8 months pregnant with triplets

Pregnant with Triplets: What to Expect

Medically reviewed by Valinda Riggins Nwadike, MD, MPH — By Emily Kopp on September 19, 2018

Expecting triplets

Fertility treatments have made multiple births more common in recent years. That means triplets are no longer a rarity.

Doctors still consider being pregnant with multiples high-risk. But there are straightforward, simple things that expectant moms can do to stay comfortable and well.

Here’s how to increase your chances for a healthy triplet pregnancy.

Pick your team

For starters, pick a good doctor and medical team. They’ll become your new best friends for the next few months.

Women pregnant with triplets should expect to see their doctor every two weeks, says Dr. Dimitry Zilberman, a practicing obstetrician and gynecologist in Danbury, Connecticut.

This will continue until your fetuses reach 24 weeks. After that, it’s a doctor visit once a week until delivery.

Eating for four?

Doctors may prescribe supersized prenatal vitamins, extra folic acid, or iron pills to make sure moms-to-be are getting enough nutrients.

The amount of extra calories you’ll need depends on how active you are. Moms of multiples may need up to 600 extra calories a day to gain the appropriate amount of weight. But your doctor might recommend a lot less, depending on your circumstances.

That was the case for Rupal Shah when she was pregnant with triplets in 2010. She had acid reflux that left her unable to eat much. Her doctors told her to eat whatever she could tolerate and leave it at that.

She gained 20 pounds during the pregnancy. Her babies were born healthy at 32 weeks.

Symptoms of pregnancy

In many respects, moms of triplets will have more intense symptoms during pregnancy. They’re more likely to feel exhausted and sense the growth within their bodies sooner.

Maria Damjan, a mother of 2-year-old triplets and a 4-year-old girl, says she felt her uterus expanding the day she found out about her triplet pregnancy.

She remembers needing maternity clothes at week eight. That was about three months earlier than she needed them with her first child.

Many women also retain water, particularly in their ankles.

“I was literally, waist down, a big bowl,” Shah says. She remembers the swelling being so painful that she would not let anyone touch her. Showers gave her temporary relief.

Water retention is normal. But it can also be a sign of preeclampsia, a life-threatening condition. That’s one of the reasons why doctors monitor multiple pregnancies so carefully.

Exercising while pregnant

Zilberman says women who are carrying triplets can go about their regular daily routines, as long as they’re comfortable.

Exercise should be fine, but get your doctor’s approval first. Some women choose to wear maternity belts for extra support. You may need to take frequent breaks from activity.

“Listen to your body,” Zilberman says. “If you are short of breath or the movement is very difficult, go from running to biking or walking. ”

One of his patients, Laurena Liu, stopped running around 18 weeks into her pregnancy. But she recalls taking a spin class the day she went to the hospital. She recommends women who are pregnant with triplets stay active for as long as they can.

“It helps to make the entire pregnancy comfortable and recovery faster,” she says. “That said, don’t overdo it. I was so bummed that I could no longer run, but I had to think about what’s best for the babies, not just myself.”

Bed rest with triplets

Zilberman doesn’t recommend bed rest for the majority of his patients. But he admits that it’s a controversial topic among high-risk pregnancy doctors.

Damjan’s doctor ordered her to go on bed rest at 20 weeks out of an abundance of caution. Damjan, who describes herself as a health nut, says she was used to exercising regularly. But she was 47 years old and had suffered two miscarriages before. She didn’t want to take any chances.

She spent the next 15. 5 weeks on bed rest, and the final three weeks at the hospital. Two of her babies went home from the hospital with her. The third one stayed in the NICU for just a few days.

Risk factors with triplets

If you are considering undergoing in vitro fertilization (IVF) or another fertility treatment, talk to your doctor about the risks of delivering multiples before you get pregnant.

About 20 percent of triplet pregnancies result in the delivery of one child with a major long-term disability. Talk to your doctor about how you can stay healthy throughout pregnancy and delivery.

The takeaway

Any pregnancy comes with its share of jitters. Considering the heightened risks, it’s no surprise that moms of multiples might feel especially anxious.

Two doctors recommended that Damjan reduce her pregnancy to one fetus, something she did not want to consider.

Then she found a specialist. With careful monitoring, he told her that he believed she could carry three babies safely. His team became her champions, she says. She drew strength from their confidence.

Shah remembers getting aggravated during her pregnancy because of the physical discomfort. She did breathing exercises and listened to Indian hymns to relax.

“The best advice I ever got was to keep calm, relax, and enjoy the moment,” she says. “There’s a light at the end of the tunnel. It’s so worth it the minute you deliver and you see your children.”

Last medically reviewed on September 19, 2018

Parenthood
Pregnancy
2nd Trimester

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Damjan M. (2015). Personal interview.
Liu L. (2015). Personal interview.
Mayo Clinic Staff. (2018). Twin pregnancy: What twins or multiples mean for mom.
mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/twin-pregnancy/art-20048161?pg=2
Multiple pregnancy and birth: Twins, triplets, and high-order multiples. (2012).
reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/multiple-pregnancy-and-birth-twins-triplets-and-high-order-multiples-booklet/
Shah R. (2015). Personal interview.
Zilberman D. (2015). Personal Interview.

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Share this article

Medically reviewed by Valinda Riggins Nwadike, MD, MPH — By Emily Kopp on September 19, 2018

Pregnant with Triplets: What to Expect

Medically reviewed by Valinda Riggins Nwadike, MD, MPH — By Emily Kopp on September 19, 2018

Expecting triplets

Fertility treatments have made multiple births more common in recent years. That means triplets are no longer a rarity.

Doctors still consider being pregnant with multiples high-risk. But there are straightforward, simple things that expectant moms can do to stay comfortable and well.

Here’s how to increase your chances for a healthy triplet pregnancy.

Pick your team

For starters, pick a good doctor and medical team. They’ll become your new best friends for the next few months.

Women pregnant with triplets should expect to see their doctor every two weeks, says Dr. Dimitry Zilberman, a practicing obstetrician and gynecologist in Danbury, Connecticut.

This will continue until your fetuses reach 24 weeks. After that, it’s a doctor visit once a week until delivery.

Eating for four?

Doctors may prescribe supersized prenatal vitamins, extra folic acid, or iron pills to make sure moms-to-be are getting enough nutrients.

She gained 20 pounds during the pregnancy. Her babies were born healthy at 32 weeks.

Symptoms of pregnancy

In many respects, moms of triplets will have more intense symptoms during pregnancy. They’re more likely to feel exhausted and sense the growth within their bodies sooner.

Maria Damjan, a mother of 2-year-old triplets and a 4-year-old girl, says she felt her uterus expanding the day she found out about her triplet pregnancy.

She remembers needing maternity clothes at week eight. That was about three months earlier than she needed them with her first child.

Many women also retain water, particularly in their ankles.

“I was literally, waist down, a big bowl,” Shah says. She remembers the swelling being so painful that she would not let anyone touch her. Showers gave her temporary relief.

Water retention is normal. But it can also be a sign of preeclampsia, a life-threatening condition. That’s one of the reasons why doctors monitor multiple pregnancies so carefully.

Exercising while pregnant

Zilberman says women who are carrying triplets can go about their regular daily routines, as long as they’re comfortable.

Exercise should be fine, but get your doctor’s approval first. Some women choose to wear maternity belts for extra support. You may need to take frequent breaks from activity.

“Listen to your body,” Zilberman says. “If you are short of breath or the movement is very difficult, go from running to biking or walking.”

Bed rest with triplets

Zilberman doesn’t recommend bed rest for the majority of his patients. But he admits that it’s a controversial topic among high-risk pregnancy doctors.

She spent the next 15.5 weeks on bed rest, and the final three weeks at the hospital. Two of her babies went home from the hospital with her. The third one stayed in the NICU for just a few days.

Risk factors with triplets

If you are considering undergoing in vitro fertilization (IVF) or another fertility treatment, talk to your doctor about the risks of delivering multiples before you get pregnant.

About 20 percent of triplet pregnancies result in the delivery of one child with a major long-term disability. Talk to your doctor about how you can stay healthy throughout pregnancy and delivery.

The takeaway

Any pregnancy comes with its share of jitters. Considering the heightened risks, it’s no surprise that moms of multiples might feel especially anxious.

Two doctors recommended that Damjan reduce her pregnancy to one fetus, something she did not want to consider.

Shah remembers getting aggravated during her pregnancy because of the physical discomfort. She did breathing exercises and listened to Indian hymns to relax.

Last medically reviewed on September 19, 2018

Parenthood
Pregnancy
2nd Trimester

How we reviewed this article:

Damjan M. (2015). Personal interview.
Liu L. (2015). Personal interview.
Mayo Clinic Staff. (2018). Twin pregnancy: What twins or multiples mean for mom.
mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/twin-pregnancy/art-20048161?pg=2
Multiple pregnancy and birth: Twins, triplets, and high-order multiples. (2012).
reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/multiple-pregnancy-and-birth-twins-triplets-and-high-order-multiples-booklet/
Shah R. (2015). Personal interview.
Zilberman D. (2015). Personal Interview.

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Share this article

Medically reviewed by Valinda Riggins Nwadike, MD, MPH — By Emily Kopp on September 19, 2018

The story of a family who had triplets in 2022 without IVF, although the doctors said that there would be no children | Chita.ru

A woman could not get pregnant for a long time, and then she gave birth to triplets

Photo: Irina Sharova / 72.RU

Vladlena and Andrey Boboshko from Tyumen could never even imagine that they would become the parents of triplets. The couple dreamed of having at least one baby. But for a long time they did not succeed. Vladlena had already come to terms with the fact that she would not become a mother, but a week before the wedding, the doctors stunned her, reporting a multiple pregnancy. And at first, doctors suspected that in the stomach of our heroine there were not even three, but four babies. Before you hear this amazing story from our colleagues at 72.RU, we note that Vladlena did not do IVF. nine0003

The couple was preparing for the wedding when they found out that they would soon become parents

Photo: Vladlena Boboshko

Vladlena had long wanted to become a mother, but because of health problems, doctors did not encourage her. They said that most likely nothing would work. But the woman herself did not leave the dream and was looking for new doctors. So she met a doctor, about whom mothers say: “Yes, after him everyone gets pregnant.” He prescribed hormonal therapy for the patient and gave some recommendations. During the next scheduled appointment, Vladlena came for an ultrasound scan, but several fibroids were found in her. The woman was upset and decided not to try to get pregnant again. And she resigned herself to the idea that she would not give her future husband children. Beloved, seeing the suffering of Vladlena, supported her. nine0003

Just a little bit more and the video will load

Video: Mikhail Petelin / 72. RU

— Then suddenly I started having health problems. There were signs of pregnancy: nausea, aversion to food, and so on. But even after that, I didn't think I was pregnant. After all, I recently visited doctors and they said that, unfortunately, this is impossible, ”says Vladlena. - One fine morning, when I felt bad again, it dawns on my husband: “Honey, you’re pregnant!”

Vladlena denied it at first, but then decided to take a pregnancy test. One showed a positive result, the other did not reveal anything, and the third was with one stripe and a small manifestation of the second.

— It was all on the eve of the wedding. We decided to have an ultrasound just in case. Well, suddenly the test showed a false pregnancy? This kind of thing happens too. We went to the clinic after work. Vladlena went to the examination, and I stayed in the car. She was gone for about an hour and a half. And immediately thought that yes, pregnant. After all, if not, they would immediately let her go! - Andrey Boboshko, the husband of our heroine, says with a smile on his face. nine0003

Vladlena got married while pregnant. On the day of the wedding, she had a terrible toxicosis. But this did not spoil the holiday, because a miracle happened in the couple's life

Photo: from the archive of Vladlena Boboshko

— I was on an ultrasound, and the doctor said: "I see three eggs." I thought about everything, but not about pregnancy. Then everything was explained to me. The doctor also couldn't believe that everything had worked out. The ultrasound went on for over an hour. I remember how I was lying, and tears were flowing down my face, ”recalls Vladlena. - The medic could not catch the angle the first time to count all the kids. She began to count them: "One, two, three ... And what is this, is it really the fourth?" And at that moment I got scared and prayed that she was wrong. And in the end, there really were three children. nine0003

Vladlena recalls that she was afraid to go out to her husband. It took me a long time to find the words to tell him the good news. As a result, with tears in her eyes, she handed over an ultrasound picture.

Three dots were drawn there. I thought that it was just photographed, and I began to imagine, I said to Vladlena: “Is this a head, arms and legs?” And she replied that it was like triplets. Words cannot express how happy I was, - Andrey Boboshko said. - On this day, I went to my friends to celebrate, because I was very happy. And the beloved remained at home crying, she was very excited. nine0003

— I was very afraid of my husband's reaction. I was in shock myself, - Vladlena laughs. But he was just blown away with happiness. I have never seen him so happy in my life.

Vladlena calls her pregnancy the most terrible period in her life

Photo: Vladlena Boboshko

The couple's parents reacted to the news of the triplets in different ways. In order not to immediately shock future grandparents, Vladlena and Andrey first said simply about pregnancy. And only then they clarified that there would be three grandchildren at once. The husband's parents were delighted and immediately began to plan how they would help a young large family. But Vladlena’s mother at first jumped for joy and clapped her hands, and then sat down in a chair and said: “Poor daughter, how sorry I am for you.” The woman realized that Vladlena would not be easy in the coming months, and therefore took pity on her. nine0003

And my grandmother's expectations came true. It was really hard for Vladlena throughout her pregnancy.

— My whole pregnancy was very difficult. Therefore, I had an idea: I would sooner give birth, and that’s it. Doctors told me: "You will remember this golden time." But this is not the golden age. This is a terrible time! Lately, I've barely moved at all. It seemed to me that the pelvis would crumble. I remember walking to the bank, which is next to the house. If you walk in a normal state, then the road will take a maximum of five minutes. But while I was pregnant with triplets, five people managed to approach me, they wanted to call an ambulance. Because it was so hard for me,” recalls the Tyumen woman. - I slept for two hours. The belly was just huge. They even bought me an air mattress so that I could roll over comfortably. nine0003

Most of all Vladlena was afraid of premature birth. And on March 30, 2022, she came to the hospital for another examination. The doctor noticed severe swelling in the woman. As the heroine herself describes, her ankles were swollen. And so she was immediately sent to give birth. Everything happened so quickly that Vladlena only had time to write a short SMS to her husband.

She was taken to the delivery room and had a caesarean section. And after 15 minutes, two boys and a girl were born in the perinatal center. nine0003

— It was impossible to pull, because there was a threat to one of the kids, — Vladlena explained. - They gave me an injection, I didn’t feel how they cut my stomach. But when they began to get the children out of there, I screamed in hellish pain.

Two brothers on discharge from the hospital. My sister was still in the intensive care unit at that time

Photo: Vladlena Boboshko

Immediately after the birth, the children were sent to the intensive care unit. The boys, Mark and Matvey, were discharged a week later, but Milan stayed in the hospital for a long time. She was the smallest of the trio and weighed only 960 grams. The girl was left under the supervision of doctors so that she could gain the desired weight.

A little later it turned out that the baby was not being discharged due to a more serious health problem.

- At first they told me that Milanochka had tachycardia. I thought that she was not being discharged, because it was tachycardia that was being treated. So I calmed myself down. And when she came to visit her, she was frightened, she was all in tubes. So scary. Then I did not suspect anything terrible. I thought that this is how tachycardia is treated. And only then the doctor said that she had intestinal necrosis. nine0003

The little girl survived intestinal surgery

Photo: Vladlena Boboshko

Intestinal necrosis is a life-threatening condition characterized by the death of intestinal wall tissue. It can occur as a complication of the oncological process, severe inflammation, infection, intestinal obstruction.

This was terrible news. After all, the parents of the babies were told throughout the pregnancy that the children would be healthy - development is going well.

Milana spent some time in the perinatal center. Then the spouses agreed to transfer the baby to OKB No. 2 for surgery. They did not immediately take the girl away, because they realized that she was still too weak. And then, two days later, they still operated on at OKB No. 2, they removed her rotten intestine. The girl was transferred to the ward, where she had to lie alone. Her parents only brought her everything she needed. It had been a few days since she was switched to normal infant formula and she had a bowel failure. nine0003

- Milan was supposed to be discharged on June 10, but there was an intestinal breakdown. She was left in the hospital, - Andriy Boboshko said. - We were immediately told that the gastroenterologist is her main friend in life. Well, be an athlete. On proper nutrition.

But this was not the only problem. The child's nose was burned in intensive care during ventilation. Mom saw redness, but she was assured that it was a small burn that would soon pass without leaving a trace. However, in reality it turned out quite differently - the girl's face was disfigured. Now she has no tip of her nose. nine0003

— The doctor told me that, in principle, the nose is intact. I looked, the nose is really intact. I thought: well, burn and burn. Everyone has burns. I didn’t know what degree the burn was, because it was hidden under a layer of spray. I was calm because my nose was completely intact. Yes, it was red, with a crust, but whole, - says Vladlena.

Every premature baby has such rockets. They are donated by the Charitable Foundation

Photo: Vladlena Boboshko

This is the stroller of the large Boboshko family. When they walk around the yard, all the people turn around

Photo: Irina Sharova / 72.RU

When the child's condition stabilized and it became possible to visit the girl, Vladlena came to her room and was horrified.

— I saw that my daughter was missing part of her nose up to the septum. I was very upset, I asked the doctors who was to blame. But no one could answer. I began to look for third-party doctors to find out how this could happen. She showed a photo with redness when the nose was still there, but already with burns, and what was left after. And the specialist explained to me that such a burn does not occur immediately. In one of the photos, he saw puffiness, which means that the process was already underway and then lasted until the tissue died off, ”the girl’s mother said. nine0003

Milana looks at her favorite toy

Photo: Irina Sharova / 72.RU

According to Milana's mother, no one even apologized for what they did to the girl. And this despite the fact that the child will now have to undergo plastic surgery.

— We consulted doctors. Now only plastic surgery can help Milan. And given that she does not have a nose to the very cartilage, she will have to do plastic surgery every year. We are experiencing. Of course, we love her very much, no matter what nose she has. But we are afraid that this situation will not affect her life in any way, - says Andrei Boboshko. She is still too small for operations. Yes, and so she already had too many in a short time. We think that we will decide on a nose job closer to the kindergarten, so that she feels confident there. nine0003

Mark, Milana and Matvey Boboshko

Photo: Irina Sharova / 72.RU

One of the triplets sneaked into the frame while his brother and sister were dozing in the crib

Photo: Irina Sharova / 9002.RU 9002.RU Share

The family is not going to leave what happened. They have already applied to the police, the Investigative Committee and the prosecutor's office. And then - only the court. The couple want the doctors to answer for their negligence and the spoiled health of the baby.

The health department, where we sent the official request, knows this story. They also got involved in the proceedings.

— Based on this fact, checks are currently being carried out aimed at assessing the quality and safety of care provided to mother and child at the Perinatal Center. Considering that this institution is a medical organization where women with a high degree of risk of maternal and fetal health, who have severe somatic diseases or fetal pathology, give birth, checks are carried out by the competent departments. The situation is still being analyzed, the department said. nine0003

Time will tell whether the perpetrators of what happened will be found. We will follow the development of this story.

Delayed birth of the second and third fetuses in multiple pregnancy with triplets (Clinical case)

HEALTH OF WOMAN. 2016.5(111):148–152; doi 10.15574/HW.2016.111.148

Delayed birth of the second and third fetuses in multiple pregnancy with triplets (Clinical case)

Dubossarskaya Yu. A., Padalko L. I., Zakharchenko L. G., Savelyeva E. A. nine0003

State Institution "Dnepropetrovsk Medical Academy of the Ministry of Health of Ukraine"

KU "Dnepropetrovsk Regional Perinatal Center with a hospital"

The article describes a clinical case of vaginal delivery in a 24-year-old primipara with a delay in the birth of the second and third fetuses during spontaneous multiple pregnancy with dichorionic triamniotic triplets in a perinatal center of the III level of medical care. After preterm birth at 27 weeks and 5 days of gestation with the first fetus to reduce perinatal morbidity and mortality of two more fetuses that remained in the uterus, after the informed consent of the woman, preterm birth with the second and third fetuses occurred with an interval of 38 days at 33 weeks and 1 day of gestation . Careful monitoring of the condition of the mother and fetus was carried out. To increase the interval between the birth of the first fetus, second and third fetuses, prevent obstetric and perinatal complications, tocolysis, antibacterial drugs, progesterone, prevention of neonatal respiratory distress syndrome with corticosteroids, and bed rest were used. Three girls were born alive weighing 980, 1800 and 1950 respectively. Childbirth was complicated by rupture of the perineum of the second degree and retention of the placenta and membranes, the postpartum period was uncomplicated. After 1.5 months, all infants in a satisfactory condition with a body weight of more than 3000 g were discharged home with their mother.

Keywords : multiple pregnancy, triplets, delayed birth of the second and third fetuses, premature birth.

References:

1. Dobrokhotova YuE, Kuznetsov PA, Shchukina AV et al. 2015. New section for the Preterm Birth protocol. Status Praesens. 2(25):119-122.

2. Order of the Ministry of Health of Ukraine No. 205 dated April 8, 2015 "About the approval of the Order of medical aid for women with high vaginess."

3. Arabin B, van Eyck J. 2009. Delayed-interval delivery in twin and triplet pregnancies: 17 years of experience in 1 perinatal center. American Journal of Obstetrics & Gynecology. 200;2:154.e1–154.e8.

4 Tran PL, Desveaux C, Barau G et al. 2015. Delayed-Interval Delivery in Multifetal Pregnancy: A Review and Guidelines for Management. Gynecol. obstet. (Sunnyvale). 5;11:333. nine0003

5. Padilla-Iserte P, Vila-Vives JM, Ferri B et al. 2014. Delayed interval delivery of the second twin: obstetric management, neonatal outcomes, and 2-year follow-up. J. Obstet. Gynaecol. India. 64;5:344–348. http://dx.doi.org/10.1007/s13224-014-0544-1; PMID:25368458 PMCid:PMC4199429

6. Garcna-Benitez CQ, Cevallos Bustillos J, Ortiz Reyes H. 2012. Asynchronous birth in twin pregnancy. Literature review and case report. Ginecol. obstet. Mex. 80;2:91–94.

7. Lachowska M, Palusznska D, Fuchs T et al. 2013. Neonatal Outcome from Triplet Interval Delayed Delivery: A Case Report. Case Reports in Obstetrics and Gynecology. Article ID 451360. 4 p. nine0003

8. Doger E, Cakiroglu Y, Ceylan Y et al. 2014. Obstetric and neonatal outcomes of delayed interval delivery in cerclage and non-cerclage cases: an analysis of 20 multiple pregnancies.