How long is pregnancy with twins
Twins and multiple births - Better Health Channel
Multiple births are more common than they used to be, due to the increased use of assisted reproductive techniques, in particular the use of fertility drugs. Older women are more likely to have a multiple pregnancy and, because the average age at which women give birth is rising, this is also a contributing factor. Twins account for more than 90 per cent of multiple births. There are two types of twins – identical (monozygotic) and fraternal (dizygotic).
To form identical twins, one fertilised egg (ovum) splits and develops two babies with exactly the same genetic information. This differs from fraternal twins, where two eggs (ova) are fertilised by two sperm and produce two genetically unique children, who are no more alike than individual siblings born at different times. Twins are equally likely to be female or male. Contrary to popular belief, the incidence of twins does not skip generations.
The likelihood of having twins
Some women are more likely than others to give birth to twins. The factors that increase the likelihood include the following:
- age of the mother – women in their 30s and 40s have higher levels of the sex hormone oestrogen than younger women, which means that their ovaries are stimulated to produce more than one egg at a time
- number of previous pregnancies – the greater the number of pregnancies a woman has already had, the higher her likelihood of conceiving twins
- heredity – a woman is more likely to conceive fraternal twins if she is a fraternal twin, has already had fraternal twins, or has siblings who are fraternal twins
- race – black African women have the highest incidence of twins, while Asian women have the lowest
- assisted reproductive techniques – many procedures rely on stimulating the ovaries with fertility drugs to produce eggs, which can result in several eggs being released per ovulation
- IVF – multiple embryos are often transferred to the woman’s uterus to increase the chance of success.
Identical twins
Twins conceived from one egg and one sperm are called identical or ‘monozygotic’ (one-cell) twins. Identical twins occur when the fertilised egg divides in two while it is still a tiny collection of cells. The self-contained halves then develop into two babies, with exactly the same genetic information. Around one in three sets of twins is identical. What causes the fertilised egg to split in two remains a mystery.
Types of identical twins
Depending on when the fertilised egg divides in two, monozygotic twins may:
- each have their own placenta, inner membrane (amnion) and outer membrane (chorion)
- share one placenta and one outer membrane, but have two inner membranes
- share one placenta, one outer membrane and one inner membrane.
If the division of the fertilised egg is incomplete, the twins will be conjoined (previously known as ‘Siamese’ twins).
Approximately one-quarter of identical twins are mirror images of each other, which means the right side of one child matches the left side of their twin. It is not known what causes this.
Risks to mother and baby in multiple pregnancy higher
Twin pregnancies are associated with more frequent complications for both the mother and the babies. The mother might experience severe morning sickness that is persistent, diabetes in pregnancy, high blood pressure, or early onset of labour due to waters breaking prematurely giving rise to preterm delivery of babies. For the babies, the increased risks are due to being born prematurely or due to complications due to a shared placenta or blood vessels and due to uterine restriction.(1)
Antenatal care for women carrying identical twins
It is important to know whether your twins are sharing a placenta, as sharing a placenta also means sharing the blood supply from the mother. If the sharing of the blood supply is unequal, this can lead to complications. For this reason, women carrying twins sharing a placenta will need to have more frequent antenatal check-ups.
Twins sharing an inner membrane (which means they share the amniotic sac) carry an even higher risk of complications, as there is the potential for their umbilical cords to become tangled and to cut off their blood supply. In this case the pregnancy is monitored even more closely, and it may be recommended that your twins be delivered earlier.
Fraternal twins
Around two in three sets of twins are fraternal. Two separate eggs (ova) are fertilised by two separate sperm, resulting in fraternal or ‘dizygotic’ (two-cell) twins. Dizygotic twins each have their own placenta, inner membrane and outer membrane.
These babies will be no more alike than siblings born at separate times. The babies can be either the same sex or different sexes.
Higher order multiples – triplets, quadruplets, quintuplets, sextuplets or more
Triplets and more can be a combination of both identical and fraternal multiples. Triplets are most commonly a combination of monozygotic and dizygotic, with a set of identical twins (two) and a fraternal (one) triplet. Triplets or more require a closely monitored pregnancy.
The normal length of gestation (period of time spent developing in the womb) for a single baby is around 40 weeks. However, gestation for twins, either identical or fraternal, is usually around 38 weeks. This shorter time is due to the increased demands on the mother’s body, and the inability of the babies to receive all the nutrients they need in the womb.
As twins are usually premature, they are more likely to have lower birthweights. Prematurity is associated with increased risk of a number of disorders, including jaundice.
Looking after yourself when expecting twins or multiple babies
Like in any pregnancy, if you are pregnant with twins or multiple babies, eating well and getting enough rest are the cornerstones of good self-care.
Aim for healthy, balanced meals and drink plenty of fluids, ideally at least eight large glasses of water a day. Sugary snacks can give you highs and lows, which may feel unpleasant. ‘Slow-burning’ foods (foods that take longer for your body to turn into energy, also known as low glycaemic index or low GI foods) will keep your blood sugar more stable and will probably keep you satisfied longer – try introducing more wholegrain breads, vegetables, beans, oats, brown rice and wholegrain pasta into your diet.
Your body will be needing extra protein, calcium, iron, iodine, vitamin D,(2) folic acid and vitamin B12 than if you were only having one baby, so make sure your diet is varied. Try to eat little and often. Fresh foods will meet more of your body’s nutritional needs than processed foods. Speak with your doctor or midwife about taking a pregnancy supplement too.
Giving birth to multiple babies
Childbirth can give rise to complications when just one baby is being born, so twins or other multiples present extra potential for difficulties. If you are carrying more than one baby it is best to give birth in hospital, rather than at home. The babies can be delivered vaginally, but caesarean section delivery may be considered a better alternative in some circumstances.
Mothers of multiple births face higher rates of postpartum depression (3) Talk to your doctor or other health professional if you feel you may be experiencing this.
Zygosity testing – identical or fraternal twins
It is difficult to tell if twins are identical or fraternal at birth. Fraternal twins are born with individual sets of membranes, but some identical twins can also be.
One way to tell the difference is to have the twins DNA-tested (this is also known as zygosity testing). Identical twins share the same genetic information, while fraternal twins share around half.
DNA testing can be done with a sample of cheek cells, collected painlessly, or by performing blood group examinations, which require a blood sample to be taken.
While the distinction may not seem important if you have two (or more) healthy babies, it can be useful to know for health reasons because identical twins have a high likelihood of experiencing the same illnesses or having the same health condition. Identical twins are also compatible for organ transplantation, should it be required.
Where to get help
- Your doctor
- Midwife
- Obstetrician
Twin Pregnancy: Answers from an Expert
Twin Pregnancy: Answers from an Expert | Johns Hopkins MedicineReviewed By:
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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Preparing for the birth of twins
The news of a multiple pregnancy often throws future parents into a small (or big) shock. Even if the pregnancy was planned and expected, you still need to get used to the idea that you will return from the hospital with two babies, and not with one. Get used to and start preparing for a joyful event, based on new circumstances.
Features of multiple pregnancy
Before the first ultrasound, you might not have suspected that two hearts were beating inside at once. But now that this has been clarified, the doctor will take you under special control: be prepared for the fact that you will have to visit the antenatal clinic more often than you planned.
1. Toxicosis
In the case of multiple pregnancies, it can manifest itself more strongly and for a longer time. Toxicosis can disturb the expectant mother not only in the early stages, but sometimes in the later ones. Strange taste preferences may be more pronounced. Such unpleasant manifestations as digestive problems and constipation are also more common in multiple pregnancies.
Be sure to follow your doctor's recommendations for nutrition and diet. Eat a varied diet and choose healthy foods. Now you need more vitamins and minerals. But DO NOT OVEREAT either. During pregnancy with twins, weight gain will be more than with one child. Excess weight is a burden on the whole body as a whole, and on the heart in particular. So try to gain kilograms within the normal range.
2. Belly
It will appear earlier and will increase faster than during pregnancy with one baby. Get ready to need the special maternity clothes sooner than you think. Be sure to wear a bandage when your belly is big enough.
3. Childbirth
In multiple pregnancies, childbirth usually occurs . If the approximate terms of delivery with one baby are 39-40 weeks, then during pregnancy with twins they happen at about 35-37 weeks. This does not mean that you will definitely have it - twins are born later than this period - but it is still worth preparing mentally (and financially) for an earlier birth.
4. Preparing for childbirth and returning from the hospital
Preparing your home for the reception of new residents - also plan all these things for an earlier date. If you want to participate in this in person, then plan to do so by around week 20. Later, it will be just physically difficult for you to do all this.
A double burden on a woman's body, the likelihood of premature birth - a mother of twins should take care of herself and have more rest. For the health and well-being of babies, it is very important to develop before the due date in the mother's tummy. And your primary task is to remain a happy pregnant woman for as long as possible. If possible, go EARLY ON Maternity Leave. Before the expected maternity leave, you can take another regular leave or leave at your own expense.
We organize life with two babies
Even with one baby, the first year is not easy for a mother. Her every day is a cycle of the same things: washing-cleaning-ironing-cooking. It is good if someone can help you with the children and around the house. But besides the “live”, there are also all kinds of mechanical helpers in everyday life (glory to progress). Of course, they cost money and will take up space in the house, but they will save you a lot of time and effort.
1. Household helpers
- multicooker . It is convenient to cook diet meals for a nursing mother, and later for babies who receive complementary foods. It is also a big plus that it can keep dishes hot for a long time;
- thermopot . Especially useful for diluting baby food;
- dishwasher .
With the advent of children, you will have more of it at times. Along with the actual washing machine, a dryer will also come in handy. You will not need to hang up and remove a bunch of wet laundry, but just shift from one machine to another. And many things, if taken out immediately after the completion of a certain program, do not need to be ironed.
You can attract numerous relatives who are eager to give something for the birth of babies to buy these helpers.
2. Breastfeeding
Two babies at once exclusively breastfed - this, of course, is not easy, but as practice shows, it is quite feasible. To make the process as comfortable as possible, there are special underwear and comfortable clothes for breastfeeding for nursing mothers.
Also, when feeding two children at the same time, a special pillow for feeding twins is useful. It allows you to place the kids in the most convenient way. And mom's back will not strain and get tired.
In any case, every mother understands that no mixture can replace everything that breast milk gives the child, so it is worth making every effort to establish lactation and feed two babies at once. If there are difficulties with this, in our time of available information, you can always seek help and advice in this matter from experienced mothers who have had experience in feeding twins, or from specialist breastfeeding consultants.
3. Walks
A sling can be an indispensable help for a mother of twins. It will be useful to you both at home and on a walk. The temperament and regimen of babies can differ significantly: while one lies calmly or sleeps in a crib, the second requires mother's hands. At home, a sling can be used for motion sickness, feeding, or simply to carry a naughty baby.
Walking with a stroller for twins is a separate “song”. Even with an ordinary stroller, it is not always convenient for a mother to walk and drive everywhere, to say nothing of a larger design. With a stroller for twins, you need wide doors and ramps, a freight elevator in the house and enough space in the apartment for storage. Not to mention the fact that such a stroller also has an impressive weight.
An excellent option for walking can be a tandem of a regular stroller and a sling. Again, while one baby is sleeping peacefully in the stroller, the second can be awake or receive a portion of mother's milk in a sling.
Both babies can be worn in the sling at the same time . This will require more experience and skill from the mother, but it will also allow her to be more mobile.
Despite all the everyday difficulties, the birth of twins is a double happiness. Undoubtedly, you will have a difficult period before the kids become large enough and independent. But all these difficulties will block the joyful and amazing moments of your communication with children.
Named features of pregnancy twins or triplets - Gazeta.Ru
Named features of pregnancy twins or triplets - Gazeta.Ru | News
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Today, multiple pregnancy is no longer considered a rarity, but it still requires great responsibility from both the expectant mother and the doctor. Anastasia Sokolovskaya, an obstetrician-gynecologist of the Nova Clinic network of reproduction and genetics centers, told Gazeta. Ru about this.
The doctor warns that in multiple pregnancy, the risk of spontaneous abortion is higher than in normal pregnancy, and women often develop anemia, toxicosis, thrombophlebitis due to the need for a double consumption of body resources. Therefore, in most cases, a pregnant woman will have to visit a gynecologist more often and have an ultrasound.
“The tummy can be seen as early as the 12th week of pregnancy, and early movements can be felt as early as 14-16 weeks. There may be high blood pressure, which is associated with the need to pump more than when carrying one fetus, the amount of blood. Pregnancies with twins or triplets usually do not last more than 37 weeks and often end in premature birth. Therefore, the period of maternity leave for women with multiple pregnancies begins two weeks earlier (on the 28th, and not on the 30th week) and lasts longer, ”explains Anastasia Sokolovskaya.
The OB/GYN advises women who are pregnant with twins or triplets to write down their feelings and report them to their attending OB/GYN in a timely manner; eat right and eat small meals; eliminate any bad habits; in the absence of contraindications, maintain moderate physical activity.
“In the early stages, an examination should be done to assess the condition of the cervix. If necessary, the doctor may recommend suturing or installing a pessary,” the expert clarifies.
Doctor has previously warned about B9 deficiency in women and men.
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