Are you worried about your pregnancy? Are you expected to give birth to twins or multiple babies? 

A multiple birth, like twins or triplets, is more common now due to fertility treatments and older pregnancies. In the UK, 16 out of 1,000 births are multiple pregnancies, with 98% being twins. 

Although such type of pregnancies are somewhat risky as compared to normal pregnancy(where mother carries single fetus), you can curb the challenges using right fetal medicine. 

If you're expecting twins or more, here's what you need to know about fetal medicine and other management tips to keep pregnancy safe and healthy. 

Different Kinds of Multiple Pregnancies

There are various types of pregnancies where more than one baby is expected. Here are the common ones:

Fraternal Twins

This happens when two eggs are fertilized and placed in the mom's uterus.

Your babies:

- Are like siblings

- Grow in the same uterus

- Can look alike or different

- Might be the same gender (two girls or two boys) or different genders (a boy and a girl)

A pregnancy with fraternal twins is usually safer because each baby has its placenta and bag. Fraternal twins are sometimes called 'dizygotic' twins, meaning two fertilized eggs.

Identical Twins

These twins occur when one fertilized egg splits into two.

Both embryos are identical, so the babies have the same DNA. This means they'll share many traits. However, sometimes, identical twins can look different because of their surroundings.

Identical twins may:

- Share the same placenta and bag

- Share a placenta but have their bag

- Have their placenta and bag

Identical twins are sometimes called 'monozygotic,' meaning one fertilized egg.

Triplets and More

When there are three, four, five, or more babies, they can be a mix of both identical and fraternal.

For example, triplets can be:

- Fraternal (tri zygotic): formed from three separate eggs

- Identical: when one egg splits into three embryos

- A mix of fraternal and identical babies

Complications of Twin or Multiple Pregnancy

Here are some complications that may occur in the case of twin or multiple pregnancies.

• Preterm Labour and Birth

If a mother is having multiple foetus pregnancy, the chances are high that babies will take birth before their due date. It means they may experience preterm labour (before 37 weeks). The more the number of foetuses, the higher the risk of early birth. 

Know that premature babies can be of low birth weight. Plus, they can have other problems like in breathing, eating or staying warm. Besides, babies born before 28 weeks are highly vulnerable and need care in a neonatal intensive care unit (NICU).

• Gestational Hypertension 

Women who go through multiple foetuses are more likely to have high blood pressure during pregnancy. It can also cause pleasant abruption, which is early separation of the placenta. 

• Anaemia

Anaemia is a disorder that occurs when red blood cells become lower than usual in blood. Anaemia is a pretty common case in mothers having multiple pregnancies as compared to a single pregnancy.

• Birth Defects 

Babies who come from multiple pregnancies develop a higher risk of health problems like spina bifida, along with neural tube defects. They can also have issues with digestion and heart. 

• Entangled Cord

Since the place inside the womb is very congested for twins or multiple babies, their umbilical cord that shares amniotic fluid becomes entangledentangled e.g monoamniotic monochorionic twins. Therefore, the foetuses need to be under observation, especially in the third trimester. Mothers dealing with twin or multiple pregnancies must visit their doctors frequently.

• Caesarean or C-section delivery

It becomes very tough for mothers to deliver more than one baby through a natural process due to abnormal foetal positions and presentation. Therefore, the chance of caesarean delivery increases. 

• Miscarriage

Sometimes, one of the babies might not make it in the early months. This could happen with or without any signs of a problem.

• Problem With Blood circulation

For twins who share a place where they grow, there can be a problem with how their blood circulate between them due to shared placentation in monozygotic twins.This result in sone special type of cimplications e.g Twin to twin transfusion, selective IUGR, Twin anemia polycythemia, Twin reverse arterial perfusion. This happens in about 15 percent of these twins.

• High or Low Amniotic Fluid Around The Baby

The amount of water around the baby can be abnormal in multiple pregnancies, especially if the twins share the same placenta where they grow.

Management and Treatment For Twins and Multiple

Your doctor or midwife will decide how to manage your multiple pregnancies based on the following:

• Your pregnancy, overall health, and medical history
• The number of babies you're expecting
• How you handle specific medications, procedures, or therapies
• What's scheduled of follow up during your pregnancy
• Your thoughts and preferences

Here are a few things that will help you to manage multiple pregnancies. 

• More Nutrition

Women having two or more foetuses need higher nutrition than mothers caring for Singleton foetus because the demand for their bodies increases. Mothers with multiple pregnancies require more calories, nutrients, minerals, protein and iron than they consume without pregnancy. It's normal to gain weight during this time. The Institute of Medicine suggests pregnant women with normal BMI should earn at least 37-54 pounds. On the other hand, overweight women can gain 31-50 pounds, while obese women should gain 25-42 pounds of weight. 

• Seeing The Doctor More Often

Since having more than one baby can lead to more issues, you must visit the doctor more to catch and handle problems early. They'll also keep a closer eye on your nutrition and weight. You may need to be sent to a particular doctor or a perinatologist for special tests or extra ultrasounds. This is to make sure everything is going well.

• Tocolytics For Preventing Early Labour

If labour starts too early, your doctor might give you Tocolytic medications to slow it down or stop it. This medicine pauses the contraction of the uterus. You can consume it as a pill, a shot, or through a vein. Magnesium sulfate is a standard medicine for this.

• Corticosteroid Medications

Sometimes, you get steroids to help the babies lungs develop faster. This is important because babies born too early often have trouble with their lungs.

• Help For a Weak Cervix

If your cervix is weak and can't stay closed during pregnancy, you may need to go for cervical encirclage procedure. This involves stitching the cervix shut. Some women with higher-order multiples might need this in early pregnancy.

Conclusion

There is nothing to fear about if you are carrying double or multiple foetuses. It is a beautiful thing. Make sure to follow right diet, take your foetal medicine  consultation regularly and observe your condition thoroughly throughout your journey.