Conception of Identical Twins video
Twin-to-Twin Transfusion video
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Under natural conditions, your chance of having a pregnancy with more than one baby is relatively low (approximately a 1.5% chance). However, the number of multiple births has increased dramatically over the past 15 years. There are two specific reasons contributing to this increase. The first one is the use of fertility drugs and in vitro fertilization. The second is the increase of later age pregnancies, which have an increased likelihood of multiple birth pregnancy.
According to the CDC, as reproductive technology becoming more refined, the number of triplets, quadruplets and other multiple births dropped the first time in more than 10 years in 1999. The number of twins, however, continues to increase.
Fraternal Or Identical Twins
There are two types of twins, fraternal and identical (fig. 1). Fraternal twins are more common because each baby develops from a separate egg and sperm. Generally, the ovaries release one egg a month, but sometimes more than one egg is released and fertilized. Fraternal twins will have individual placentas and amniotic sacs. Since each has a different egg and a different sperm, it is like siblings being born at the same time.
Identical twins come from one fertilized egg that splits early in the pregnancy and develops into more than one fetus (fig. 2). This is different because not only do the fetuses share the same placenta, but they also share the same genetic material. That is why they are identical in the way they appear (having the same hair color, eye color, sex, and blood type).
How Will I Know I Have A Multiple Pregnancy?
Today, most multiple pregnancies are discovered long before delivery. Some signs and symptoms that may make you and your healthcare provider suspicious include:
- Family history of fraternal twins
- Larger uterus than expected
- Use of fertility drugs
- Extreme nausea and vomiting in the beginning (from increased levels of pregnancy hormones)
- More than one heartbeat!
Generally, if multiple pregnancies are suspected, an ultrasound will be done to confirm it.
What Can I Expect?
Having more than one baby puts you at a greater risk for developing problems during the pregnancy, as compared with a single-birth pregnancy (one baby). All multiple pregnancies are considered high risk ("special care") and will be treated as any other high-risk pregnancy.
You can expect to see your health care provider more often than if you were just carrying one baby. More ultrasounds will be done in order to make sure there is enough room for the babies, and that they are growing at the same rate throughout the pregnancy.
You are at a higher risk for maternal and fetal complications, so you will be more closely monitored overall.
Having a multiple pregnancy may make you more uncomfortable, because you will gain more weight than with one baby. Your uterus will become much larger, and this may place more pressure on the other organs earlier than in a single-birth pregnancy.
You may experience symptoms earlier and more intensely. Some of these include:
- Shortness or breath
- Urinary problems
- Back pain
- Pelvic pain
As your pregnancy progresses, the physical discomfort may prevent you from continuing to work as long as you had planned, and it may even require hospitalization for several weeks before you are ready to deliver. However, some women have no more problems than with a normal pregnancy.
What Are The Risks?
Multiple birth pregnancies are put into the high-risk category because problems occur more often with these pregnancies.
There is a higher likelihood for you to get the following:
Some of the increased risks to the babies include:
- Preterm delivery
- Slowed growth of babies
- Low birth weight or unequal size
- Birth defects or death of one or more babies
How Can I Take Care Of My Babies And Myself?
For many women expecting multiple babies, they experience the typical discomforts of pregnancy, but the discomforts may be more intensified. As with any pregnancy, eating right, getting enough rest, and going to your scheduled doctor appointments is the best way that you can take care of yourself and your babies.
Following the recommended pregnancy nutritional guidelines will be helpful. Your doctor will give you additional recommendations for vitamins and minerals, and probably an increased caloric intake that you may need when carrying more than one baby.
You will need to get enough rest and sleep. Physical exercise should be discussed with your doctor - what you should and should not do. It will probably change as you get closer to delivery.
Make sure you are also nurturing your emotions during this time. Your partner may be able to help you by giving you a nice massage, or standing by while you take a warm bath to help you out of the tub.
Try to ease any emotional stress you may be feeling, especially as the due date approaches and you prepare for the delivery and care of more than one baby.
What Can I Expect During Labor And Delivery?
With more than one baby to deliver, the chances of needing a C-section are greater. The decision generally will be based on the positioning of the babies. If the babies are headfirst, there is a greater chance that you may be able to deliver them vaginally. Some doctors feel more comfortable than others in delivering twins vaginally, especially if one baby is headfirst and the other is breech (feet first). Others will attempt a series of maneuvers to turn the baby to the headfirst position in the uterus so that both can be delivered headfirst.
You will want to discuss all these possibilities with your doctor in order to understand the various scenarios that may take place on your delivery day. Recognize that even with all the discussions and planning prior to the actual event, there is still a chance that the plans may change on that special day!
Conception of Twins and Twin-to-twin Transfusion videos
Review Date: July/16/2001
Reviewed By: A.D.A.M. Medical Illustration Team
Review Date: June 29, 2001
Reviewed By: Peter Chen, M.D., Obstetrics and Gynecology, University of
Pennsylvania School of Medicine. Review provided by VeriMed Healthcare
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