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Twin Babies (The Double Whammy) - Types, Complications, and Management

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These days due to technology and many internal factors, the chances of mothers conceiving twins have increased. This article will give more details about it.

Medically reviewed by

Dr. Veerabhadrudu Kuncham

Published At October 20, 2022
Reviewed AtJune 12, 2023

What Is Multiple Pregnancy?

Multiple pregnancies are when the mother is carrying two or more babies at the same time in the womb. If a mother is carrying two babies, they are called twins, and if she is carrying three babies at the same time, they are called “triplets.” Across the globe, there are many cases of mothers carrying more than three babies as well. However, with multiple pregnancies, the health risk for the mother and babies is more than a single pregnancy.

With advancing fertility techniques, drugs, and the increased average age of women, chances for twin pregnancy are higher than in past cases. Although, there are many external and internal factors that affect this type of pregnancy. At the end of 28 days of the menstruation cycle, a rise in the level of estrogen hormone plays an important part in thickening the wall of the ovaries. After that, one of the ovaries releases an egg or eggs, and the fertilization journey starts. When a woman carries two fetuses in her womb, it is called a multiple or twin pregnancy.

Additionally, there are three different scenarios in twin pregnancy with regard to sharing a placenta and amniotic sac. In the scenario, there are chances of two different placenta and amniotic sacs in the optimal pregnancy. Here, both fetuses have their own nutritional source and membrane protecting them. In the second scenario, there is one placenta and two amniotic sacs. Here the chances of having identical twins are higher, and so are complications. This type of pregnancy requires a great amount of care and regular follow-ups. In the third scenario, there is one placenta and one amniotic sac. It is the riskiest and rare type of pregnancy where the chances of umbilical cord entanglement and imbalance of nutrients put the pregnancy and twins at risk.

There are many unproven myths about conceiving twins. Some of them advise different therapies, and some suggest specific diets. In order to debunk all the unproven claims, there is not a single logical reason behind having twins. The etiological factors that increase the chances of having twins are almost uncertain.

What Are the Types of Twin Babies?

Depending on the number of eggs they develop from and with the possibility of sharing the same placenta, there are two types of twins; fraternal twins and identical twins.

  • Fraternal Twins - When two separate eggs are fertilized by different sperm cells. Hence they are called dizygotic (two cells) twins. In this pregnancy, each twin has its own placenta and amniotic sac. One twin shares half of their genes with another, making them non-identical twins.

  • Identical Twins - During ovulation, when a single egg is fertilized with multiple sperm cells, and later the same egg is divided into two independent and fertilized eggs, and it is called monozygotic (single-cell) twins. As a result, both individual fetuses carry the same genes; hence, they are identical twins. On the contrary, there are few recent studies that suggest that monozygotic twins share indistinguishable signatures that are chemical markers, not DNA. Their identical facial features and some of their natural habits are found to be uncanny.

What Are the Signs of Multiple Pregnancies?

The only way to know about multiple pregnancies is through ultrasound imaging. During the test, the doctor can confirm if a mother is carrying two fetuses in the uterus. With multiple pregnancies, a mother might experience intense symptoms, such as:

  • Severe nausea.

  • Rapid weight gain.

  • Tender breasts.

  • High level of human chorionic gonadotropin (hCG) hormone.

What Are the Factors Affecting the Chances of Having Multiple Pregnancy?

There are many determinants that play a part in a woman conceiving twins, such as:

  • Age: Women with ages above 30 to 40 years have a higher level of a hormone called estrogen. This elevated hormone level is responsible for producing more eggs at a time, and because of more production of ovulating eggs, the chances of multiple fertilization also increase.

  • Race: Contrary to Asian women with the lowest probability of having multiple fetuses, black African women have the highest probability.

  • Previous Pregnancies: Women with multiple pregnancies carry twice the chance of having twins.

  • Family History: It is seen that women with mothers or sisters who have a history of twin pregnancies in the family are at higher odds of having the same.

  • Hormone Therapy: Hormone-stimulating medicines can help in more egg production, and this, in turn, results in higher chances of having multiple babies.

  • Vitro Fertilization: Assisted reproductive techniques like in-vitro fertilization and fertility drugs increase the production of eggs, hence the chances of having twins.

Moreover, the result of the most commonly used tool in the psychiatry and behavioral genetics field, “Twin Studies: A Unique Epidemiological Too,” shows nature (environment) versus nurture (genetics) contributes to multiple pregnancies.

How to Manage Health During Multiple Pregnancies?

It is important to keep an eye on the health of the mother as the fetus gets all the nourishment from his mother. Especially during twin pregnancy, a mother should be twice careful with her health. There are certain things that pregnant women should be careful about, such as:

  • Routine checkups with the doctor.

  • A healthy diet and lifestyle changes.

  • Regular exercises for pregnant women.

  • Rest.

  • Maternal and fetal testing.

  • Take regular supplements suggested by the doctor.

Even though there are many healthy twins born on a daily basis, there are some complications that sometimes the mother carries, such as:

  • Pregnancy-related diabetes.

  • Pregnancy-related high blood pressure.

  • Weight gain.

  • Premature birth.

  • Cesarean delivery.

  • Twin-twin transfusion.

  • Miscarriage.

  • Postpartum hemorrhage.

  • Placenta abruption.

  • Fetal growth restriction.

Conclusion

Some factors may increase the chance of having twins, but the odds of having twins naturally have nothing to do with therapy or treatments. Additionally, with twice as much joy, twin babies often come with some complications. The usual pregnancy symptoms such as morning sickness and rapid weight gain are seen visibly more in the mother carrying twin pregnancies. It is very important for a mother to take extra care of her health and get regular checkups.

Frequently Asked Questions

1.

What Causes Multiple Pregnancies?

 
Multiple pregnancies usually occur when more than one egg is fertilized, or it can also happen when one egg is fertilized and then splits into two or more embryos that grow into two or more babies. Invitro fertilization commonly leads to multiple pregnancies.

2.

Multiple Pregnancies Are Also Called?

If the individual is pregnant with more than one baby, it is called multiple births. Three babies are called triplets, and two babies are called twins. Multiple pregnancies from a single zygote is called monozygotic, and from two zygotes is called dizygotic.

3.

What Are the Symptoms and Clinical Signs of Multiple Pregnancies?

Symptoms and signs may include:
- A larger uterus than expected.
- Increased morning sickness.
- Increased appetite.
- Excessive weight during early pregnancy.
- Fetal movements are felt in different parts at the same time.

4.

Are Multiple Pregnancies High-Risk?

 
Pregnancy with multiple babies does not necessarily mean problematic pregnancy. However, women carrying multiple babies do have a higher chance of developing complications such as preterm labor and high blood pressure.

5.

What Increases the Chances of Having Multiple Pregnancies?

Twins occur in about one in 250 pregnancies, quadruplets in 700,000 pregnancies, and triplets in about one in 10,000 pregnancies. The main element that increases the chances of having multiple pregnancies is the use of infertility treatments.

6.

What Is the Management of Multiple Pregnancies?

Tocolytic agents are given if preterm labor occurs to help stop or slow contractions of the uterus. They are given orally or intravenously. Tocolytic medications constitute magnesium sulfate. Corticosteroid medicines help the fetus's lungs mature.

7.

Which Parent Determines if It Is Twins?

Multiple pregnancies are determined by the mother. Only the mother's genetics matter. Fraternal twins take place when two eggs are simultaneously fertilized instead of one. A father is not responsible for the release of two eggs.

8.

Is Having Twins Familial?

Yes, some types of multiple pregnancies may be hereditary. Heredity on the maternal side increases the chances of conceiving fraternal twins. Fraternal twins are two babies conceived from two different eggs.

9.

Is It Possible to Have Twins Vaginally?

 
Yes, it is possible to have twins vaginally. Many women assume that they have to undergo cesarean section when pregnant with twins. But more than 40 % of twin births are vaginal delivery.

10.

Which Food Helps Conceive Twins?

Hyperovulation-stimulating foods are a few foods that naturally increase the chances of ovulation and stimulate the ovaries to produce multiple eggs. Hyperovulation foods include:
 
- Cassava.
- Tofu.
- Whole wheat.
- Soy isoflavones.
 
- Whole grains.

11.

Do Two Eggs Mean Twins?

 
There are instances where a woman's ovaries release two eggs, and a separate sperm fertilizes each egg. This leads to twins. They are called fraternal twins, nonidentical or dizygotic twins (two zygotes).

12.

Are Twins Implanted on the Same Day?

 
Twins can be implanted on the same day, or they can be implanted in the uterus at different times. Superfetation is when a second pregnancy initiates during an initial pregnancy. An ovum is fertilized days or weeks after the first one.
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Dr. Veerabhadrudu Kuncham
Dr. Veerabhadrudu Kuncham

Pediatrics

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