When are most twins born

Twin Pregnancy: Answers from an Expert

Twin Pregnancy: Answers from an Expert | Johns Hopkins Medicine

Reviewed 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.

Sign Up for Our Free Newsletter

One of the best things you can do to protect and improve your health is to stay informed. Your Health is a FREE e-newsletter that serves as your smart, simple connection to the world-class expertise of Johns Hopkins.

Planning a Pregnancy
How to Prepare for Pregnancy
Fertility, Pregnancy and Childbirth
Complications of Pregnancy
Planning a Pregnancy
Ovarian Tissue Freezing Cryopreservation

Giving birth to twins | Pregnancy Birth and Baby

Twins are more likely to be born early, often before 38 weeks, so it's important to understand your birth options. Less than half of all twin pregnancies last beyond 37 weeks.

Because of the likelihood that your babies will be born early, there is a good chance one or both of them will spend some time in special care.

As twins are often born prematurely, it's a good idea to discuss birth options with your midwife or doctor early in your pregnancy.

You should also discuss where you would like to give birth. You will most likely be advised to give birth in a hospital because there's a higher chance of complications with a twin birth.

It's common for more medical staff to be involved in the birth of twins, such as a midwife, an obstetrician and two paediatricians - one for each baby.

While the process of labour is the same as when single babies are born, twin babies are more closely monitored. To do this, an electronic monitor and a scalp clip might be fitted on the first baby once your waters have broken. You will be given a drip in case it is needed later.

Vaginal birth

About one third of all twins are born vaginally and the process is similar to that of giving birth to a single baby. If you're planning a vaginal delivery, it's usually recommended that you have an epidural for pain relief. This is because, if there are problems, it's easier and quicker to assist the delivery when the mother already has good pain relief.

If the first twin is in a head down position (cephalic), it's usual to consider having a vaginal birth. However, there may be other medical reasons why this would not be possible. If you have had a previous caesarean section, it's usually not recommended you have a vaginal birth with twins.

If you have a vaginal birth, you may need an assisted birth, which is when a suction cup (ventouse) or forceps are used to help deliver the babies.

Once the first baby is born, the midwife or doctor will check the position of the second baby by feeling your abdomen and doing a vaginal examination. If the second baby is in a good position, the waters will be broken and this baby should be born soon after the first as the cervix is already fully dilated. If contractions stop after the first birth, hormones will be added to the drip to restart them.

Caesarean section

You may choose to have an elective caesarean from the outset of your pregnancy, or your doctor may recommend a caesarean section later in the pregnancy as a result of potential complications. You’re nearly twice as likely to have a caesarean if you’re giving birth to twins than if you’re giving birth to a single baby.

The babies' position may determine whether they need to be delivered by caesarean section or not. If the presenting baby - the one that will be born first - is in a breech position (feet, knees or buttocks first), or if one twin is lying in a transverse position (with its body lying sideways), you will need to have a caesarean section.

Some conditions also mean you will need a caesarean section; for example if you have placenta praevia (a low-lying placenta) or if your twins share a placenta.

If you have previously had a very difficult delivery with a single baby, you may be advised to have a caesarean section with twins. Even if you plan a vaginal birth, you may end up having an emergency caesarean section.

This could be because:

one or both babies become distressed
the umbilical cord prolapses (falls into the birth canal ahead of the baby)
your blood pressure is going up
the labour is progressing too slowly
assisted delivery doesn't work

In very rare cases, you may deliver one twin vaginally and then require a caesarean section to deliver the second twin if it becomes distressed.

After the birth

After the birth, your midwife will examine the placenta to determine what type of twins you have. Twins can either be fraternal or identical.

If your babies need special care

Depending on where you plan to give birth, you may need to go to another hospital with appropriate facilities if complications in your pregnancy indicate you're likely to have an early delivery. This may not be near to home, so make sure to check there are enough beds for both your babies in the neonatal unit.

Ask if your chosen hospital has a transitional care unit or a special care nursery. These are places that allow mothers to care for their babies if they need special care but not intensive care. These hospitals are more likely to be able to keep you and your babies in the same place.

You might also want to ask if your hospital has cots that allow co-bedding (where your babies sleep in a single cot), if this is appropriate and if you want your babies to sleep together.

If you have one baby in the hospital and one at home, you will need to think about splitting your time between the two. When you visit your baby in hospital, ask if you can bring their twin and if co-bedding is allowed during visits.

If you want to breastfeed and only one twin can feed effectively, you may need to express milk to feed the twin who is having trouble feeding. You may then need to put the twin who can feed on the breast to encourage milk production in order to get enough milk to feed both babies.

Check if your hospital offers support from a community neonatal nurse, which would allow for you and your babies to leave hospital earlier, for example if your baby is still tube-fed.

When you go to clinics for follow-up appointments, it's a good idea to ask not to be booked into early morning appointments. Getting out of the house with two babies, particularly if one is unwell, can be difficult.

For more information and support, visit Twins Research Australia.

Learn more here about the development and quality assurance of healthdirect content.

Today more twins are born in the world than ever before

March 15, 2021 13:53 Olga Muraya

Most twins in recent years were born in Asia and Africa.
Pixabay Photos.

Since the 1980s, the number of twins born worldwide has increased by a third. Scientists have also found that in some regions of the world, twins are always born more often than in others.

Researchers from the Netherlands, Great Britain and France have studied twin birth statistics for 2010-2015. They found that today in the world one in 42 newborns is a twin, and in total about 1.6 million twins are born every year. Scientists compared these data with statistics 1980s and it turned out that the birth rate of twins has increased by a third since then.

Recall that children born from one pregnancy are considered twins. There may be two or more. Most often, two types of twins are distinguished - identical and fraternal (they are also called twins).

Identical, or monozygotic, twins develop from one egg, fertilized by one sperm, which at some point split into two parts. These twins are called identical because they share 100% of their genes.

Fraternal or heterozygous twins, respectively, result from the fertilization of two eggs by different spermatozoa. Such twins can be of different sexes, and they do not necessarily look like two peas in a pod, because they have only 50% of their genes identical.

Pregnancy in which the mother bears such twins (or more children) is called multiple pregnancy.

The chance of multiple pregnancy increases with maternal age and is also associated with ovulation-stimulating drugs. Today, in vitro fertilization (IVF) is increasingly practiced, as a result of which twins are also often born.

Scientists attribute the rise in the birth rate of twins in the 20th century to the achievements of modern medicine. They believe that in recent years the proportion of twins among newborns has become higher than was ever possible. Therefore, the findings of the current study did not come as a surprise to them.

After examining data from 165 countries, scientists noticed that over the past 40 years, the proportion of newborn twins has declined only in countries in South America. At the same time, approximately 80% of twin births occur today in Asia and Africa. The most interesting thing is that in Africa and at 19The 1980s, and now a record number of twins were born, and their proportion among newborns has hardly changed over the years.

This led scientists to the idea that the population of the African continent has a certain genetic feature that makes women predisposed to multiple pregnancies.

"This is important to note because twin births are associated with increased infant mortality and a high risk of complications during pregnancy, childbirth and postpartum recovery," said study lead author Christiaan Monden, professor at the University of Oxford. ).

Some researchers argue that the proportion of twin births in high-income countries has peaked today and will only decline further. They explain this by the fact that IVF technologies are changing today in the direction of reducing the number of multiple pregnancies. Most women who want to get pregnant still do not want to give birth to several children at the same time, and their desires are taken into account by scientists and doctors.

Sociologists are planning to update the data in a few years to determine whether the birth rate of twins in high-income countries will decline soon. They also look forward to seeing what changes will happen in poorer countries where reproductive medicine (including IVF) is just beginning to develop.

A scientific article detailing this large scale study was published in the journal Human Reproduction.

Earlier Vesti.Ru wrote about how scientists were able to increase the effectiveness of artificial insemination and found out at what age it is best to turn to the IVF method. We also reported that the danger of artificial insemination is just a myth.

science genetics ECO sociology demography Twins society news

Previously related

Cannibals and art lovers: what were the oldest inhabitants of Britain
An original method for predicting stomach ulcers was patented by Russian scientists
Therapy improved the mental abilities of people with Down syndrome
Discovery of the Year: Very similar non-relatives have a lot in common in DNA
Achilles' heel found for nearly all cancers, including drug-resistant ones
Male life expectancy depends on their sex chromosome

Scientists have explained in which families twins appear

Sergei Malgavko/TASS

How many of these and who is "responsible" for the fact that a double replenishment suddenly appears in a family? Professor of genetics and psychology, director of the International Laboratory for Interdisciplinary Research on Individual Differences in Learning (Goldsmiths, University of London) Julia Kovas, who has been studying twins for many years, answered: “About one-third of all twins are monozygotic (resulting from the division of one fertilized egg) , another third - dizygotic same-sex (the so-called twins of the same sex - either two boys or two girls) and the same number - dizygotic heterosexual (when both a boy and a girl are born in the family at once). 0003

Monozygotes, which are genetic copies of each other, are approximately 1 percent worldwide. This number does not change. Why the cell divides in two, scientists do not yet know. But in the birth of dizygotic (in other words, twins) there is a genetic component - if there are dizygotic twins in the relatives, then all relatives are more likely to have dizygotic twins. when one gene is responsible for something specific, for example, the appearance of some kind of disease. "There is a mutation in the gene - there will be something specific, for example, Huntington's disease (a hereditary disease that leads to the occurrence of degenerative processes, usually manifests itself in 30-50 years). There is a mutation - there is a disorder, there is no mutation - and there is no disorder. Complex genetic influences are polygenic, that is, a large number of genetic factors affect some trait.

So, twinhood is such a complex trait, which is provided by a large number of genes. Dizygotic twins are maternally traceable, possibly because some process is inherited that is associated with ovulation. However, we now know that fathers can carry these genes and can pass them on to their daughters. It is possible that other processes can increase the likelihood of twins. Many genetic factors associated with this phenomenon have not yet been identified.

It is interesting that in Asian countries, for example, in Japan, there are very few twins, but in some African countries there can be more than 20 percent of such children.

"The environmental component also plays a role here, but many factors that can explain such geographical differences in the frequency of twins have not yet been established," Julia Kovas told RG. "In recent years, the number of dizygotic twins has increased, for example, due to such technologies such as IVF.Sometimes, during in vitro fertilization, a woman is implanted with two or even three fertilized cells, which leads to a higher frequency of dizygotic twins.However, in many countries this approach has begun to be abandoned, since multiple pregnancy poses an increased risk for the mother, and for children.