Average delivery week for twins

Twin Pregnancy: Answers from an Expert

Twin Pregnancy: Answers from an Expert | Johns Hopkins Medicine

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When you’re expecting twins, you know you’ll need two of everything for your registry. But what about staying healthy during your pregnancy? Do you need to double your food intake, weight gain and visits to the doctor? With regard to the babies, are there two placentas and two amniotic sacs, or can they share these?

Johns Hopkins maternal-fetal medicine specialist Jeanne Sheffield answers eight commonly asked questions.

Do twins share a placenta and an amniotic sac?

While some twins may share a placenta and an amniotic sac, that is not the case for the vast majority of pregnancies. Here are three major possibilities that exist:
- Two placentas and two amniotic sacs. A twin pregnancy with two placentas and two amniotic sacs is the optimal twin pregnancy, as each baby has its own nutritional source and protective membrane.
- One placenta and two amniotic sacs. In pregnancies with one placenta and two amniotic sacs, you will definitely have identical twins. Additionally, when your babies share a placenta, there is a greater risk for complications, such as twin-to-twin transfusion syndrome. Your physician will closely monitor your pregnancy to check for potential problems.
- One placenta and one amniotic sac. This is the riskiest and rarest type of twin pregnancy. Fetal complications can arise due to tangling of the umbilical cords or an imbalance in nutrients, blood or other vital life supporting systems.
Do I need to double my caloric intake during a twin pregnancy?

A common misconception surrounding twin pregnancy is that you need to double your caloric intake to provide your babies with enough nutrients. However, pregnancy nutrition guidelines aren’t simply based on the number of babies you’re carrying. Instead, they’re based on your body mass index at the time you became pregnant.

Your doctor will make individualized recommendations based on your starting weight. On average, it’s estimated that a woman’s caloric requirements will increase about 40 percent for a twin pregnancy. What’s most important, though, is that a woman eats as healthy as possible.
Do I need to take different prenatal vitamins for twins?

If you’re pregnant with twins, you should take the same prenatal vitamins you would take for any pregnancy, but your physician will recommend extra folic acid and iron. The additional folic acid and extra iron will help ward off iron-deficiency anemia, which is more common when you’re pregnant with multiples.
Will I need to visit my doctor more frequently?

While every pregnancy is different, most women carrying twins will have more frequent prenatal visits than women carrying only one baby. If your twins are sharing one placenta, you will automatically have a more frequent monitoring schedule.

If your pregnancy doesn’t have complications, your prenatal visits may not differ much from a singleton pregnancy until you get to the end of your second trimester. At that point, you’ll be seen more frequently because there is a higher risk of pre-eclampsia and preterm labor.
Do I have to see a maternal-fetal medicine specialist for a twin pregnancy?

Maternal-fetal medicine specialists see high-risk pregnancies, but not every twin pregnancy will fall into this category.

To find the best care provider for your twins, make sure that the physician is comfortable managing twins, including vaginal delivery of twins rather than only offering a cesarean section (C-section) for delivery.
Are all twin pregnancies delivered preterm?

A little more than half of twin pregnancies end in preterm delivery (before 37 weeks). While 40 weeks is the full gestation period of the average pregnancy, most twin pregnancies are delivered at approximately 36 weeks (range 32-38 weeks depending on the type of twin pregnancy).

Unfortunately, preventing preterm labor with multiples is more challenging than with a singleton pregnancy because the interventions used with singleton pregnancies are not as effective with multiples.
Can bed rest reduce the risk of preterm delivery?

Scientific data show that bed rest does not prevent preterm delivery. In fact, bed rest can increase your risk of developing blood clots and have negative financial and social consequences.

Although bed rest is not prescribed as frequently as it once was, your doctor may suggest reducing your activity level if you’re showing signs of early labor at the end of your second trimester or early in your third trimester.
Is labor and delivery significantly different with twins?

Labor is generally the same whether you’re having one baby or two. During delivery is when things differ significantly.

When it’s time to deliver your twins, you will go to an operating room even if you are delivering vaginally. This is a safety precaution known as a double setup. Following the vaginal delivery of the first baby, there is a small risk of an emergency cesarean section for the second baby. There is also the possibility of the second twin being delivered breech, which is a safe form of vaginal delivery if the obstetrician is experienced in this type of delivery.

Of women giving birth to twins over 32 weeks, only about 4 percent who try for a vaginal delivery will have a combined vaginal and cesarean section delivery. While it doesn’t happen very often, by delivering both babies in the operating room, physicians are better prepared to protect the health of the mother and the babies.

Although being pregnant with twins can seem very different, your doctor will treat your pregnancy like any other unless a complication occurs.

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What Is The Average Length of Twin Pregnancy

Being pregnant is an amazing time. It can be a time of celebration as soon as you learn you’re expecting. That being said, there are quite a few things to worry about when pregnant. Even more so when pregnant with twins, such as if the baby is healthy or not and how long is the average length of twin pregnancy. Sometimes these concerns are unnecessary, but other times they have a good reason behind them.

Let’s look at some of the main concerns for expecting mothers and how long twin pregnancies tend to last, on average.

Many women in their first pregnancies do not know what to expect when it comes to the average length of twin pregnancy, sometimes called twin gestation. We’ll take a look at the average length of a twin pregnancy.

It is important to know that there are different kinds of twins. There are identical twins which develop from a single embryo that splits into two separate ones. These two babies will have almost identical DNA, making them look very similar in appearance. There are also fraternal twins. These twins both develop from separate embryos, creating two babies. These two babies will share roughly 50% of their DNA, making them no more or less alike than any full-blood siblings.

Twin pregnancies can be dangerous for mothers and babies if they are high-risk pregnancies. There may be a higher chance of health problems arising during pregnancy or labor. This means that the average length of twin pregnancy is something that should be monitored closely.

Preterm labor is always a concern when you are pregnant, particularly during twin gestation.

What is considered a full-term twin pregnancy?

A full-term average length of twin pregnancy is 37 weeks. Many obstetricians will not allow an expecting twin mom to carry their twins past the 38-week mark. After that time, there is a slight rise in the risk of stillbirth with each subsequent week after 38 weeks along.

It is important to note that in monochorionic (identical twin) pregnancies, pregnancies with 1 placenta are often delivered between 34 and 37 weeks since these pregnancies are at higher risk. In contrast, dichorionic pregnancies are twin pregnancies with 2 placentas and obstetricians often recommend delivery between 37 and 39 weeks.

So, the word “term” may change depending on whether you are carrying identical twins or fraternal twins. You should ALWAYS follow your doctor’s orders and recommendations.

What is the average length of a twin pregnancy?

About half of all twins are delivered before 37 weeks, with just 10% arriving before 32 weeks.

As it turns out most twins are born at about 36 weeks which is barely premature at all, so there is no need to worry just because you are carrying twins. Every pregnancy is different and there is no reason to worry about preterm labor until your doctor tells you to worry.

Keep in mind that 40 weeks is considered term for a singleton pregnancy.

What might cause twins to be born earlier than the due date?

Twins can be born early for any number of reasons, just like a singleton. There could be growth restrictions, infection, pre-eclampsia, gestational diabetes, placenta abnormalities, among other things.

There is also spontaneous labor. The causes of spontaneous labor are widely unknown and unpredictable. If you think you are experiencing signs and symptoms of preterm labor it is important to contact your health care provider immediately.

What might cause twins to be born later than the due date?

It is hard to know exactly why your twins aren’t coming before their due date. There are a few risk factors that might make an overdue delivery more likely.

This is your first baby
You, yourself were born past your own due date
Other women in your family have gone past their due dates
You have had other late babies

How early should you expect your twins to be born?

There’s no way to tell exactly how early your twins may be born. This is because every pregnancy and woman is unique. Do yourself a favor and don’t compare your situation to someone else’s. Your doctor can give you a better idea of what the average length of a twin pregnancy would be for your specific situation (ie fraternal or identical twins), and an estimated due date. Remember that this doesn’t mean that is when your babies will come.

You should also be prepared for your due date to change early in your pregnancy. With twins, it can be difficult to measure your belly properly, especially before you know you are having twins. You might need to adjust your due date expectations once you get that first ultrasound confirming twins.

Will I need to visit my doctor more frequently with a twin pregnancy?

Women carrying twins will have more frequent visits to the doctor than women with single pregnancies. If your twins are sharing one placenta, you will automatically have a more frequent monitoring schedule. (hopkinsmedicine.org)

Prenatal care visits may not differ much from a singleton pregnancy until you get to the end of your second trimester if there are no complications. At that point, you’ll be seen more frequently because there is a higher risk of high blood pressure, pre-eclampsia, and preterm labor. (hopkinsmedicine.org)

Will I be able to have a vaginal delivery with twins?

Many women are able to deliver their twins vaginally. It is estimated that about one-third of twins are delivered this way. It should be noted that there is always a chance you will need a C-section, or even after one twin is delivered vaginally.

The decision on whether to attempt a vaginal delivery depends upon several things:

Your own health – You must be healthy enough to carry two children safely through childbirth.

The health of the unborn babies – If there is concern that either or both of your babies may be put in danger during labor, your doctor will opt for a C-section. This could happen at any time so it is best to be prepared just in case.

The position of your babies – If neither of your twins is had down, it is unlikely you will be able to try a vaginal delivery.

Check out this double-whammy twin birth story.

If you just heard that second heartbeat for the first time, or you know it’s been two for a while, you need to read our twin pregnancy week by week timeline to help you learn what happens week by week with twins. Click here to learn more… and while you’re at it, check out our expecting twins classes and twin parent coaching services.

Should twins be induced if they are overdue?

If your twins are past due, then you and your doctor will need to decide whether or not it is best for labor to be induced. This will depend on a variety of different factors, such as the health of the babies and how far along they are, among other things.

As always, communicate with your doctor about your concerns and comfort throughout your pregnancy.

At what point should I call my doctor?

Contact your provider if you are experiencing any complications during your twin gestation. Also, if you have any reason to believe that your twins aren’t developing as they should be. Usually around the 32nd week of your twin pregnancy is when doctors will want to begin monitoring the health and development of your babies more closely.

Does bed rest reduce the risk of preterm delivery?

There isn’t any evidence that bed rest can reduce the risk of premature birth. While getting some rest is important, doctors don’t recommend giving up activities completely or to the extent that it causes stress for you or your unborn children. Additionally, being on bed rest will not prevent twins from coming early since this is typically caused by factors that the mother cannot control.

Are all twin pregnancies preterm deliveries?

It is reported by Johns Hopkins that slightly more than half of all twin pregnancies will result in preterm delivery. That means that more than half of all twin pregnancies are delivered before 37 weeks. Most of their deliveries average at 36 weeks gestation.

What are the risks of preterm delivery with twins?

Preterm birth with twin gestation has been linked to increased rates of low-birth-weight infants, respiratory distress syndrome, jaundice, cerebral palsy, hearing loss, visual impairment, developmental delays, cognitive deficits, behavioral disorders, learning disabilities, autism spectrum disorder, attention deficit hyperactivity disorder, and epilepsy. It is possible that these conditions could affect your child’s future quality of life.

This sounds very scary, and it certainly can be. But the most important thing you can do for your unborn babies is to find a doctor you trust. Also, find a hospital to deliver your babies with the appropriate NICU staff to handle any spontaneous preterm birth during your twin gestation.

The right medical team will go a long way towards combatting the complications of premature delivery.

If you are a pregnant woman, we hope you found this article helpful in understanding what might cause twins to come early or late. If you have any questions or concerns regarding the average length of twin pregnancy, contact your health care provider for peace of mind.

Multiple pregnancy - Gemabank

Multiple pregnancy can be accompanied by a number of complications. However, you should not be afraid - with timely diagnosis and its correct management, all problems are completely solvable

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Problem 1.

Miscarriage

Miscarriage is considered to be the most frequent complication of multiple pregnancy. The duration of pregnancy directly depends on the number of fetuses: in the case of twins, it averages 36-37 weeks, and in case of triplets, 34-35 weeks. The trigger for childbirth is the overstretching of the uterus due to the large number of fetuses, as well as due to polyhydramnios, which often occurs during such pregnancies.

Solution to the problem: Prevention of preterm birth is carried out primarily by limiting an active lifestyle and in some cases by prescribing bed rest. After 20 weeks in the daytime, expectant mothers are advised to rest at least 4-6 hours. At later dates - up to 8 hours a day.

In order not to miss the threat of preterm labor, every two to three weeks the gynecologist evaluates the condition of the cervix. If before 23 weeks it begins to shorten, stitches are applied to it. This procedure is called cervical cerclage. The most important thing is not to miss the time to perform this operation. After 23 weeks, to remove the threat of premature birth, the doctor prescribes special drugs - tocolytics. In some cases, with the threat of preterm birth, pregnant women are recommended the introduction of corticosteroids in order to accelerate the maturation of the lungs and prevent respiratory disorders in newborns.

Problem 2: High risk of complications

Anemia is common in multiple pregnancies. In addition, the risk of early toxicosis increases, and late toxicosis (gestosis) is more severe.

Problem Solving: More than 90% of multiple pregnancies are virtually uncomplicated and resolve successfully. One of the reasons for this success is the possibility of early detection of various abnormalities using ultrasound. Indeed, in addition to establishing the number of embryos, ultrasound allows you to observe their development, position, number of placentas and the volume of amniotic fluid.

Naturally, in the case of multiple pregnancy, a woman should visit the doctor more often: after 20 weeks - every second week, and after 30 weeks of pregnancy - once a week. To prevent anemia, women with multiple pregnancies are prescribed large doses of iron (up to 60 mg per day) and folic acid (up to 1 mg per day).

Problem 3. Fetal development disorders

In fraternal twins, the frequency of intrauterine malformations is the same as in singleton pregnancy, and in fraternal twins it is 2 times higher. The course of such a pregnancy may be complicated by growth retardation of one of the fetuses (dissociated development). The most pronounced degree of dissociated development is observed in the syndrome of feto-fetal blood transfusion: identical twins with one placenta eat as follows: one fetus from the other. One becomes a donor and the other becomes a recipient. In this case, the life of both fetuses is in danger.

Solution of the problem: When the syndrome of feto-fetal blood transfusion is established, the anastomoses are separated abroad using a laser, and both children continue to develop normally. Unfortunately, intrauterine fetal surgery has not yet become widespread in our country. Therefore, when this pathology is detected, treatment is often limited to the release of excess amniotic fluid through a thin needle (amniodrainage), which allows prolonging the pregnancy, but does not eliminate the cause of the syndrome. In such a situation, a woman should be under constant medical supervision. If necessary, she may need an emergency delivery.

Problem 4. Low body weight of newborns

In 40-60% of cases with twins, the body weight of children is less than 2500 g. As a rule, the difference in body weight between both twins is small and is about 200-300 g. In feto syndrome - fetal blood transfusion, there can be a significant difference in weight: up to 1 kg or more.

Solution: To minimize the possibility of having children with low birth weight, a woman should pay special attention to her nutrition, especially in the first trimester. Each child needs approximately 300-400 calories per day. At the same time, vitamins are also prescribed in a double dose. If during a singleton pregnancy the optimal weight gain is 12-13 kg, then for a multiple pregnancy, weight gain should be at least 18-20 kg.

A neonatologist must be present at the birth. In addition, an incubator and intensive care equipment for newborns should be prepared.

Indications for caesarean section in multiple pregnancy:

Severe preeclampsia (late toxicosis), in which natural childbirth is contraindicated.
Pelvic position of the first fetus (in nulliparous).
Excessive distension of the uterus and large fetuses (weighing more than 6 kg).
Fetal hypoxia(s).

If there is no special indication for caesarean section, vaginal delivery is preferred. But in the presence of three or more children, regardless of the condition of the woman, it is recommended to perform a caesarean section at 34-35 weeks.

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Twin birth - Juno

Twin birth: the content of the article

Twin birth: understanding the terminology

Carrying 2 or more children is a multiple pregnancy. It rarely happens - a maximum of 1.6% of expectant mothers. Now there is an upward trend.

Twins are dizygotic twins. They appear when two eggs fertilize two sperm. Such brothers and sisters are not alike. By appearance, you can determine that they are relatives, but the children are not the same.

Twins are different and same-sex. They may have a radically different character, temperament.

Causes of twins

Researchers have identified a number of factors that increase the likelihood of conceiving two babies:

Maturity - in a woman at 35 - 40 years old, the level of gonadotropin increases, it increases the chances of becoming a mother twice in one pregnancy;
Heredity - women on the line of the future mother had twins. She is also at risk;
Genetics - the IGF-1 gene is responsible for tissue development, cell division. There is a direct connection between his rise and the conception of twins;
High levels of IGF-1 protein - observed in women who are overweight and consume a lot of dairy products. Therefore, vegan women are much less likely to have two babies;
Hormonal therapy - for example, treatment of infertility with gonadotropic drugs;
IVF - the procedure involves the stimulation of the ovaries, which leads to the fertilization of two eggs.
Nationality - African women most often on the planet give birth to two or more children in one pregnancy.

Scientists from Amsterdam have identified another factor - 2 genes (one or a combination of them). The first is associated with an increase in the FSH hormone, a natural ovarian stimulator for the release of an egg. With a high level of the hormone, 2 eggs can be released.

The second is SMAD3. It is responsible for the reaction of a woman's body to the FSH hormone. If the ovaries are sensitive to it, two eggs can be fertilized. In this case, the level of FSH is not important.

The first version of the gene increases the chance of carrying and giving birth to two children by 18%, the second - by 9%, their combination - by 29%.

Features of pregnancy

Bearing several fruits is harder than one. After all, the body of the expectant mother works in an increased load mode: the uterus grows, the diaphragm and internal organs are displaced and compressed.

The heart works harder, the urge to urinate becomes more frequent, the woman suffers from shortness of breath and a feeling of lack of air. More weight gain negatively affects the spine, legs, and veins.

Higher risk of preeclampsia, hemorrhoids, varicose veins, intestinal disorders, heartburn - few pregnant women are lucky to avoid these troubles.

Probability of complications during pregnancy and childbirth of twins

We will determine the risks for the future mother.

Preeclampsia. Diagnosed five times more often. It proceeds more severely, against its background, acute pyelonephritis develops.

Anemia. It develops as a result of iron deficiency - it is consumed in large quantities.

Gestational diabetes. It occurs more often than when carrying a single child.

pathology of pregnancy. Bleeding, placenta previa, premature birth, miscarriage, abnormalities in labor activity.

Wrong position of children. Low position, breech, foot or mixed presentation complicate the birth of twins.

Postpartum complications. After the first birth (older twin), the uterus may begin to contract - this leads to placental abruption and a threat to the life of a younger brother or sister.

Massive blood loss. An overstretched uterus can contract poorly after the birth of children. For the mother, this is fraught with blood loss, uterine atony.

Complications for children

Among the risks for babies, doctors point to the following:

Body weight less than normal by at least 10%. In most cases, the weight does not reach 2.5 kg;
Developmental delay. The mother's body is not able to saturate two children at the same time with nutrients and oxygen. Therefore, twins are born small and immature;
Unpreparedness for birth. Babies are born prematurely, often severely premature. Even if one baby is ready to meet his mother, then the chances are high that the second one will be less ready for this.

Due dates for multiple pregnancies

In most cases, pregnancy ends at 35-36 weeks.

The birth at 32-33 weeks is assessed as premature. Both or one of the babies may not be ready. The consequences are a lag in physical development, low body weight and height. This is an indication for a caesarean section.

At 35 weeks, it is advisable for the expectant mother to be hospitalized in the maternity hospital. From now on, a meeting with children can happen at any moment. At 36 weeks, independent childbirth is possible.

The appearance of children at 37 weeks is considered optimal. Usually around this time this happens. They are as ready for the event as possible: healthy, strong. Weigh less than single peers. In the absence of previously identified pathologies, everything proceeds without complications.

At 38 weeks, twins appear extremely rarely. This is the best outcome.

How to calculate the due date of twins

The reference point is the first day of your last period. Subtract 3 months from this day and add 7 days. Here is the expected day of delivery. This method is more suitable for women expecting one child.

It would be more correct for you to subtract 2-3 weeks from this date. If this is your second birth, twins may be born even earlier.

Duration of twin labor

The birth process includes 3 stages:

Cervical dilation - from irregular contractions to full dilation;
Expulsion of the fetus - from attempts to birth;
Postpartum - from the appearance of the child to the release of the placenta.

The duration of these stages does not depend on the number of fruits. The state of health of their mother plays a role.

The duration of childbirth - the period of exile - is longer than with uniform gestation. This is due to the successive exit of the children. For most women, this step takes 15 minutes.

The kids go out one after another on average with an interval of 13.5 minutes.

Method of delivery in multiple pregnancy

Expecting twins is not a reason for operative delivery. With good health of them and their mother, easy bearing and no contraindications, the woman in labor can handle it herself. An important condition is the cephalic presentation of both children, the normal location of the placenta.

In case of complications, pathology of pregnancy, contraindications on the part of the mother or babies, surgical intervention is indicated.

Natural childbirth

First, the harbingers of an imminent meeting with babies come.

The stomach drops - mom breathes easier. With repeated births, the stomach drops shortly before an important event - in a couple of days, with a third it may not fall.

Liquid stool is the second harbinger. Substances are more actively released to start the contractile activity of the uterus. They also irritate the intestines.

Increased urge to the toilet "in a small way." The uterus presses on the bladder - urination becomes more frequent.

Decreased activity in children. The symptom is not typical for everyone.

Pain. The sacrum, lower back aches - twins can appear from day to day or even in the next few hours.

In first-born mothers, these signs are more pronounced.