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From One to Many: The Journey of Embracing Multiple Pregnancy

The joy of discovering a pregnancy is immeasurable, but imagine the excitement multiplied when you find out you're carrying more than one baby. Multiple pregnancies, particularly twin pregnancies, bring a unique set of experiences and challenges for expectant parents. In this blog, we will delve into the journey of embracing multiple pregnancies, exploring the twin pregnancy symptoms, causes of multiple pregnancy, complications of multiple pregnancy, and various multiple pregnancy types.

 

What is Multiple Pregnancy?

 

Multiple pregnancies occur when a woman carries more than one foetus in her womb simultaneously. Even though multiple pregnancies are relatively uncommon, accounting for only about 3% of pregnancіеs, their effects on families and society are profound. Usually, thesе pregnancies are the result of either thе division of a single fertilised egg (idеntіcal twіns) or the release and fertilisation of two or more eggs (fraternal twins). The journey of multiple pregnancies is often characterised by both excitement and unique challenges.

 

Twin Pregnancy Symptoms

 

The experience of carrying twins involves distinct physical and emotional twin pregnancy symptoms. Here are some of the twin pregnancy symptoms: 

  • Rapid weight gain
  • Expanded belly earlier in pregnancy
  • Increased appetite and food cravings
  • Heightened fatigue and exhaustion
  • More pronounced morning sickness (nausea and vomiting)
  • Increased frequency of urination
  • Shortness of breath and difficulty in finding a comfortable position
  • Intense backache and pelvic pain
  • Swollen and tender breasts
  • Hormonal fluctuations leading to mood swings
  • Difficulty sleeping due to discomfort and frequent trips to the bathroom
  • Higher levels of foetal movement and kicks
  • Feeling full quickly during meals due to limited space in the abdomen
  • Increased likelihood of experiencing varicose veins and haemorrhoids
  • Higher chances of developing stretch marks

 

Causes of Multiple Pregnancy

 

Multiple pregnancies can be influenced by various factors. Maternal age plays a role, as women over the age of 30 are more likely to conceive twins. Family history also contributes to the likelihood of multiple pregnancies, as having a close relative who experienced a multiple pregnancy increases the chances. 

 

Additionally, certain ethnic backgrounds, such as African and African-American, have a higher incidence of twins. Furthermore, fertility treatments significantly increase the likelihood of multiple pregnancies. 

 

Assisted reproductive technologies (ART) livе іn vitro fertilisation (IVF) frеquently involve thе transfеr of multіplе embryos, which raіses thе lіkelihood of twіns and othеr multiplеs to increase the likelihood of a succеssful concеption.

 

Complications of Multiple Pregnancy

 

While multiple pregnancies bring joy, they also present unique challenges and potential complications of multiple pregnancy. One of the most significant risks associated with multiple pregnancies is preterm birth, with about 60% of twins being born prematurely. Preterm babies face increased health risks and may require specialised care in the neonatal intensive care unit (NICU). 

 

The strain on the mother's body is intensified in multiple pregnancies, increasing the likelihood of gestational diabetes and preeclampsia. These conditions require careful monitoring and management to ensure the well-being of both the mother and the babies. 

 

Additionally, mothers carrying multiples fetuses may experience higher rates of anaemia and excessive weight gain, which can impact their overall health.

 

Types of Multiple Pregnancy

 

Multiple pregnancies come in different configurations, ranging from twins to higher-order multiples. Each type of multiple pregnancy has its unique characteristics and implications for both the expectant mother and the babies involved.

 

Twins

Twins are the most common type of multiple pregnancy. They can be classified as either identical (monozygotic) or fraternal (dizygotic).

  1. Identical Twins (Monozygotic): Identical twins result from the division of a single fertilised egg, forming two embryos with identical genetic material. They share the same placenta (monochorionic) and the different amniotic sac (diamniotic) mostly, but in some cases, they may have same amniotic sacs (monoamniotic). Identical twins may have a close bond and physical resemblance, but they can also experience various degrees of individuality.
  2. Fraternal Twins (Dizygotic): Fraternal twins develop when two separate eggs are fertilised by two different sperm. They have their own placentas (dichorionic) and amniotic sacs (diamniotic). Fraternal twins can be of the same or different genders, and they share about 50% of their genetic material, similar to siblings born at different times.

 

Triplets and Higher-Order Multiples

Triplets, quadruplets, and beyond occur when three or more foetuses develop simultaneously. These higher-order multiples can be a combination of identical and fraternal pregnancies, depending on the fertilisation process.

 

  1. Triplet Pregnancies: Triplet pregnancies can occur in different combinations. They can be all identical (monozygotic), all fraternal (dizygotic), or a mix of both. The placentas and amniotic sacs can also vary. Triplet pregnancies present unique challenges, as the mother's body must accommodate three growing babies, increasing the risk of complications of multiple pregnancy and preterm birth.
  2. Quadruplet and Quintuplet Pregnancies: Quadruplet and quintuplet pregnancies are relatively rare but not unheard of. These pregnancies involve the development of four or five foetuses simultaneously. The chances of identical and fraternal pregnancies occurring together increase with higher-order multiples. The complexity and risks associated with managing quadruplets and quintuplets are significantly higher, requiring specialised medical care and close monitoring throughout the pregnancy.
  3. Higher-Order Multiples (Beyond Quintuplets): While extremely rare, pregnancies with six or more foetuses have been reported, though they are typically the result of assisted reproductive technologies. These pregnancies are highly challenging and carry a significant risk of preterm birth, developmental complications, and the need for specialised care.

Triplet and higher birth order most of the time is result of assisted conception and require the need for fetal reduction procedure to reduce the high birth order in to twin gestation to decrease the maternal complications e. g diabetes, hypertension, antepartum and postpartum bleeding as well as fetal complications e.g miscarriage, preterm rupture of membrane, preterm labour and prematurity related complications. 

 

Embracing Multiple Pregnancy

 

Embracing the journey of a multiple pregnancy requires a combination of emotional support, self-care, and open communication with healthcare providers. Expectant parents should seek support from family, friends, or support groups specifically tailored for multiple pregnancies. It is essential to manage stress, practice self-care, and prioritise rest throughout the pregnancy. 

 

Maintaining open communication with healthcare providers ensures that expectant parents receive specialised care and guidance tailored to their unique needs. Creating a birth plan that takes into account the potential complexities of multiple pregnancies can also help alleviate anxiety and ensure a smoother delivery experience.

 

Conclusion

 

From the discovery of multiple pregnancies to navigating the twin pregnancy symptoms, causes of multiple pregnancy, complications of multiple pregnancy, and various types of multiple pregnancy, embracing the journey of carrying multiple is an extraordinary experience. 

 

Expectant parеnts must еducatе themselves, look for support, and bе opеn with healthcare professionals to еnsure the health of both thе mother and thе babiеs. Multiple pregnancies may present challenges, but they also bring immeasurable joy and the opportunity to welcome multiple bundles of love into the world.

 

If you think you are going to have multiple pregnancies, visit a super speciality hospital as soon as possible!

Dr. Geetanjli Behl
Obstetrics & Gynaecology
Meet The Doctor
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