Triplets babies in the womb
Twins, Triplets, Complications & Symptoms
What is a multiple pregnancy?
A multiple pregnancy is a pregnancy where you’re carrying more than one baby at a time. If you’re carrying two babies, they are called twins. Three babies that are carried during one pregnancy are called triplets. You can also carry more than three babies at one time (high-order multiples). There are typically more risks linked to a multiple pregnancy than a singleton (carrying only one baby) pregnancy.
How do multiple pregnancies happen?
There are two main ways that a multiple pregnancy can happen:
- One fertilized egg (ovum) splits before it implants in the uterine lining.
- Two or more separate eggs are fertilized by different sperm at the same time.
These two different types of multiple pregnancy result in either identical or fraternal siblings. The difference between identical and fraternal babies goes back to how the multiple pregnancy happens.
Identical twins or triplets happen when a single egg is fertilized and then later splits. These newly divided embryos are identical. Children that are identical multiples will look like each other and be the same sex.
Fraternal multiples develop from separate eggs that are fertilized by a different sperm. Because these are different eggs and different sperm, the genetic material is varied. These children won’t look identical and can be different sexes from each other.
In a pregnancy with triplets or more, your babies could be all identical, all fraternal or a mixture of both. This can happen if your body releases multiple eggs and more than one is fertilized. In a case where you have both identical and fraternal multiples, more than one egg was fertilized and then at least one of those eggs also split after fertilization.
Are identical twins or triplets always the same sex?
Because identical twins or triplets share genetic material, they are always the same sex. The sex of a baby is determined by the particular sperm cell that fertilizes the egg at conception.
There are two kinds of sperm cells — those carrying an X chromosome or Y chromosome. The mother’s egg carries an X chromosome. If a sperm cell carrying an X chromosome fertilizes the egg, it will make a XX combination (female). If the sperm cell is carrying a Y chromosome, you end up with an XY pairing (male).
Identical multiples start as one egg and then split, so whatever chromosome combination is present at fertilization is the sex of all multiples.
What increases the chance of a multiple pregnancy?
There are several factors that can increase the risk of a multiple birth. You might be at a higher risk of getting pregnant with more than one baby at a time if you:
- Are older (women in their 30s are at a higher risk of multiples because the body starts to release multiple eggs at one time when you get older).
- Are a twin yourself or have twins in your family.
- Are using fertility drugs.
You might also be at a higher risk of a multiple pregnancy if you are taller than average or have a higher body weight.
Another risk factor for a multiple pregnancy is genetic. There is an increased possibility of a multiple pregnancy if you are a multiple yourself, or if multiples run in your family. This heredity trait is generally passed down through the maternal (mother’s) side of the family.
The use of fertility drugs can be another reason you might have a multiple birth. Treatments for infertility can increase your risk of a multiple pregnancy because procedures, like in vitro fertilization (IVF), often involve transferring more than one fertilized egg into your uterus. Your provider usually transfers more than one egg at a time to increase the odds of a successful pregnancy.
How common are multiple births?
Multiple births have become more common in recent years because more people are using fertility drugs and procedures, such as IVF, to help conceive a baby.
What are the signs of a multiple pregnancy?
The only way to know if you’re pregnant with more than one baby during your pregnancy is through an ultrasound exam with your healthcare provider.
During this test, your provider can look at images of the inside of your uterus and confirm how many babies are in there.
You might experience more intense symptoms during a multiple pregnancy than with a single pregnancy. These can include:
- Severe nausea and vomiting (morning sickness).
- Rapid weight gain in the first trimester of pregnancy.
- Sore or very tender breasts.
- High human chorionic gonadotrophin (hCG) levels — this hormone is made during pregnancy and is what a pregnancy test picks up.
- High amounts of the protein alpha-fetoprotein in your blood.
Apart from an ultrasound, your provider might suspect multiples if there’s more than one heartbeat detected during a fetal Doppler scan.
What complications are linked to multiple births?
Anyone can experience complications during pregnancy — regardless of how many babies you’re carrying. However, most healthcare providers consider multiple pregnancies higher risk than single pregnancies.
This doesn’t mean that every woman who carries more than one baby during a pregnancy is going to have problems. If you’re pregnant with multiples, your provider will want to watch you for possible complications that can happen when you carry more than one baby at once. Your provider will talk to you about each risk factor and frequently check with you to make sure you aren’t experiencing anything concerning.
Possible complications include:
- Premature labor and birth: The most common complication of multiple births is premature labor. If you’re pregnant for multiples, you are more likely to go into premature labor (before 37 weeks) than a woman carrying only one baby. The goal for many moms of multiples is to complete 37 weeks. This is considered term in a twin pregnancy and reaching this week of gestation increases the chance the babies will be born healthy and at a good weight. Babies that are born prematurely are at risk of another complication of multiple births — low birth weight.
- Preeclampsia or gestational hypertension (high blood pressure): High blood pressure is called hypertension. During pregnancy, your healthcare provider will watch your blood pressure carefully to make sure you don’t develop gestational hypertension (high blood pressure during pregnancy). This can lead to a dangerous condition called preeclampsia. Complications related to high blood pressure happen at twice the rate in women carrying multiples compared to women pregnant with only one baby. This complication also tends to happen earlier in pregnancy and be more severe in multiple pregnancies than single pregnancies.
- Gestational diabetes: You can develop diabetes during pregnancy. This happens because of the increased amount of hormones from the placenta. The size of the placenta can also be a factor in this condition. If you have two placentas, there’s an increased resistance to insulin.
- Placenta abruption: This condition happens when the placenta detaches (separates) from the wall of your uterus before delivery.
This is an emergency situation. Placenta abruption is more common in women who are carrying multiples. - Fetal growth restriction: This condition can also be called intrauterine growth restriction (IUGR) or small for gestational age (SGA). This condition happens when one or more of your babies is not growing at the proper rate. This condition might cause the babies to be born prematurely or at a low birth-weight. Nearly half of pregnancies with more than one baby have this problem.
Fraternal twins always have two placentas. The risks of pregnancies with fraternal twins are similar to those of pregnancies with only one baby. However, the number of possible risks are increased when compared to pregnancies with one baby.
Identical twins may have one placenta (70% of the cases) or two placentas (30% of the cases). The risks of identical twins with two placentas are similar to those listed above for fraternal twins. Identical twins with one placenta (called monochorionic) have risks that are unique to them.
In 5 to 15% of the cases, they may develop a condition called twin-twin-transfusion-syndrome (TTTS). This is the consequence of vascular communications at the placenta level between the twins. Due to these communications, the twins may share their blood. When this happens — if nothing is done — there is a 90% risk that the twins will die in-utero. In-utero procedures are performed to decrease the fetal death risk for the twins.
Another complication that can happen in identical twins with one placenta is called twin-anemia-polycythemia sequence (TAPS). This is due to blood that goes from one twin to the co-twin because of vascular communications at the placental level. In this condition, one twin becomes anemic (low red-blood cells), whereas the co-twin becomes polycythemic (too many red-blood cells). Several treatments/interventions are performed when this happens.
A third condition that can occur in identical twins with one placenta is called” selective IUGR”. One twin grows well, whereas the co-twin does not experience much growth.
Another condition typical of identical twins is called twin-reversed-arterial-perfusion syndrome. In this condition, the heart of one twin pumps blood for the circulation of both twins. One twin does not have the heart and will not survive following birth. The outcome of the twin with the normal heart varies. Fortunately, this syndrome is rare (1 in 20,000 to 40,000) and it is amenable to in-utero procedures.
Identical twins with one placenta may also be in the same sac. They are called monochorionic (one placenta)-monoamniotic (one gestational sac). This pregnancy occurs in 1% of multiple gestations and it’s associated with an increased risk for one or both twins.
Your healthcare provider will diagnose the above conditions with an ultrasound.
Am I more likely to have a C-section delivery if I’m carrying multiples?
A cesarean section is a procedure used to deliver a baby through an incision (cut) in the abdomen. This type of delivery might be used for a variety of reasons, but it’s fairly common in multiple births.
Your chance of having a C-section for a multiple birth is higher than if you were pregnant for only one baby. However, even in single births, a C-section can sometimes be the safest option for delivery.
Often, the babies aren’t in the right position for birth — head down. A C-section can also happen if you have a complication during pregnancy that means a vaginal birth isn’t the safest option for you or your babies. Your healthcare provider will monitor you leading up to your due date and talk to you about the best option for delivery.
What can I do to stay healthy during a multiple pregnancy?
Eating nutritious foods, getting enough rest, and visiting the doctor regularly are important steps for any pregnant woman to take toward a healthy pregnancy. These steps are especially important during multiple pregnancies.
If you’re expecting multiples, you have additional dietary needs to meet. Getting enough protein and enough hydration (fluids) is important. You’ll also need to make sure you get enough extra calories for the developing fetuses.
One rule of thumb is to eat an extra 300 calories a day per baby. That means that if you’re pregnant with twins, you will need to add 600 calories to your daily diet. Talk to your healthcare provider about your diet and the specific amounts you’ll need for a healthy pregnancy.
Moms of multiples might also experience the typical discomforts of pregnancy more intensely. It’s important to take good care of yourself and get plenty of rest to help ease the stresses of pregnancy.
In some cases, you might want to find a healthcare provider who has experience with multiple births. Specialized healthcare can help ensure that you and your babies are receiving the best care available. The need for frequent, intensive prenatal care is very important in a multiple pregnancy. Talk to your family doctor or OBGYN about their recommendations for specialists.
Can I be active and exercise during a multiple pregnancy?
Exercise and activity is an important part of any pregnancy. In most cases, you can absolutely exercise during a multiple pregnancy.
Low-impact exercises are a great way to stay in shape and maintain your health throughout pregnancy. Some low-impact exercises to try during a multiple pregnancy can include:
- Swimming.
- Walking.
- Prenatal yoga.
Even though activity is wonderful during pregnancy, you should talk to your healthcare provider about the best activities for you. Some more strenuous activities might not be a good idea during a multiple pregnancy, including:
- Jogging.
- Aerobics that involve jumping.
It’s also important to remember that your exercise routine might need to change over time if you experience any complications.
Multiple pregnancy (triplets or more)
Multiple pregnancy (triplets or more) | Pregnancy Birth and Baby beginning of content7-minute read
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During your pregnancy, you may find out that you're expecting 3 or more babies.
This can sometimes be a surprise or even a shock. Most families with multiple pregnancies find having several babies at once to be a very positive experience. Being pregnant with triplets or more does mean you will need extra medical support throughout your pregnancy.
How do 'higher order multiples' occur?
If you are having 3 or more babies, they are known as 'higher order multiples'. This sort of multiple pregnancy can occur when:
- a single fertilised egg splits
- more than one egg is fertilised
Both of these things can also happen at the same time. This means that multiple babies could be fraternal (non-identical) or identical.
Higher order multiples rarely happen naturally and are usually the result of fertility treatments.
In 2020, 1.4% of all births in Australia were multiple births. Of these, almost all were twins. Just 1 in 100 of the multiple births were triplets or higher.
You can find out if you are having a multiple birth when you have an ultrasound.
When carrying triplets or more, you can expect the same early pregnancy symptoms that you would have with one baby. But they can start sooner and be more severe.
You will need extra medical care throughout your pregnancy. Choose an experienced doctor and medical support team that is right for you.
You may see a team of health care professionals who are experienced in higher order multiple pregnancies. These may include:
- obstetricians (specialist doctors who give medical care during pregnancy and birth)
- midwives (specialist nurses who give medical care during pregnancy and birth)
- sonographers (specialist in imaging with ultrasound)
- physiotherapists
- dietitians
You will need tests such as a glucose tolerance test to check for gestational diabetes. Frequent ultrasounds may be recommended to see how your babies are growing. Ultrasound scans can also check whether there are any problems with the placentas or cords.
The most common pregnancy complication with triplets or more is premature birth. Your healthcare team will keep a close eye on your health. Carrying multiple babies puts you at higher risk of certain problems. These can include:
- pre-term labour (going into labour early)
- anaemia (not having enough red blood cells, usually caused by iron deficiency)
- gestational diabetes (diabetes during pregnancy)
- hypertension or pre-eclampsia (potentially dangerous forms of high blood pressure)
- hyperemesis gravidarum (severe morning sickness)
- polyhydramnios (having too much amniotic fluid around the baby)
- miscarriage or stillbirth (sometimes one of the babies may die in the womb)
- Postpartum depression (also known as postnatal depression, and perinatal anxiety and depression)
- postpartum haemorrhagep (heavy bleeding after the birth)
Talk to your healthcare team if you have any concerns while you are pregnant.
Looking after yourself during multiple pregnancy
Having a multiple pregnancy can be physically and mentally overwhelming. It is important to take care of yourself. Make sure to surround yourself with a positive support network.
Nutrition
If you are carrying triplets or more, you may grow bigger than with a normal pregnancy. You may also grow more quickly. You will need to eat more to meet the babies' nutritional needs, and your own.
You may need to take iron, calcium, Vitamin B12 and folic acid supplements. Your healthcare team will provide you with a nutrition plan.
Conditions associated with pregnancy
With a multiple pregnancy, you may be more likely to experience:
- reflux
- haemorrhoids
- varicose veins
- constipation
See your doctor for information and advice about how to manage these symptoms.
You may experience backache, so correct posture is very important. To keep good posture while pregnant, you should:
- continue gentle exercise as advised
- bend your knees when lifting
- tilt your pelvis forward when sitting, standing, or lying down
- consider stomach support
Activity and rest
Doing some gentle exercise during pregnancy can help ease tension and improve your muscle tone.
Towards the end of your pregnancy, you may need to make some changes, such as
- limiting physical activity
- limiting travel
- possible bed rest
You can feel very tired in the later stages of the pregnancy. You may have problems sleeping. Frequent rest and drinking plenty of water will help.
You will also usually have to stop work earlier than with a single pregnancy. Your healthcare team can advise you on the right time for this.
Preparing for multiple babies
Be as prepared as you can. The babies are likely to be born earlier so it's a good idea to get the nursery ready.
Attend antenatal classes earlier than you would for a single pregnancy. Some classes or information evenings are designed specifically for women expecting multiple babies. These sessions can provide support, and a chance to meet other families.
Before your babies are born, you can speak with your midwife or lactation consultant about feeding.
They can provide advice and support on:
- what to expect when feeding multiple babies
- positions for breastfeeding
- different baby formula options
- how to bottle feed
- what equipment you may need
When are multiple babies born?
While a normal pregnancy usually lasts 40 weeks, triplets are often born earlier.
Usually, the longer your babies can stay in the uterus, the better. But when you are pregnant with triplets or more, complications can often develop. With some complications, it may be better for you and your babies if they are delivered early.
Most multiple births take place by caesarean section. Your medical team will decide when to deliver. This will be based on your health and the health of the babies. You may need to stay in hospital for a while before the birth.
If you experience any signs of preterm labour, call your doctor immediately.
Where to find more information
If you are expecting higher order multiples, it's common to worry about things such as:
- possible pregnancy complications
- changes to your body
- how your other children will cope
- what help you will need
For support and resources, contact the Australian Multiple Birth Association.
You can also call Pregnancy, Birth and Baby on 1800 882 436 for advice or support 7 days a week
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
Sources:
Australian Multiple Birth Association (What to expect when you're expecting multiples), Australian Bureau of Statistics (Births, Australia), Multiples NZ (Pregnancy and Birth)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: June 2022
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Multiple pregnancy
Author: Mikheeva Natalia Grigoryevna, Malyshok magazine
A multiple pregnancy is a pregnancy in which two or more fetuses develop simultaneously in the uterus. Multiple pregnancy occurs in 0.4 - 1.6% of all pregnancies. Recently, there has been an obvious trend towards an increase in the incidence of such pregnancies due to the active use of assisted reproduction technologies, including in vitro fertilization (IVF).
Types of multiple pregnancies
Children born in multiple pregnancies are called TWINS. There are two main types of twins: monozygotic (identical, homologous, identical, similar) and dizygotic (fraternal, heterologous, different). African countries have the highest twin birth rate, Europe and the USA have an average rate, and Asian countries have a low rate.
Dizygotic (fraternal) twins are more common (in 66-75% of all twins). The birth rate of dizygotic twins varies from 4 to 50 per 1000 births. Dizygotic twins occur when two separate eggs are fertilized. The maturation of two or more eggs can occur both in one ovary and in two. The predisposition to develop dizygotic twins may be maternally inherited. Dizygotic twins can be either same-sex or opposite-sex, they look like each other like ordinary brothers and sisters. With fraternal twins, two placentas are always formed, which can be very close, even touching, but they can always be separated.
Two fruit spaces (i.e., fetal bladders or two “houses”) are separated from each other by a septum consisting of two chorionic and two amniotic membranes. Such twins are called dizygotic dichorionic diamniotic twins.
Monozygotic (identical) twins are formed as a result of the separation of one fetal egg at various stages of its development. The frequency of birth of monozygotic twins is 3-5 per 1000 births. The division of a fertilized egg into two equal parts can occur as a result of a delay in implantation (immersion of the embryo in the uterine mucosa) and oxygen deficiency, as well as due to a violation of the acidity and ionic composition of the medium, exposure to toxic and other factors. The emergence of monozygotic twins is also associated with the fertilization of an egg that had two or more nuclei. If the separation of the fetal egg occurs in the first 3 days after fertilization, then monozygotic twins have two placentas and two amniotic cavities, and are called monozygotic diamniotic dichoriones (Fig.
A). If the division of the ovum occurs between 4 - 8 days after fertilization, then two embryos will form, each in a separate amniotic sac. Two amniotic sacs will be surrounded by a common chorionic membrane with one placenta for two. Such twins are called monozygotic diamniotic monochorionic twins (Fig. B). If division occurs by 9- 10th day after fertilization, then two embryos are formed with a common amniotic sac and placenta. Such twins are called monozygotic monoamniotic monochorionic (Fig. B) If the egg is separated at a later date on the 13th - 15th day after conception, the separation will be incomplete, which will lead to the appearance of conjoined (undivided, Siamese) twins. This type is quite rare, approximately 1 observation in 1500 multiple pregnancies or 1: 50,000 - 100,000 newborns. Monozygotic twins are always the same sex, have the same blood type, have the same eye color, hair, skin texture of the fingers, and are very similar to each other.
Twin births occur once in 87 births, triplets - once in 87 2 (6400) twins, quadruples - once in 87 3 (51200) triplets, etc.
(according to the Gallin formula). The origin of triplets, quadruplets, and more twins varies. So, triplets can be formed from three separate eggs, from two or one egg. They can be monozygotic and heterozygous. Quadruples can also be identical and fraternal.
Features of the course of multiple pregnancy
In case of multiple pregnancies, the woman's body is subject to increased requirements. All organs and systems function with great tension. In connection with the displacement of the diaphragm by the enlarged uterus, the activity of the heart becomes difficult, shortness of breath, fatigue occur. Enlargement of the uterus, especially towards the end of pregnancy, leads to compression of the internal organs, which is manifested by impaired bowel function, frequent urination, and heartburn. Almost 4-5 times more often there is the development of preeclampsia, which is characterized by an earlier onset, a protracted and more severe clinical course, often combined with acute pyelonephritis of pregnant women.
Due to the increased need and consumption of iron, iron deficiency anemia often develops in pregnant women. Significantly more often than with a singleton pregnancy, complications such as bleeding during pregnancy and childbirth, anomalies in labor, and a low location of the placenta are observed. Often, with multiple pregnancies, abnormal positions of the fetus occur. One of the most common complications in multiple pregnancy is its premature termination. Preterm birth is observed in 25-50% of cases of such pregnancies.
The development of term twins is normal in most cases. However, their body weight is usually less (by 10% or more) than in singleton pregnancies. With twins, the weight of children at birth less than 2500 g is observed in 40-60%. The low weight of twins is most often due to insufficiency of the uteroplacental system, which is not able to adequately provide several fetuses with nutrients, trace elements and oxygen. The consequence of this is a delay in the development of the fetus, which is a common occurrence in multiple pregnancies.
The mass of twins, respectively, decreases in proportion to their number (triplets, quadruplets, etc.).
With monochorionic twins in the placenta, anastomoses are often formed between the vascular systems of the fetus, which can lead to a serious complication - the syndrome of feto-fetal transfusion. In this case, there is a redistribution of blood from one fetus to another, the so-called "stealing". The severity of feto-fetal transfusion (mild, moderate, severe) depends on the degree of redistribution of blood through the anastomoses, which vary in size, number and direction.
Diagnosis in multiple pregnancy
The most reliable method for diagnosing multiple pregnancies is ultrasound, which allows not only early diagnosis of multiple pregnancies, but also to determine the position and presentation of fetuses, localization, structure and number of placentas, the number of amniotic cavities, the volume of amniotic fluid, congenital malformations and antenatal fetal death, the state of the fetus from a functional point of view, the nature of the uteroplacental and fetal-placental blood flow.
In multiple pregnancies, due to the higher risk of complications, ultrasound monitoring is performed more frequently than in singleton pregnancies. With dizygotic twins, about once every 3-4 weeks, with monozygotic twins - once every 2 weeks.
In addition, examinations and control of clinical tests are carried out with great care, and CTG is regularly recorded from 28 weeks of pregnancy.
Birth management
Indications for caesarean section associated with multiple pregnancies are triplets (quadruple), the transverse position of both or one of the fetuses, breech presentation of both fetuses or the first of them, and not associated with multiple pregnancy - fetal hypoxia, anomalies labor activity, prolapse of the umbilical cord, extragenital pathology of the mother, severe gestosis, placenta previa and abruption, etc.
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ECO
In the department of assisted reproductive technologies of the Maternity Hospital No.
2
, IVF is performed at the expense of the Republican budget for couples
who have received a positive decision from the Minsk city or regional commissions to provide one free IVF attempt.
No drug supply problem. There is no waiting list. -
Farewoman
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Individual care for patients
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Ultrasound diagnostics
- Pregnant women often complain of fatigue and shortness of breath, which increases towards the end of pregnancy.
The cause of shortness of breath is a difficulty in the activity of the heart due to a significant displacement of the diaphragm by the bottom of the uterus, the size of which is larger in multiple pregnancy than in singleton. - Often there is a dilation of the veins of the lower extremities. By the end of pregnancy, there is often an increase in the urge to urinate due to the pressure of a large fetus on the bladder.
- Pregnant women often complain of heartburn and constipation.
- In multiple pregnancies, toxicosis occurs more often than in singleton pregnancies: vomiting, salivation, edema, nephropathy, eclampsia.
- With twins, polyhydramnios of one of the fetuses is often found, which leads to a sharp increase and overstretching of the uterus, shortness of breath, tachycardia and other disorders. Polyhydramnios is more common in one of the identical twins. In some cases, the polyhydramnios of one twin is accompanied by an oligohydramnios of the other fetus.
- Premature termination of multiple pregnancies often occurs.
- With twins, preterm birth is observed in at least 25% of women.
- Triplets are more likely to miscarry than twins. The greater the number of gestated fetuses, the more often preterm births are observed.
- Development of term twins is normal in most cases. However, their body weight is usually less than that of single fetuses. Often there is a difference in body weight of twins by 200-300 g, and sometimes more.
- Uneven development of twins is associated with unequal intake of nutrients from a single placental circulation.
- Often there is a difference not only in weight, but also in the length of the body of the twins. In connection with this, the theory of supergenesis (superfoetatio) was put forward. Proponents of this hypothesis believe that fertilization of eggs of different ovulation periods is possible, i.e., the onset of a new pregnancy in the presence of an already existing, previously occurring, pregnancy.
- Due to the uneven delivery of nutrients and oxygen, a significant developmental disorder and even death of one of the twins can occur. This is more commonly seen in identical twins. The dead fetus is squeezed by the second, well-growing fetus, the amniotic fluid is absorbed, the placenta undergoes regression. The compressed mummified fetus ("paper fetus") is released from the uterus along with the placenta after the birth of a live twin. Polyhydramnios of one fetus, which occurs during multiple pregnancies, often also prevents the other twin from developing correctly. With pronounced polyhydramnios, certain anomalies in the development of the fetus, which grows with an excess of amniotic fluid, are often observed. Rarely, fused twins are born (fusion can be in the head, chest, abdomen, pelvis) and twins with other malformations.
- The position of the fetuses in the uterine cavity in most cases (about 90%) is normal. In the longitudinal position, different presentation options are observed: both fetuses are presented with the head, both with the pelvic end, one with the head, and the other with the pelvic end.
With longitudinal presentation, one fetus may be behind the other, which makes diagnosis difficult. Less commonly observed is the longitudinal position of one fetus and the transverse position of the other. The most rare is the transverse position of both twins. - The position of the twins in the uterus, both fetuses are presented with the head, one fetus is presented with the head, the second - with the pelvic end, both fetuses are in the transverse position
- In case of multiple pregnancies, women are taken into special account and carefully monitored. When the earliest signs of complications appear, the pregnant woman is sent to the pregnancy pathology department of the maternity hospital. Given the frequent occurrence of preterm birth, it is recommended that a pregnant woman with twins be sent to the maternity hospital 2 to 3 weeks before delivery, even in the absence of complications.
- The enlargement of the uterus in multiple pregnancies occurs faster than in pregnancy with one fetus, so the size of the uterus does not correspond to the gestational age. The bottom of the uterus is usually high, especially at the end of pregnancy, the circumference of the abdomen during this period reaches 100-110 cm or more.
- The following signs are unstable and not sufficiently reliable: a) deepening of the uterine fundus (saddle uterus), the formation of which is associated with protrusion of the corners of the uterus with large parts of the fetus; b) the presence of a longitudinal depression on the anterior wall of the uterus, which is formed as a result of the fruits that are in a longitudinal position adjacent to each other; c) the presence of a horizontal groove on the anterior wall of the uterus with the transverse position of the fetus.
- The small size of the presenting head with a significant volume of the pregnant uterus and the high standing of its bottom also make it possible to suspect a multiple pregnancy. The presence of this sign is explained by the fact that the study determines the head of one and the pelvic end (in the bottom of the uterus) of another fetus, which lies slightly higher.
- Feeling the movement of the fetus in different places and probing parts of the fetus in different parts of the abdomen (both on the right and on the left) also indicate multiple pregnancies.
Curious facts are
0
, how many are the Geminis? up to 80 million pairs of twins.
The number of twins born in relation to the total number of newborns in different countries and on different continents is different, but in general the trend is such that it continues to grow. Compared with the 60s, the percentage of twins has increased from 1.18 to 2.78, that is, almost 2.5 times.
The largest number of children
The largest number of children born to one mother, according to official data, is 69. According to reports made in 1782, between 1725 and 1765.
The wife of a Russian peasant Fyodor Vasiliev gave birth 27 times, giving birth to twins 16 times, triplets 7 times and 4 twins 4 times. Of these, only 2 children died in infancy.
The most prolific mother of our contemporaries is considered to be Leontina Albina (or Alvina) of San Antonio, Chile, who at 1943-81 years gave birth to 55 children. As a result of the first 5 pregnancies, she gave birth to triplets, and exclusively male.
Most birthed
The record 38 births are said to be Elizabeth Greenhillies Abbots-Langley, c. Hertfordshire, UK. She had 39 children - 32 daughters and 7 sons.
The largest number of multiple births in one family
Maddalena Pomegranate from Italy (b. 1839) had triplets born 15 times.
There is also information about the birth on May 29, 1971 in Philadelphia, Pennsylvania, USA, and in May 1977 in Bagarhat, Bangladesh, 11 twins. In both cases, no child survived.
Most fertile pregnancies
Dr.
Gennaro Montanino, Rome, Italy, claimed to have removed, in July 1971, the embryos of 10 girls and 5 boys from the uterus of a 35-year-old woman who was 4 months pregnant. This unique case of 15-fertility was the result of infertility pills.
9 children - the largest number in one pregnancy - were born on June 13, 1971 by Geraldine Broadrick in Sydney, Australia. 5 boys and 4 girls were born: 2 boys were stillborn, and none of the rest survived more than 6 days.
The birth of 10 twins (2 boys and 8 girls) is known from reports from Spain (1924), China (1936) and Brazil (April 1946).
The father with many children
The largest father in the history of Russia is Yakov Kirillov, a peasant from the village of Vvedensky, who in 1755 was presented to the court in connection with this (he was then 60 years old). The first wife of a peasant gave birth to 57 children: 4 times four, 7 times three, 9once twice and 2 times once. The second wife gave birth to 15 children.
Thus, Yakov Kirillov had 72 children from two wives.
Longest Birth Intervals for Multiple Pregnancies
Peggy Lynn of Huntington Pennsylvania, USA, gave birth to a girl, Hanna, on November 11, 1995, and the second of the twins, Erika, only 84 days later (February 2, 1996).
Siamese twins
United twins became known as "Siamese" after Chang and Eng Bunkers were born fused in the area of the sternum on May 11, 1811 in the Maeklong region of Siam (Thailand). They married Sarah and Adelaide Yates of pc. North Carolina, USA, and had 10 and 12 children, respectively. They died in 1874, and with a difference of 3 hours.
The science of twins - gemellology.
"Secret language"
Twins often talk to each other in a language that others do not understand. This phenomenon is called cryptophasia.
Left-handed twins
18-22% of left-handed twins (for non-twins this percentage is 10).
articles from specialists of the clinic "Mother and Child"
Arifullina Claudia Viktorovna
Gastroenterologist
Clinical Hospital "AVICENNA" GC "Mother and Child"
There is data on the frequency of twins in case of anomalies in the development of the uterus, characterized by its bifurcation (bicornuate uterus, having a septum in the cavity, etc.
). The cause of polyembryony may be the separation of blastomeres (in the early stages of crushing), resulting from hypoxia, cooling, acidity and ionic composition of the medium, exposure to toxic and other factors. Multiple pregnancy can occur: as a result of the fertilization of two or more simultaneously mature eggs, as well as the development of two or more embryos from one fertilized egg.
Twins formed from two (three, etc.) eggs are called dizygotic (polyzygotic), those arising from one are called identical. The origin of fraternal twins (polyzygotic twins): the simultaneous maturation (and ovulation) of two or more follicles in one ovary is possible. There may be maturation of two or more follicles and ovulation in both ovaries.
A third way of the origin of fraternal (multi-ovular) twins is possible - the fertilization of two or more eggs that have matured in one follicle. The origin of identical twins: most often, the occurrence of identical twins is associated with the fertilization of an egg that has two or more nuclei.
a single embryonic germ in the stage of crushing is divided into two parts; from each part an embryo (fruit) is formed. Twin twin. Fertilized eggs develop on their own. After penetration into the mucous membrane, each embryo develops its own aqueous and fleecy membranes; in the future, each twin forms its own placenta with an independent network of vessels, each fetal egg, except for the chorion and amnion, has an independent capsular membrane (decidua capsularis). In some cases, anastomoses are formed between the vessels of independent placentas. Twins can be same-sex (both boys or both girls) or different-sex (boy and girl). Their blood type can be the same or different. Identical twin. Identical twins have a common capsular and fleecy membrane and a common placenta; the vessels (both arterial and venous) of both twins in the placenta communicate with the help of numerous anastomoses. The water membrane of each twin is separate, the septum between the fetal sacs consists of two water membranes (biamniotic twins).
Identical twins always belong to the same sex (both boys or both girls), look alike, have the same blood type.
In fraternal twins, the membranes in the septum are arranged as follows: amnion - chorion, chorion - amnion; with monozygotic amnion-amnion.
Important signs for the diagnosis are: blood type (and other blood factors), eye color, hair color, skin texture of the fingertips, shape and location of teeth. In identical twins, these signs are completely the same. Fraternal twins share the same similarities as normal siblings.
MULTIPLE PREGNANCY
With multiple pregnancy, increased demands are made on the woman's body: the cardiovascular system, lungs, liver, nights and other organs function with great stress. In this regard, multiple pregnancies are more difficult than single pregnancies.
RECOGNITION OF MULTIPLE PREGNANCY
Diagnosis of multiple pregnancy often presents significant difficulties, especially in its first half.
In the second half, towards the end of pregnancy, the recognition of twins (triplets) is facilitated. However, diagnostic errors occur during the study at the end of pregnancy and even during childbirth.
When recognizing a multiple pregnancy, the following signs are taken into account:
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