Carrying a single baby to term is hard enough, but when it comes to twins, that could be an entirely different experience! For example, prenatal appointments for women carrying twins are often much more frequent than those carrying a single child, however, always remember that each pregnancy is unique. Pregnancy with twins can occur spontaneously, but in other situations, certain elements are involved. For instance, if you are older, hormonal changes may enable many eggs to be released at once, increasing the likelihood of a twin pregnancy, and this likelihood is further increased by the use of assisted reproductive technologies, such as in vitro fertilization. 

Pregnancy problems can affect anybody, although twin pregnancy complications can be more extreme! That is when the use of fetal medicine comes into play! Perinatology, the medical specialty that addresses the requirements of unborn children, is another name for fetal medicine. It has grown in importance over the past few years as a result of the technological developments that have led to more precise medication and accurate diagnosis. If you are expecting twins, the impact of fetal medicine on you and your baby’s health cannot be overstated. Twin birth is more common than you think, and actually one out of every 250 pregnancies results in twins, so if you are the lucky mother expecting twins, consulting a fetal medicine specialist would be a wise decision. 

What is Twin Pregnancy?

When you have two fetuses in your uterus at the same time, it's called a twin pregnancy, which would result in the birth of identical or fraternal twin babies. 

• Identical twins - When a single embryo from one egg and one sperm divides in two, identical twins are produced, and these twins may have different placentas or share one. The sex of identical twins is always the same since they are formed from the same embryo and they have nearly identical appearances and the same genes.

• Fraternal twins - When two sperm fertilize two eggs in a single cycle, fraternal twins are produced, and as a result, each infant has its own placenta. The DNA of fraternal twins is similar to that of siblings of various ages, and they might be of different sexes or the same sex.  
  

These two twin pregnancy types produce healthy babies, but sometimes incomplete division of an embryo in identical twins can result in conjoined twins, which is incredibly uncommon. In such cases, vital organs may be shared by the united bodies of the newborns, and the chest and abdomen are the most common parts that remain joined during birth. However, with modern medical technology, it is often possible to separate conjoined twins, and they can live a healthy life after prolonged treatment and care!

Even though having one baby is the most common kind of pregnancy, compared to earlier times, more women are becoming pregnant with twins. This is mostly due to the fact that more individuals are having children later in life and women over thirty are more likely to have twins or multiple babies. Additionally, more women are getting pregnant through fertility procedures, and these reproductive treatments are more likely to produce twins.

What is Fetal Medicine?

The health and development of the growing fetus within the womb are the primary concerns of fetal medicine, a relatively young and sophisticated area of medicine! Fetal medicine is one of the fastest-growing medical specialties in terms of identifying and treating issues with the developing fetus, thanks to advancements in fetal medicine foundation and medical imaging research and technology. It provides screening, diagnosis, monitoring, and treatment for a range of health issues affecting both the expectant mother and the fetus or fetuses. 

Early in pregnancy and continuing until delivery, the health of the fetus is regularly assessed, and fetal medicine inputs significantly improve the health results for both the mother and the fetus. Fetal medicine makes it possible to identify women who are at risk for a number of disorders, such as pre-eclampsia and fetal chromosomal abnormalities, as well as to identify structural issues and genetic issues through invasive testing in conditions that are inherited. Fetal medicine experts collaborate with neonatologists and obstetricians to arrange additional treatment for the expectant mother to achieve the best possible result when any fetal health concerns are found.

Fetal Medicine Helps Avoid Twin Pregnancy Complications 

The use of foetal maternal medicine can truly help the mother avoid various complications that may arise from carrying twins. A history of pregnancy difficulties, multiple pregnancies (twins or triplets), fetal abnormalities, and maternal medical concerns can all be considered high-risk pregnancies, and fetal medicine is equipped to deal with these problems! 

• Fetal medicine provides women with high-risk pregnancies with routine prenatal care.

• It aids in the management of the mother's current medical conditions, including high blood pressure and diabetes.

• Fetal medicine also provides assistance to women who experience delivery problems because of twin pregnancy.

• It diagnoses and treats the developing baby’s birth abnormalities, cardiac issues, and blood illnesses.  

• Procedures like amniocentesis, chorionic villus sampling (CVS), or umbilical cord samples to check for birth abnormalities and genetic illnesses are part of fetal medicine.

Technologies Used in Fetal Medicine

Fetal medicine has been transformed by modern medical technology, which makes it possible to detect and treat a wide range of disorders in the fetus with accuracy and precision.

What are the Complications of a Twin Pregnancy? 

Twin pregnancies are associated with various maternal and fetal complications during pregnancy and postpartum, e.g., gestational diabetes, pre-eclampsia, early labour, antepartum or postpartum bleeding while in a fetus there is more risk of abortion, structural or chromosomal abnormalities, preterm, prematurity related complications, additionally, there are certain complications specific to identical twins like a twin to twin transfusion syndrome, TRAP twin anaemia polycythemia sequence, selective IUGR and single fetal demise due to shared placentation. These are the most common issues women with twin pregnancies face:

• Placental abruption

When the placenta separates from the uterine wall before delivery, this is known as placental abruption, and if the woman is carrying more than one baby, it is more prevalent. Abdominal discomfort and bleeding are common symptoms of this issue, particularly during the third trimester, and it should be dealt with as an emergency.  

• Fetal growth restriction 

This occurs when the twins are not growing at the appropriate rate, and low birth weight or premature labor may result from this. 

• Premature birth 

Your chances of bringing your pregnancy to full-term decrease with the number of babies you are carrying! You may receive injections of a steroid drug to hasten the development of your unborn children's lungs if you exhibit symptoms of preterm labor but complications, such as infection, eye issues, and respiratory issues, might still arise for the babies even after the treatment.  

• Twin-twin transfusion

A blood artery in a shared placenta may cause one identical twin to get too much blood, while the other receives too little, and this is a dangerous condition that might cause cardiac problems and necessitate fetal surgeries(laser Phototcopulation) while you are still pregnant.

Final Remarks

Being pregnant with twins increases the chance of birth abnormalities, early labour, and various other health issues for the mother and the unborn babies! That is why special care for twin pregnancy management is highly necessary, and fetal medicine can help with that. 

Throughout the pregnancy, fetal specialists offer continuous monitoring to ensure the health of the mother and to evaluate the development and general health of the fetus they do routine exams. Fetal medicine professionals work in multidisciplinary teams with other specialists, including pediatric surgeons, neonatologists, and genetic counsellors, to provide complete treatment until the twins are born.  

If you are pregnant with twins, contact Medanta to receive the best pregnancy care from top doctors!