activities are okay.
• Get babies monitored regularly by physical exams + ultrasound assessments as advised.

What are the risks of a multiple pregnancy?

Any pregnancy has some risks, however having twins does mean that some of the problems that pregnant women face may get magnified in women with twins . The problems of early pregnancy like nausea/vomiting may be more troublesome and the miscarriage risk is higher in twin pregnancy.

The babies need to be checked carefully to rule out birth defects and chromosomal problems as these tend to increase in twin pregnancies. The babies may also show slowing of growth from mid pregnancy and need to be monitored for this.

The pregnant woman with twins needs careful monitoring to detect development of anemia, of high blood pressure and preeclampsia as well as ‘diabetes in pregnancy’ (Gestational Diabetes).

However the greatest risk to the babies is from higher chances of premature labour and preterm birth in twin and higher order pregnancies. When babies are born too early, their organs haven’t had a chance to fully form. This can cause serious lung, brain, heart, and eye problems. Prevention and effective treatment of premature birth is the major goal of management of twin pregnancies. Women with twin pregnancies should be cared for by specialist senior obstetrician in a hospital with facilities for safe delivery of the mother and baby( advanced NICU facility for care of preterm babies).

How does ultrasound assessment of pregnancy help in twin gestation?

Ultrasound assessment of twin pregnancy is a must in improving outcomes for both mother and baby. Ultrasound determination of chorionicity ( whether babies share a placenta or have separate placentas) establishes the pattern of antenatal care needed as babies who share a placenta( monochorionic) have a higher chance of complications than babies who have their own placentas (dichorionic). Ultrasound is also used

• to diagnose birth defects ,screening for chromosomal abnormalities
• to check growth and well being of babies as well as chances of preterm labour
• position of placentae and position of babies in the womb.

The sonographer must be specially trained to perform ultrasound scanning in twins to pick up problems specific for twin pregnancies.

To summarise, twin and higher order multiple pregnancies need special attention in a hospital well equipped to deal with the unique challenges posed by twin and other multiple pregnancies.  You can meet our gynaecologist in Gurgaon for more queries and consultation.