One of the wonderful moments in the life of every woman is the news of pregnancy; there are several months of anticipation, excitement and, finally, a joyful meeting at the end of the journey. However, the news that two “bellies” have “settled” in the belly at once does not bring every mother into indescribable delight, because a woman in such a situation becomes afraid for the successful course of her pregnancy. But you shouldn’t worry too much, because now medicine has made great progress and, under the close supervision of qualified gynecologists, the expectant mother will be able to safely carry her babies. The most important thing is to recognize the signs of twins in the early stages of pregnancy as early as possible in order to promptly begin to monitor the process of fetal development and monitor the well-being of the mother. So, what are these signs?

• Heredity comes first

If a young mother has already experienced a similar happy phenomenon in her family, then you need to be prepared for the birth of twins to happen again in a young family. This phenomenon is not always natural, and does not mean at all that it will be observed in all relatives. Most often, twins are born within a generation due to heredity.

• We hibernate

Many pregnant women experience increased sleepiness in the first stages of pregnancy, but, of course, all this is individual. As for expectant mothers who are expecting twins, many of them noted increased sleepiness in the first couple of months, so much so that they literally fell asleep on the go.

• Oh, this toxicosis

Toxicosis causes a lot of trouble for expectant mothers. For those women who still don’t realize they have two babies in their tummy, toxicosis can be very strong. It is worth saying that everything depends on the individual characteristics of the body and this is not a 100% guarantee that there are two fruits in your tummy at once.

• Very bright

How, most often, does a woman find out about an interesting situation? The absence of menstruation on time prompts her to take a test and two lines indicate that in 9 months a new person will appear in the family. A sign of twin pregnancy in the early stages is two brightly colored stripes on the test, most often in mothers expecting one baby, the second stripe is too pale or invisible.

• And what about the appearance?

With the onset of pregnancy, any woman experiences a global restructuring of her body, a real hormonal “explosion,” which naturally affects her appearance. Being pregnant with two children at once, such changes in appearance can be expressed even more clearly, these include:
- pigment spots on the face;

1. acne and pimples on the skin of the face and back;
2. change in skin color;
3. hair loss;
4. in rare cases, papillomas appear on the body.

• Belly like a watermelon

The belly of a mother who is carrying twins in her final stages is simply huge and it seems that there really is a huge watermelon there. What about in the early stages? Women who are pregnant with twins at once notice that their stomach, which was flat up to this point, begins to grow by leaps and bounds.

In addition, they note that they begin to feel movements much earlier than the due date. This happens because two fetuses take up much more space and, of course, the belly has to expand. As for the movements, two babies create twice as many movements and, willy-nilly, you will feel them much sooner than if there was only one baby.

• Why so much

It is quite natural that a mother who is carrying two children under her heart will gain more kilograms than a woman expecting one baby. According to average standards, in the first three months a woman gains weight from one and a half to 2.5 kilograms. For those lucky women who are expecting twins, these weight indicators can be safely multiplied by two!

• The older, the more!

It is so inherent in nature that the older a woman gets, the greater the likelihood of receiving double joy during conception. If you are over 35 years old, then the probability of being a “mother squared” in one birth is high!

• What will the doctors say?

Doctors, for their part, can also detect twin pregnancies quite early.

Distinctive signs of multiple pregnancy

Signs of twin pregnancies in the early stages of pregnancy, which can be pronounced, are:

• The belly will tell you everything

Doctors always note the appearance of a characteristic horizontal stripe on the stomach of a woman pregnant with twins.

The first ultrasound most often dispels all the guesses and doubts of both the mother and the doctors. Although there are also cases of errors when the ultrasound specialist simply did not notice the second fetus.

• When two hearts beat together

Experienced doctors, listening to the belly of the expectant mother, clearly distinguish the beating of two small hearts at once.

• Skillful hands

During palpation, the obstetrician-gynecologist leading the pregnancy can feel the two heads and two pelvises of the developing fetuses.

• Strange word - fano electrocardiography

A similar procedure is carried out closer to the 20th week of pregnancy, and thanks to it, doctors can clearly distinguish the beating of two hearts, which certainly confirms a multiple pregnancy.

• Test – alphafetoprotein

A similar test is carried out during the transition from the 1st to the 2nd trimester of pregnancy and is done in order to identify possible abnormalities in the fetus. If you are pregnant with two fetuses, the test result will be very high.

• Stimulation

If pregnancy does not occur for a long time, and doctors take any measures to stimulate it, then in most cases several eggs ovulate at once, which subsequently leads to multiple pregnancies.

• Stopping taking contraceptives

Prevention with hormonal oral contraceptives for a long period of time suppresses the functioning of the ovaries. After stopping taking them, the ovaries begin to work at full capacity, making up for lost time, and often produce several eggs at once.

As you can see, dear readers, the signs of twins in the early stages of pregnancy are quite varied, they can be both medical and everyday. It is important for the expectant mother to listen to her own feelings, visit an obstetrician-gynecologist and an ultrasound room to find out for sure how many babies are in her growing belly. Good luck with your pregnancy and safe delivery! See you soon in new articles!

Today we will discuss all the issues of the development of twin pregnancy, features of the course of pregnancy itself and childbirth. As a pediatrician, I will even say a few words about my observations of the development of twins and pairs of twins after birth in my area.

So, a pregnancy is usually called multiple when two or more fetuses develop. But, since triplets and even more multiple pregnancies are not so common, today we will talk only about twins. If the problem of triplets is relevant for some of you, then I will say that everything works out in approximately the same way.

Twins and twins: what's the difference?

Twins develop when not one egg, but two, matures in a woman’s body. These germ cells can develop both in one ovary and in different ones at the same time. Of course, the obligatory condition is that both of them will be fertilized by two sperm (different ones, of course).

This results in two organisms with different genetic material. They can be the same or different gender. There is no particular similarity in their appearance; they look just like brothers and sisters.

Since children develop from different eggs, they may be called fraternal twins. Touching upon medical details, let me explain that each baby has its own fetal sac, its own placenta.

Twins are babies who develop from one egg fertilized by one sperm, which at a certain time divided into two parts, and from each part the development of a separate organism began. One egg, one sperm, same genetic material. Thus, twins are always the same sex, have an identical set of genes and the same appearance.

Twins can also have their own two sacs and two placentas. Doctors call such twins bichorionic and biamnionic. The earlier the egg is separated, the greater the likelihood of a separate placenta and separate amnion (fetal sac) forming. So, for example, the above-described version of twins will occur if the separation of the egg occurred on the 3rd day from the moment of fertilization.

But more common are twins with one placenta and two separate membranes (biamnic monochorionic twins). This scenario is possible if the fertilized egg decides to give two lives 3-8 days after meeting the sperm.

The third option for the development of twins is also common. This is when one amnion and a single placenta are formed (monochorionic monoamnionic twins). Typically, this option is possible when the division of the egg is quite late - 9-10 days after conception.

Why does multiple pregnancy develop?

Not everyone can experience double happiness. The incidence of twin births in the human population is approximately 1.5%.

The main reasons for the development of twins and multiple pregnancies in general are:

• hyperstimulation of the ovaries by hormones. It is used in medicine as an auxiliary technique for conceiving a child as quickly as possible. Hyperstimulation is indicated for a woman whose cause of infertility has been identified, and it consists of impaired maturation of female germ cells in the ovary;
• Twins are often born after in vitro fertilization. To increase the likelihood of pregnancy during IVF, several embryos are simultaneously fertilized and implanted into the expectant mother's uterus (in Russia, up to three embryos are possible at once). In the early stages, embryo death may occur, so doctors count on the successful consolidation of at least one of the implanted embryos.
• Of course, at the request of the parents, embryo reduction is possible if two have implanted. But this is a rather risky step, not to mention a sin. Reduction of an implanted embryo at the request of the parents after unsuccessful attempts to become pregnant is uncommon;
• recent cessation of oral contraceptives after long-term ovarian rest also increases the likelihood of multiple eggs maturing at the same time;
• hereditary factor. Heredity plays an important role in this phenomenon. Moreover, this feature is transmitted more through the female line, and more often through a generation. That is, for a woman who has given birth to twins, her granddaughter is more likely to give birth to twins, not her daughter. Although this is not a fact. For example, my mother never had twins in her family. But in my father’s family, after delving into the pedigree, we finally found a case of twins. Few people remembered this case, since out of two children there, only one survived after birth. And the fact that the possibility of multiple pregnancies was transmitted through the paternal line does not in any way contradict genetic laws.

Are there early signs of multiple pregnancy?

It is practically impossible for a woman to find out about her multiple pregnancy on her own. More often, pregnant women with twins note the appearance of early toxicosis. Moreover, the pregnancy test can be with the usual color intensity of the indicator strip. Only at the appointment can the doctor note that the size of the uterus is too large and does not correspond to the calculated period of pregnancy.

It is not always possible to recognize two embryos at the first ultrasound confirming the fact of pregnancy. But at 8-10 weeks of pregnancy, when it is possible to determine the heartbeat using Dopplerometry, it is already possible to accurately say about the beating of two hearts. And at the mandatory first screening ultrasound, which is carried out up to 12 weeks, the specialist will always notice the development of two babies, since their size at this stage is no longer tiny.

At later stages, women with twins report more severe heartburn, shortness of breath, and swelling of the lower extremities. A pregnant woman gains weight more rapidly. Normally, during a multiple pregnancy, a woman can gain 20-22 kg.

After 18-20 weeks, a woman may feel tremors simultaneously in different parts of the abdomen. And the doctor can feel several large parts, for example, two heads and two butts of babies.

Features of multiple pregnancy

I already wrote above about the earlier appearance and more pronounced toxicosis. It is understandable that pregnancy with one child puts a colossal load on all the systems and organs of a woman, and with twins it is even more difficult for the body to withstand the load.

Women pregnant with twins more often suffer from iron deficiency anemia, since it is incredibly difficult to provide oxygen and iron for the synthesis of red blood cells to two babies.

During pregnancy with twins, the volume of circulating blood increases. Since the mother's blood performs the function of providing the embryos with nutrients, the blood in the mother's body must circulate more intensively than during a normal pregnancy in order to provide nutrition to two babies.

Placental insufficiency is a fairly common occurrence during pregnancy with two babies, since two embryos require a more intense metabolism in the placenta. Because of this, changes inevitably appear in the structure of the placenta, leading to disruption of the blood supply and nutrition of the babies.

More often, this malnutrition occurs in one of the babies, which can lead to fetal fading in the early stages. There is another option that often occurs - one baby develops more intensively and is born with a noticeably greater weight than the second.

As a rule, during pregnancy with twins, the size of the placenta is more impressive than during pregnancy with one fetus. That is, it is often partially or completely attached to the baby’s path at the time of birth. This phenomenon is called placenta previa. With this development of events, childbirth through the birth canal is contraindicated. Placenta previa is one of the absolute indications for surgical delivery.

Since a double load falls on the kidneys of a pregnant woman with twins, very often edema in such women appears earlier and manifests itself to a greater extent than during pregnancy with one baby.

An excessively enlarged uterus forces a change in the location of internal organs - the stomach, intestines, and ureters. In this regard, such women have more severe heartburn, constipation, and a greater risk of urinary tract diseases during pregnancy.

The expectant mother can hear the babies moving as early as the 15th - 16th week. The intrauterine development of children in both singleton and multiple pregnancies is the same. However, during pregnancy with twins, due to the close location of the enlarged uterus to the surface of the skin, the woman notices the first movements earlier.

The intensity of fetal movements also differs from their intensity during a more common singleton pregnancy. In the later stages, babies push very intensely, trying to compete for a more comfortable position in the cramped space of the uterus.

At the antenatal clinic, a woman with a multiple pregnancy is observed more carefully and examined more often. Until the 30th week, an appointment is scheduled every 10 days, and after the 30th week of pregnancy - once a week.

The condition of the cervix is ​​carefully monitored, since isthmic-cervical insufficiency (prenatal dilatation of the cervix) due to overdistension of the uterus is a fairly common occurrence in multiple pregnancies.

A woman with twins can receive maternity leave and sick leave two weeks earlier than with a singleton pregnancy. That is, at 28 weeks, and not at the required 30 weeks of pregnancy. Payments of benefits after the birth of babies do not differ in terms. But they are charged for each of the kids.

Twin pregnancy calendar

Obstetricians-gynecologists count the first week of pregnancy from the first day of the last menstruation, when, in fact, menstruation is still ongoing and the egg is not fertilized. That is why, with the arrival of a delay in regular menstruation, a woman learns about the existence of pregnancy with a fairly decent period of 3-4 weeks.

Let's look week by week at what happens to babies and mothers at different stages of pregnancy.

First trimester

• 1-4 week

As a rule, a woman does not even suspect she is pregnant yet.

After the fusion of the egg and sperm in the fallopian tube, a zygote is formed. This is a single cell from which a multicellular organism will subsequently be formed. If there were initially two eggs, and they are fertilized by two different sperm, then two zygotes will be formed, and fraternal twins will develop.

During the process of cleavage, the zygote turns into a morula. First there are 2 cells (one cell is divided in half), then 4, then successively 8, 16 and 32 cells, located in a dense cluster in the shape of a raspberry. It is at the morula stage of 32 cells that the proembryo enters the uterine cavity. It may not be implanted into the wall of the uterus immediately, but after 2-3 days.

I will dwell in more detail on the moment when one fertilized egg gives two lives. This happens if, during crushing, the morula at some point suddenly “falls apart” into two parts, and each part begins to develop further independently, forming a separate organism.

If the division of a single fertilized egg occurs in the first three days after meeting the sperm, twins develop with separate membranes and separate placentas (second column in the figure).

If this division of the egg occurs between the 3rd and 8th days after conception, the twins will have separate membranes and one placenta (third column in the figure).

If the egg decides to divide later than 8 days, but before the 13th day from the moment of fertilization, twins will develop with a single membrane and a single placenta (fourth column in the figure).

Late division of the egg (after 13 days of life) threatens the development of undivided twins (Siamese).

Before implantation, a cavity is formed between the morula cells, and it turns into a blastocyst - a hollow vesicle filled with liquid contents.

Implantation occurs approximately on the 7th day after conception. At this stage, the process of cell division is only progressing. The process of implantation of the embryo into the wall of the uterus can take a couple of days. This is considered the first critical period in the development of pregnancy.

In the second week, the formation of primary and secondary chorionic villi (the future placenta) and differentiation of the germ layers, which will subsequently give rise to all the organs and systems of the baby, occur. This is considered the second critical period in obstetrics.

Up to 14 days, the embryo looks like a vesicle consisting of three germ layers. From the third week, blood vessels form and grow into the chorionic villi. Thanks to this, when the chorionic villi come into direct contact with the mother’s blood, the fetus receives nutrients. Thus, the type of nutrition of the embryo changes to hematotrophic (through blood).

With the beginning of the third week, the formation of all organs begins (organogenesis). First, the neural tube, heart and gonads are formed, then the liver, lungs, primary intestine and primary kidney. Starting from the 3rd week, you can determine the fetal heartbeat by ultrasound, if the permission of the device and the qualifications of the doctor allow this.

At the 4th week, the nervous system continues to develop, and the rudiment of the brain and spinal cord is formed. At this time, the rudiments of the upper and lower limbs are already visible in the embryo.

By the end of the 4th week, the embryos will be no larger than 2 cm in size.

• 5-8 week

During this period, organogenesis continues, that is, the formation of organs and body systems of developing children. The structure of all previously laid down organs and systems becomes more complex. Nerve fibers are formed that connect organs with the central nervous system, that is, with the brain and spinal cord. The head of the embryos at this time is disproportionately large.

At the sixth week of pregnancy, embryos can already bend and straighten their necks, changing the position of the head. Gradually, facial features emerge, eyes, ears, and mouth are formed. There is a clear difference between the upper and lower extremities, and the fingers are different.

At this stage, gender has already been formed, but gender cannot yet be determined. The genitals visible on ultrasound have yet to form.

Blood flow in the uterus and placental bed becomes more intense to ensure such intensive growth and development of embryos.

The eighth week marks the end of the embryonic period of baby development. At this time, the embryos are usually 4.5-6 cm long and weigh about 15-20 g.

• 9-12 weeks

By the ninth week, babies are fully formed to be called not embryos, but fruits. Your own blood type and Rh factor appear. With the end of the embryonic period, complete differentiation of the brain and spinal cord, central and peripheral nervous systems is observed.

The fruits swallow amniotic fluid. Their bladder and kidneys function. The movements of the fetuses become more varied - they can cover their faces with their hands, suck their thumbs, and move to the sides. The external genitalia are formed. The structure of the placenta becomes more complex. It begins to perform more and more functions (respiratory, protective, metabolic, hormonal).

At 12 weeks, the length of the babies is approximately 85-90 mm, the babies weigh up to 30 g each.

The first trimester of pregnancy has come to an end.

What changes await the expectant mother of twins in the first trimester?

The expectant mother of twins in the first trimester may experience earlier and more severe toxicosis, which may also make itself felt in the second trimester.

The uterus quickly increases in size. By the end of the first trimester, it often extends beyond the pelvis, therefore putting pressure on adjacent organs and can disrupt their normal functioning. Thus, pregnant women with twins feel a frequent urge to urinate already in the first trimester. Constipation is also a frequent (but not obligatory) companion to multiple pregnancies.

In women during this period, the mammary gland actively enlarges and becomes moderately painful and sensitive. But this symptom is characteristic not only of twin pregnancy, but of any pregnancy.

A woman should visit her doctor once a month. The gynecologist, at his discretion, can set you an individual schedule of visits. Up to 12 weeks, women must undergo an ultrasound, during which all disorders and malformations of the babies are excluded.

Second trimester

• 13-16 weeks

The skeletal system of babies is actively developing. The rudiments of the ribs are formed. The bones of the skull become smooth and denser. Shallow breathing movements can already be observed. It's more like training your chest muscles. The digestive system begins to function. Peristaltic waves of the intestines appear. Bile production begins in the baby's liver. Interestingly, it is at this time that babies develop their sense of taste.

The movements of developing children in the uterus become increasingly active. They already have quite rich facial expressions, but so far they remain involuntary (children frown, smile, open their mouths, perform sucking movements).

The skin of babies is quite thin, blood vessels are clearly visible through it. There is practically no subcutaneous fat tissue. The scalp is gradually covered with the first vellus hairs.

The approximate size of 16-week-old babies is about 12 cm from rump to crown, and they weigh approximately 90 g each.

• 17-20 weeks

Children are growing actively. The growth of the body of children at this stage prevails over the growth rate of the head.

At the seventeenth week of pregnancy, the size of the babies from the sacrum to the crown is approximately 14-15 cm, each already weighs approximately 130-140 g.

Children at this stage of intrauterine development already hear and distinguish sounds and respond to them with certain movements. With loud, sharp sounds, babies move more intensely. Their eyes are still closed, but they can already distinguish between light and darkness. On an ultrasound, you can observe that the baby, in response to some external influences, tries to cover his face with his hands, bring his chin to his chest, that is, bend his head.

It has been proven that twins sense each other's presence.

As a rule, women carrying twins hear the first movements of the fetuses earlier than usual (16 weeks for first-time mothers, 18 weeks for repeat pregnant women). Since babies are cramped in the uterus, they push away from its walls more actively. At this stage, a woman can feel up to ten baby movements per day. At this stage, babies develop the blink reflex.

The fetal heartbeat can already be clearly heard with a phonendoscope or obstetric stethoscope. The rudiments of teeth, including permanent ones, are intensively formed. During this period, a cheese-like protective lubricant is formed on the fetal body. Subcutaneous fat tissue is formed.

Babies' bodies are already producing immune cells. Fetal hemoglobin is gradually replaced by adult hemoglobin.

By the end of the fifth month, the coccygeal-parietal size of the babies reaches 21-24 cm, and the weight is already quite decent - 320-340 g.

• 21-24 weeks

During this period, all pregnant women already felt the first movements of their babies. Baby's sleep time gradually decreases, and the time of wakefulness and active movements increases.

There is an active strengthening of bones. The skin is still wrinkled and has many folds; in large folds, especially a lot of cheese-like lubricant of the fetus accumulates.

The child actively swallows amniotic fluid containing particles of lubricant and desquamated epithelium, and dark green feces already accumulate in his intestines. In a normal pregnancy, bowel movements of babies can occur only after birth.

At this time, the amount of subcutaneous adipose tissue increases, including brown fatty tissue, which will protect babies from hypothermia after birth.

Babies are already very good at distinguishing sounds. It is noticeable that for themselves they identify sounds that are sharp, loud, pleasant or unpleasant, and react to them in a certain way (with excitement or freezing).

By the end of this period, the babies reach a height of 26-28 cm, their weight increases to 450-550 g.

• 25-28 weeks

The children’s facial features are becoming more and more clearly visible; they already have eyelashes and eyebrows. The curves of the ears gradually form.

The lungs are actively developing, so-called air sacs (alveoli) are formed. They are not yet filled with air, but at the 25th week a substance called surfactant begins to be produced, which will prevent these sacs from collapsing after birth, when they are filled with air.

Babies are actively gaining weight due to an increase in the amount of adipose tissue, muscle growth, growth and strengthening of bones.

During this period, boys' testicles begin to descend into the scrotum, and girls' genitals continue to form.

By the 28th week, as a rule, the final presentation of the fetuses is established, since they are already cramped in the uterus, they cannot turn over from the cephalic presentation to the pelvic presentation or vice versa.

By this period, babies are practically formed. In case of premature birth, with proper nursing, they are already quite capable of surviving.

By the end of this period, the weight of the babies is approximately 800-900 g, height up to 35 cm.

Changes in the body of the expectant mother of twins in the second trimester of pregnancy

The uterus has already grown enough, the tummy is noticeably rounded. At this stage, it is already more difficult for a pregnant woman to lead her usual active lifestyle. But proper alternation of periods of rest and activity will help avoid problems with constipation, varicose veins, and swelling.

During this period, the expectant mother should pay special attention to the diet, namely the sufficient content of protein and calcium in it. It is worth enriching the diet as much as possible with products containing calcium and phosphorus, vitamin D 3 (fish, canned fish, eggs, nuts, hard cheeses, dairy products), since the skeletal system in children is actively developing. At this stage, the expectant mother may already be bothered by heartburn.

It's time to use a support bandage, since during this period most often the woman still has to work, and lower back pain and heaviness in her legs are already bothering her. The very physiologically changing gait (swinging) contributes to less strain on the back and pressure from the uterus on the pelvic bones. But in case of multiple pregnancy, it is difficult to do without additional support of the bandage.

Pregnant women often complain that it is difficult for them to find a comfortable position while sleeping. Experts recommend sleeping on your left side, with your upper leg bent at the knee and your lower leg straightened. Specially designed pillows for pregnant women are designed to relieve the pelvic bones and lower back and support a woman’s already enlarged belly.

Actively in the mammary gland, adipose tissue is replaced by glandular tissue. To the touch, the mammary gland has a fine-meshed structure.

The pigmentation of the parapapillary region on the chest and the midline on the abdomen becomes more and more clear. Pigment spots and freckles may appear on the body. This is due to an increase in melanin content in the skin of a pregnant woman.

Before the 22nd week of pregnancy, women undergo a second mandatory (screening) ultrasound. During this study, they may already be told the sex of the babies, if, of course, the position of twins allows them to consider their gender.

Third trimester

• 29-32 weeks

In children, the brain and cerebral cortex are actively developing, and the number of its convolutions is increasing. The brain mass of babies is 25% of the mass of an adult.

Now one of the cerebral hemispheres is beginning to function more actively, which determines whether the child will be left-handed or right-handed, and whether left-hemisphere or right-hemisphere activity will predominate.

The endocrine glands that produce hormones (thyroid and parathyroid glands, pancreas, pituitary gland) are actively working.

Surfactant already accumulates in large quantities in the lungs, and they begin test mode of operation.

By the end of this period, the weight of the babies is 1500-1600 g, length - about 40 cm.

• 33-37 weeks

The skin of babies becomes lighter as subcutaneous fatty tissue accumulates (about 10-15 g per day). The vellus hair is gradually wiped off. By birth, they may remain on the shoulders and back. There is more and more cheese-like lubricant on the body.

During sleep, babies' eyes are closed, and during periods of wakefulness, the eyelids are open. The color of the iris of all children's eyes is the same (deep dark blue) and only after birth it can change. The pupil already reflexively reacts by narrowing or dilating to the intensity of the penetrating light.

The pulmonary and digestive systems are fully formed. The kidneys are functioning fully, excreting up to 500 ml of urine per day. Amniotic fluid is renewed approximately eight times per day (every three hours). The bones of the skull are denser, but mobile and pliable, which is so important for the normal passage of the head through the birth canal.

The babies are fully formed and ready to meet their mother. By the end of this period, the weight of babies can fluctuate significantly - from 2200 to 3000 g, height - approximately 43-46 cm.

A pregnancy at 37 weeks is already considered full-term, and a woman pregnant with twins is being prepared for a planned delivery.

Changes in the condition of the mother of twins in the third trimester

Future mothers of twins have the right to finish work early and retire. For them, maternity leave starts from the 28th week. In the third trimester until the 30th week, gynecologists prescribe a visit to a pregnant woman every 10 days, and after the 30th week of pregnancy - once a week.

During this period, the intensity of the babies' movements decreases (they are cramped), but the force of the shocks increases. A greatly enlarged uterus can compress the inferior vena cava when a woman is lying on her back. Therefore, in this position, pregnant women often experience weakness, dizziness, and lightheadedness.

Constipation, incessant heartburn, hemorrhoids are frequent (but I repeat again - not at all necessary!) companions of the third trimester of multiple pregnancy. During this period, women may notice the first drops of colostrum released from the mammary gland. This is fine. The mother's body is preparing for the birth of babies. The reproductive tract and mammary gland are prepared for childbirth and functioning after childbirth, hormonal levels change.

At 32 weeks, women undergo a third screening ultrasound. Here you can finally see the position of the babies, their presentation, which fetus is closer to the womb. You can evaluate the condition of the placenta, since when twins develop, it often shows signs of aging prematurely (fast and intense metabolism through the placenta quickly wears it out). This is another reason for earlier delivery of multiple pregnancies.

The expectant mother of twins is hospitalized in advance in an obstetric hospital. This occurs approximately 3-4 weeks before the expected due date. This is done to finalize the method and timing of delivery.

In just the third trimester, a mother of twins can gain up to 6-7 kg. In the last weeks of pregnancy before giving birth, a woman can lose from 500 to 1.5 kg. The body gets rid of excess fluid, the mother’s blood thickens, and swelling decreases.

Peculiarities of childbirth when carrying twins

A woman with twins should be prepared for early hospitalization before giving birth. This situation requires more careful monitoring of the pregnant woman in the later stages.

Premature births in such women are very common. This is due to overstretching of the uterine muscles, which can serve as one of the triggers for the onset of labor. As a rule, if surgical delivery of a multiple pregnancy is required, it is planned for 36-37 weeks.

If there are problems with carrying twins and it is difficult to safely bring intrauterine development to 36-37 weeks, doctors try to maintain and bring the pregnancy to at least 32-34 weeks.

During this period of children's development, surfactant is already produced in their lungs. This is a substance that prevents the air sacs of the lungs (alveoli) from collapsing, and the lungs become more or less prepared to perform their function after the birth of babies.

But more often a different picture is observed - when one child is in a cephalic position and the other is in a pelvic presentation. It happens less often when one child is located in the cephalic or pelvic position, and the other in a transverse presentation.

Natural childbirth with a single placenta of twins is dangerous because at the birth of one of the babies, placental abruption may occur and, accordingly, the nutrition of the other child may be disrupted. In this regard, you will still have to resort to an emergency caesarean section in order to save the second baby.

Thus, preliminary hospitalization of a woman with twins 3-4 weeks before the expected date of birth is necessary to clarify the obstetric status and additional examination of the expectant mother, as well as to resolve the issue of the method of delivery. More often, the issue is resolved in favor of a planned cesarean section, since natural births of twins much more often end in complications for both the fetus and the mother.

My observations on the development of twins and twins after birth

As a pediatrician, observing the development of twins and twins after natural birth, I always note that the first born child of twins is larger and healthier for health reasons. It is he who endures the adaptation period after birth more easily.

Children born first are less likely to experience transient (borderline) conditions after birth (toxic erythema, physiological jaundice, transient neurological disorders: depression or excitation syndrome).

And development in the first year of life, as a rule, shows that the first child of twins develops faster than the second born.

These observations are confirmed by my family of twins. The twin sister was born larger and 5 minutes earlier than her twin brother. So, let's say, the brother, like a true gentleman, let the lady go ahead.

And throughout life, my sister quickly acquired new skills. She sat up faster and crawled. I learned to walk much earlier than my brother.

Now I am the mother of two children, the youngest of whom has just learned to walk. It so happened that at different times I had to lead both of them by the hand for a long time before the children walked on their own. The little man wants to walk, but he still doesn’t have enough strength. So he demands: “Lead me, Mom, by the hand!” Although there is still a question of who is driving whom)) J More likely, the baby is driving his mother. He also shows a demanding hand: “Take me there!”

I asked my mother how she coped with twins in such a difficult time. You need to drive and hold two people. But here nature itself probably took care that the twins did not simultaneously enter a new period of development. One is still crawling - the other is learning to walk.

So it’s possible to cope with twins, although it’s not easy. If, having learned about your double joy, you doubt and are full of fear about the upcoming birth and the future in general, then do not doubt it.

Not everyone can experience double happiness, which means you are a special person. Your pregnancy time will fly by. Another positive thing is that instead of 18 months in a pregnant state, you will only have 9 months. The result will be two babies, your two wonderful little bloodies. Double positive emotions and double your difficult happiness await you.

Health and happiness to you and your children!

Practicing pediatrician and twice-mother Elena Borisova-Tsarenok told you about pregnancy with twins.

Pregnancy with two future babies at once is not only double joy and enormous responsibility, because inside the fair sex two people live and develop at once.

Twin pregnancy refers to the specification of multiple pregnancy - the process of carrying more than one fetus at the same time. Children born from this condition are called twins.

According to official statistics, before the era of in vitro fertilization, every eightieth woman gave birth to twins. The development and mass introduction of reproductive technologies has increased the incidence of multiple pregnancies several times.

Multiple pregnancy

Multiple pregnancy is a general concept and usually defines the presence of more than one fetus in a pregnant woman. Depending on their number, it can be twins, triplets, and so on.

Common reasons

There are only two basic reasons for multiple pregnancy:

1. Maturation of several eggs at once in one uterus.
2. The division of the zygote into several parts after fertilization.

In the first case, on ultrasound there is no septum between the twins, in the second there is one, but the degree of separation of the embryos may differ. If the zygote splits in the first days, then the degree of isolation of future children will be high. If this process drags on for several weeks, then the likelihood of conjoined twins becoming very high becomes very high.

There are a number of indirect and direct signs indicating a multiple pregnancy.

Medical signs

1. Ultrasound results.
2. Abnormally high AFP blood test results.
3. The sound of two hearts, diagnosed by the Doppler system.
4. Significant expansion of the uterus, determined when diagnosing the height of the uterine fundus.

Early signs of twin pregnancy

1. A very bright and saturated stripe on an express test to determine pregnancy, caused by a significant increase in the blood hormone HcG.
2. The presence in the family of women who previously carried multiple pregnancies.
3. Earlier onset of toxicosis, which is more difficult to tolerate than during normal pregnancy. At the same time, acne and signs of severe fatigue, characteristic of the middle, rather than early stages of gestation, form faster.
4. Earlier (from the fifteenth week) the babies move due to the close presentation to the walls of the uterus.
5. Large belly.

Fetal development in twins

The development of two babies at once during pregnancy is quite similar to classic singleton pregnancy, however, for the mother this process is more problematic, primarily due to possible additional complications.

In the first trimester, twins each grow in a separate zygote. By the end of the first month, the zygote is implanted into the endometrium. In the second trimester, children have their own fingerprints, begin to drink amniotic fluid and even squint, ultrasound already shows their exact gender. The third trimester is the final formation of children.

Representatives of the fair sex will have to visit the doctor more often for additional monitoring of the condition of the body and fruits, rest more, and consume the required amount of vitamins and fruits. Often, from the beginning of the third trimester, she will be offered to be kept in storage until 36 weeks and the onset of labor.

Possible complications

Multiple pregnancy implies possible additional complications for both the mother and future children. The most common of them:

1. Incorrect position of the fruits.
2. Polyhydramnios.
3. Previa of placental structures.
4. Severe fatigue, shortness of breath and palpitations.
5. Anemia.
6. Prematurity and fetal development disorders.
7. Intrauterine growth retardation and, accordingly, very low birth weight of babies.

1–10 weeks

Your body is actively reacting to pregnancy. The mammary glands swell and increase. By the eighth week, the embryos are already about three centimeters long and can already be detected using ultrasound.

The symptoms of sensations coincide with classic singleton pregnancy, only toxicosis and other negative sensations appear earlier. After the eighth week, future babies complete embryonic development, and by the 10th–11th week, hearts are formed, and the voice-producing apparatus begins to form. The weight of your babies is about five grams.

10–20 week

The uterus with two future babies is actively expanding, you begin to wear large clothes. Twins are actively growing at a rapid pace; from the 16th week, their gender can be determined by ultrasound. Their movements become more and more active (from the twentieth week they are clearly noticeable), while the coordination of the hands and head is poorly expressed. The main metabolic organ is still the placenta, but the rudiments of the excretory and digestive system are already present: future children swallow amniotic fluid and at the same time expel decay products through urination.

By the sixteenth week, the body length of twins is about 17 centimeters, weight up to two hundred grams. In the twentieth, they gain another 100 grams and up to ten centimeters in height, while they can respond to sounds.

20–30 week

A rapidly growing uterus provokes the appearance of stretch marks; the metabolism in women during this period is significantly accelerated. Future babies literally compete for the best position in the womb; the result of the struggle is constant tremors.

By 24–25 weeks, the growth of the fetus is already about thirty centimeters, the weight reaches 700 grams. The appearance of the babies is almost close to newborns, their noses are finally formed, and the formation of facial features is completed.

The woman gradually returns to frequent urination, extensive swelling occurs, and fatigue becomes more profound. By the 28th week, future children will reach the threshold of viability and, in the event of premature birth, will most likely be saved. By the thirtieth week, each baby weighs about a kilogram, height up to 35 centimeters. The formation of the body is 95 percent complete.

30–40 week

Calm and only calm - for mothers, one of the most important phases begins, namely, the final third trimester. Babies are almost ready to see the world, their bone skeleton is formed, calcium and iron are gradually accumulating, and the pancreas is developing. The size of the bodies has almost caught up with the head and now, in general, the body looks familiar.

From 32 weeks, false contractions may appear, not exceeding a few minutes. Due to a large belly and other negative factors, it is very uncomfortable for mothers to sleep; in addition, representatives of the fair sex suffer from heartburn. From the 36th week, the pregnant woman is scheduled to be hospitalized in the maternity hospital.

By 37 weeks, future babies are considered fully term and ready to be born. The sucking apparatus is formed, the height of the child reaches 55 centimeters, and the weight is about 2.3–3 kg, which is slightly lower than in a singleton pregnancy.

Pregnancy with twins, as mentioned above, has some features - in particular, this is a larger list of possible complications for the mother and future children, a more active manifestation of symptoms of toxicosis and other negative factors, lower weight and height of individual fetuses, as well as a high probability of premature birth.

Pregnancy with twins after cesarean section

Caesarean section is a rather complex operation, which significantly increases the risks for the mother and fetus in subsequent pregnancies, especially if the patient has a multiple pregnancy.

In case of twins and a normally unhealed scar on the uterus, doctors often recommend terminating the pregnancy even with normal metabolic processes and the absence of other negative factors. If a woman who has previously undergone a cesarean section carries twins until the thirtieth week, in any situation the attending physician performs a repeat operation - this will partially remove the risk of uterine rupture and other processes that can even lead to death.

Second pregnancy with twins

A second multiple pregnancy is very rare. Partially, the low probability of such an event is increased by IVF, but the process of pregnancy and childbirth in this situation significantly overloads the body. In any case, the pregnant woman is placed under very strict registration in the antenatal clinic. At the same time, it is recommended to go into confinement from the second trimester in order to monitor the condition of the body of future babies and the fair sex in a hospital setting.

Childbirth during a multiple pregnancy usually occurs earlier than 40–42 weeks, closer to 36–38. Future children are fully formed, although their weight and height are below the classical norm, therefore, to suppress possible consequences, babies are immediately sent to intensive care.

Unfortunately, even qualified specialists cannot always predict the exact course of such childbirth due to a number of features, in particular.

1. Features of the behavior of babies, each of which can interfere with the birth of another.
2. Possible monoplacental structure, often leading to the death of one of the newborns due to oxygen starvation.
3. Asynchronous conflict of fetal position: one of the babies may have a breech presentation, while the second may have a cephalic presentation. During the birth process, sometimes there is a catch and simultaneous exit of both into the pelvic opening. Which is fraught with serious consequences for the mother and future children.

Nowadays, with multiple pregnancies and the absence of direct contraindications, doctors often recommend natural childbirth, albeit under the strict supervision of a doctor. If the mother has a narrow pelvis, polyhydramnios, breech presentation of one of the fetuses, high weight of the unborn babies, anomalies in intrauterine development (one placenta, hypoxia, breech presentation, etc.), then the specialist will probably prescribe a cesarean section.

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Ultrasound of twins - 22 weeks

Question answer

What is the probability of pregnancy with twins after IVF?

IVF significantly increases this likelihood, since several embryos are implanted into the uterus: if more than one takes root, a multiple pregnancy is formed.

What size is the belly when pregnant with twins? What is the normal weight?

During the development of a multiple pregnancy, the belly of the fair sex is larger in size than that of women with one unborn child. However, its exact dimensions depend on the type of attachment of the fetus to the uterus (along the front or back wall), the size of the unborn children themselves and other factors.

The mother's weight standards during pregnancy with twins differ from the standards for weight gain during a singleton pregnancy. To do this, you need to make a simple calculation and calculate your body mass index (BMI).

IDMT = weight in kilograms / current height in meters squared

If your BMI during pregnancy was less than 18.5, then weight gain of 13–18 kilograms is considered normal. With IDMI from 18.5 to 25, the norm is 11–16 kg. From 25 to 39 - 7–11 kg and the body mass index was more than thirty - from 5 to 9 kg.

Are there any peculiarities in the movement of twins during pregnancy?

Twins subjectively begin to move faster than one child. In fact, both types of pregnancy develop approximately the same, it’s just that in the case of twins, the fetuses take up more space and are located closer to the upper edges of the woman’s epithelium, which feels the movements more clearly and strongly.

It is also worth noting that from the second trimester of pregnancy, both future children move more actively together than one, essentially “fighting” with each other for free space in the mother’s belly.

Is it possible to have a second pregnancy with twins after a previous twin pregnancy?

If you have not used IVF, then the chance of a repeat multiple pregnancy in a woman who has already given birth is negligible. However, if it did happen or reproductive technologies were involved, the next birth and, accordingly, gestation is carried out under the strict supervision of doctors, who often prescribe a cesarean section to minimize risks for the newborn and the mother.

Hello, dear subscribers! Some mothers know for sure that they are pregnant with two or more babies from the very beginning. Perhaps they have strong intuition, or, most likely, they are under the supervision of a reproductive specialist. In today's article I will list the main symptoms of multiple pregnancy in the early stages.

Looking back, many of the symptoms were obvious to me - terrible toxicosis, extreme fatigue (all I wanted to do was lie on the couch). After the news that we were having twins, my husband and I experienced a storm of emotions: from horror to happiness. But the probability of multiple pregnancy is so low (1 case in 80).

In most women, multiple pregnancies are discovered only after an ultrasound. However, is there a way to tell if you are carrying more than one child? Yes, you can understand this before visiting the doctor. Early signs of multiple pregnancy include:

Severe toxicosis

Intolerance to certain foods and smells accompanies many women at the beginning of their journey. But multiple births increase symptoms of illness, such as nausea and vomiting, which can occur throughout the day.

Fatigue

Excessive fatigue is a common complaint among women carrying twins, both early and throughout pregnancy. Their bodies undergo powerful hormonal changes, which is why they have so little energy left to carry out everyday activities.

Constant hunger

Growing a baby is hard work for the body, especially if there are two of them. You no longer eat for two, but for three. Mothers often do not know about twins in the early stages. They don't eat enough and feel constantly hungry.

Old clothes don't fit

Weight gain can vary depending on a woman's height, her build, and how much she weighed before. During a singleton pregnancy, the mother gains an average of 1-2 kg. If more, then this indicates multiple births or excessive consumption of unhealthy foods. If you have a clearly large belly at 8-10 weeks, then this indicates the presence of several babies.

Hormones are out of control

Because the body produces hormones in higher quantities, mood swings during a twin pregnancy may be worse than during PMS. Therefore, going from tears to joy, from melancholy to action and back in five minutes is not uncommon.

Elevated levels of human chorionic gonadotropin

This hormone grows at a rapid pace, reaching a maximum at about 10 weeks. Due to the fact that it is higher in multiple pregnancies, a positive test appears earlier than usual, and it will look like two fat stripes.

Extreme Heartburn and Overactive Bladder

These symptoms are more pronounced because two children take up more space than one. In addition, children grow faster; the uterus during multiple pregnancies puts even more pressure on the stomach and bladder.

A few heart beats

Hearing your baby's heart beat for the first time is one of the most memorable experiences. Using sound waves, a Doppler detector amplifies the fetal heart sounds. Unfortunately, this is not the most effective way in the early stages.
A clear heartbeat is usually recorded towards the end of the first trimester. And even what seems like the heartbeat of the second baby can be an ordinary echo of the beating of the mother’s heart. Or the babies may be located so close to each other in the uterus, especially identical ones, that their rhythms do not differ and merge into one sound.

High alpha-fetoprotein test results

An AFP test, also known as the triple screen, is usually performed in the second trimester. It eliminates the risk of congenital fetal defects. With twins, the titers of this marker are at an increased level.

In addition to physical symptoms, many mothers report an unexplained feeling or suspicion. Unusual cases often occur. One expectant mother of twins discovered that all the eggs she bought for holiday baking contained double yolks. A couple of days later, an ultrasound showed that she was expecting twins!

The surest way to diagnose twins

It is believed that it is possible to accurately see several embryos only with the help of ultrasound. At what stage is a multiple pregnancy determined? A specialist can see this fact in 5-6 weeks. But, as a rule, it is diagnosed during the first screening at 12 weeks.

Although there are cases where the ultrasound did not detect twins (there are simply too many noses to accurately determine who is who). Sometimes when twins are detected very early (before 10 weeks), only one child is found later. So called .

By the way, the largest multiple pregnancy in the modern world happened to 33-year-old Nadia Suliman in 2009. She became pregnant through IVF and gave birth to eight healthy children. Interestingly, she already had six children. The book of records also recorded ten children born at the same time, but none of them survived.

Now you know how to identify a multiple pregnancy, and this news will not take you by surprise like it did me.

As a rule, multiple pregnancies are observed in those who have undergone artificial insemination (IVF) or the lucky ones who have already had twins or triplets in their family. If you have dreamed so much about twins or triplets, and at least one of these factors has been taken into account, then you want to know about this event as early as possible. It is for this reason that today we will look at the signs of twins in early pregnancy.

The doctor will be able to please you with this news only after an ultrasound examination, and then not the first, but already in the second trimester of pregnancy. But in this situation, special medical supervision is needed.

So, what is a multiple pregnancy and what signs of a twin pregnancy can an expectant mother notice in the early stages? This is the carrying of two, three, four or more babies in the womb. Let's immediately note the statistics: in Europe, the rate of multiple pregnancies has now increased to 1% under the influence of IVF. Currently, 1 out of 89 pregnancies is multiple.

Early signs

To begin with, in this section we will list the conditions that increase the chances of several babies being born at once. These include:

1. Age from 35 years (this is a scientifically proven fact, the whole point is that with age there is an increase in the hormonal levels responsible for the maturation of eggs).
2. Genetic factor (if there have already been such cases in the family, then the chance of becoming a happy mother of several babies at once increases).
3. Malfunction of the ovaries (approximately once every 200 menstrual cycles a malfunction occurs - the maturation of 2 eggs at once).
4. In vitro fertilization (for a greater likelihood of a successful outcome of the procedure, several fertilized eggs are implanted into the woman at once).
5. Stimulation with the help of certain drugs (they enhance the work of the ovaries, and this is how the formation and maturation of 2 eggs occurs at once).
6. Refusal of OK - oral contraceptives (when taken, a hormonal background is created, as during pregnancy, the ovaries rest, and refusal to take it contributes to increased work of this organ).
7. Large family (the more children a woman has given birth to, the greater the chance of having twins).
8. Men from the Middle East and Africa are more likely to have twins (an ethnic feature).
9. The duration of the menstrual cycle, which is 21 days, contributes to the occurrence of multiple pregnancies.
10. Bicornuate uterus (this organ pathology leads to the formation of two eggs at once).

The classic version of pregnancy is carrying 1 fetus. But carrying several children creates additional stress on a woman’s body. For this reason, every expectant mother should know the signs of twins in the early stages. These include the following:

• genetics (note that re-birth of twins or triplets is possible after a generation);
• on the test that women carry out at home, the second strip will be very clear and bold, which indicates a high level of hCG;
• very strong drowsiness;
• severe toxicosis;
• acne may appear, which becomes possible due to the large amount of hormone production;
• rapid growth of the abdomen;
• early and active movements.

Medical confirmation of multiple pregnancy

The above signs of twins, which the mother herself can note even before a visit to the gynecologist, are not always easily tolerated by a woman. If you notice these signs, notify your doctor.

Here are the signs that a gynecologist may notice during a multiple pregnancy:

• horizontal furrow separating babies;
• deepening of the uterine fundus;
• detection of 4 large parts upon palpation of the abdomen (two heads and two pelvis);
• Ultrasound at 12 weeks of pregnancy;
• phonoelectrocardiography (the beating of two hearts at once is noted);
• when listening, the heartbeat is noted in different places;
• the AFP test in the second trimester of pregnancy is not just positive, but quite high (a test for detecting abnormal fetal phenomena).

Fatigue

Above, we highlighted a number of signs of twins in the early stages that the expectant mother herself can detect; now we’ll talk about them in more detail. Let's start with increased fatigue. It is important to note that expectant mothers of twins, triplets, and so on literally sleep on the move (sitting, standing, lying down). This can be noticed even at the stage when they are not even aware of their pregnancy (that is, from the first day of fertilization).

During pregnancy, lethargy, fatigue and drowsiness, especially in the first trimester, are normal, but during multiple pregnancies they literally double.

If a woman is already expecting another child, then she will easily feel the difference, but for a first-time mother, her condition is not always clear. How can you easily recognize twins based on this sign? If you have a pregnant friend, you can see her fatigue, but she still flutters around, enjoys life, and so on, and for you getting to work is a real feat, then most likely you are expecting twins. However, it is worth excluding many more factors that contribute to severe fatigue:

• stress;
• poor nutrition;
• heavy workload and so on.

Morning sickness

Another sign of twins is morning sickness. Please note that this will not necessarily be severe nausea or vomiting with a vengeance, it may simply be a loss of strength that goes away by the middle of the day.

As for toxicosis, it is worth remembering that each organism is individual. Some happy mothers of twins and triplets felt just great during pregnancy. And those who are expecting one child may experience very severe discomfort due to severe toxicosis. If you feel great, this is not an indication that you are carrying only one baby in your womb.

Don't forget about women's intuition, which is greatly aggravated during pregnancy. The expectant mother can feel for herself how many children she has and what gender they are.

Movements

Another sign of twin pregnancy is early movements. As a rule, a mother first feels her baby move only at the nineteenth week. If you are pregnant for the second time or more, you may feel tremors as early as the sixteenth week.

Often, women who are expecting two or more children experience earlier and more intense movements. In addition, during multiple pregnancies, there is a discrepancy between the size of the uterus and the delay in menstruation. At a later date, the doctor will be able to determine the number of babies by palpating and listening to the tummy. Please also note that movements during multiple pregnancies are not at all different from those that mothers feel when carrying one baby.

hCG

When you take a pregnancy test, it is human chorionic gonadotropin that alerts you to an “interesting” situation. After you are registered with a gynecologist (starting from the tenth day after fertilization), the doctor constantly monitors the level of this hormone throughout pregnancy. One of the most common signs of twins is high hCG levels.

In addition, mothers who are expecting twins gain about five kilograms more weight than women pregnant with one baby. However, please also note that this is not the only factor influencing weight gain. Pay attention to your diet; in this situation it is better not to overeat. Eat less, but more often, and be sure to watch your diet, because the baby’s well-being now also depends on it.

Gestational age

Another sign of twins in early pregnancy is a high gestational age. What it is? When you visit your gynecologist, he will definitely measure the distance between the top of the uterus and the top of the pubis. This is necessary to determine the gestational age of the child.

If you have a multiple pregnancy, the uterus expands more, therefore, the indicator increases. But we should not forget that this is not the only reason for this phenomenon. This is why it is important to visit your doctor regularly.

AFP

How else can you recognize a multiple pregnancy without an ultrasound? We looked at quite a lot of signs of twins in the article, but the AFP test went unnoticed. It is done to detect birth defects in a child. Don't be alarmed if the result is quite high or positive, this often happens with multiple pregnancies. An ultrasound is required to confirm the result.

Please note that twins are not always visible on the first ultrasound. Although there were many cases when multiple pregnancies were detected as early as the sixth week. At week 22, there is already a higher probability that the doctor will detect several babies on an ultrasound. A mistake at this time occurs only if the mother is expecting five or more children.

Risks of multiple pregnancies

We examined in detail the first signs of twins, which the mother herself can notice without consulting specialists. Now let's move on to the question of why, especially during multiple pregnancies, you should definitely visit your doctor regularly?

The risks directly depend on the connection between the membranes, placenta and twins. Every third multiple pregnancy is monochorionic (babies share one placenta). Among them:

• more than 30% - dichorionic-diamniotic (two umbilical cords, thick septum between babies);
• more than 60% - monochorionic-diamniotic (thin septum);
• 2% - monochorionic-monoamniotic (common amniotic sac and placenta).

In the first case, the risks are minimal if the first child has a cephalic presentation. This case does not require special medical supervision. In monochorionic-diamniotic twin pregnancies, there is a chance of developing feto-fetal transfusion syndrome. The mother is recommended to undergo control examinations twice a month. The most difficult and dangerous case is the third. Here, babies run the risk of their body parts growing together (Siamese twins) or intertwining their umbilical cords. Frequent ultrasound examinations are necessary, and a caesarean section is required for childbirth.

Features of pregnancy

If you listen to the recommendations given by your doctor, you will spend this time no less happily than women expecting one child. Since during a multiple pregnancy a double load is immediately placed on the mother’s body, doctors pay closer attention to you.

When you are expecting two or more babies, there is a high probability of miscarriage or premature rupture of amniotic fluid. This is especially true in recent months. Don't overexert yourself or do heavy physical work. Some are recommended bed rest or hospitalization.

As a rule, twins are born earlier (at 36 or 38 weeks). Their weight is less than that of other children, however, they are distinguished by their increased ability to adapt. The weight and abdominal circumference will be slightly greater than for women expecting one child.

Be sure to watch your diet and consult your doctor about taking vitamins and mineral complexes. During a multiple pregnancy, the body can quickly deplete its reserves.