More than one baby at birth

Preg­nant women with mul­ti­ple preg­nan­cies face a dif­fer­ent set of cir­cum­stances com­pared to those with sin­gle­ton preg­nan­cies.

The Star Malaysia - Star2 - - TELL ME ABOUT... -

MY cousin just gave birth to twins. This is so ex­cit­ing! How do twins hap­pen?

There are two dif­fer­ent types of twins. Fra­ter­nal twins are the most com­mon kind. They oc­cur when two dif­fer­ent eggs are fer­tilised by two dif­fer­ent sperm.

Each twin has his or her own pla­centa, at­tached to the mother’s womb, and am­ni­otic sac. The twins can be two girls, two boys, or a boy and a girl. They are usu­ally not very alike, no more than you are like your sib­ling. Iden­ti­cal twins hap­pen when a sin­gle egg be­comes fer­tilised. It then splits up and de­vel­ops into two ba­bies. Iden­ti­cal twins share a sin­gle pla­centa, but each baby usu­ally has a sep­a­rate am­ni­otic sac. The two ba­bies have iden­ti­cal genes. They share the same sex and the same phys­i­cal traits.

In­ter es­t­ing. M y cou sin­has no his­tor y of tw ins ever be­ing pr es­ent in­her fam ily. H ow is it that she had tw ins?

Some­times, twin preg­nan­cies just hap­pen spon­ta­neously. Twin preg­nan­cies are more likely to hap­pen when you get older, es­pe­cially when you get preg­nant when you are in your 30s or 40s.

This is be­cause your men­strual cy­cles are not as reg­u­lar any­more, and you are more likely to ovu­late more than one egg at a time.

In the US, ap­prox­i­mately three in ev­ery 100 preg­nant women give birth to twins or triplets. They are ac­tu­ally be­com­ing more com­mon in the world as women opt to give birth at an older age.

At other times, es­pe­cially these days, use of in- vitro fer­til­i­sa­tion and other re­pro­duc­tive boost­ing tech­niques of­ten re­sult in twin preg­nan­cies.

The fer­til­ity drug, clomiphene, re­sults in a higher rate of twin and mul­ti­ple preg­nan­cies com­pared to if you don’t take fer­til­ity drugs.

You of­ten hear of many fe­male celebri­ties hav­ing twins when they get older. They are very likely to have taken fer­til­ity drugs.

What about trip lets, quadru­plet sand higher mul­ti­ples?

The same rule ap­plies. They can be iden­ti­cal, fra­ter­nal or even com­bi­na­tions of both, de­pend­ing on how many eggs were fer­tilised or how they sep­a­rated. Rarely, a fer­tilised egg that is sup­posed to re­sult in twins can fail to com­pletely sep­a­rate into two in­di­vid­u­als. These ba­bies are known as con­joined or Si­amese twins. They can be sep­a­rated after birth through surgery.

Are hav­ing twins the same as hav­ing a sin­gle baby in the womb? Any­thing I should watch out for?

There are many dif­fer­ences, ac­tu­ally.

You will have to go for more fre­quent check- ups, and cer­tainly more fre­quent ul­tra­sounds and tests. An ul­tra­sound will be able to pick up twins as early as five to six weeks into your preg­nancy. Some even claim to have picked them up at four weeks.

You’ll need more folic acid, cal­cium, iron, pro­tein and other essen­tial nu­tri­ents.

If you’re al­ready eat­ing a healthy diet, keep it up – and be sure to take a daily pre­na­tal vi­ta­min. Your health­care provider might rec­om­mend an iron sup­ple­ment as well.

You will ex­pe­ri­ence more weight gain than with a sin­gle preg­nancy. You might be re­quired to eat an ex­tra 600 calo­ries a day.

You will also have to limit some ac­tiv­i­ties like work, travel, and ex­er­cise as your preg­nancy pro­gresses.

You are also very likely to give birth pre­ma­turely, or be asked to con­sider a labour in­duc­tion.

Your doc­tor may rec­om­mend in­duc­ing labour or do­ing a Cae­sarean sec­tion when you are 38 or 39 weeks into your preg­nancy.

I have heard that there are more com­pli­ca­tions with twin preg­nan­cies. I am wor­ried. Is this true?

It is true. But re­mem­ber, these com­pli­ca­tions are the rar­ity, not the norm. Many twins are born without any com­pli­ca­tions to ei­ther mother or ba­bies ev­ery day.

You are more likely to get preg­nancy com­pli­ca­tions if you have twins, such as high blood pres­sure dur­ing preg­nancy and pro­tein in your urine. This is a con­di­tion known as pre- eclamp­sia. It has to be man­aged care­fully with cer­tain med­i­ca­tions.

In the womb, there is a phe­nom­e­non known as twin- to- twin trans­fu­sion. This hap­pens when one baby re­ceives more blood than the other baby, lead­ing to dif­fer­ence in sizes and de­vel­op­ment.

You are also more likely to give birth pre­ma­turely. The more ba­bies you are car­ry­ing, the more likely you are to give birth be­fore term.

Nat­u­rally, if the ba­bies are pre­ma­ture, the more they have to fight to sur­vive. There­fore, many doc­tors give you a steroid jab these days to let the lungs of the ba­bies in your womb ma­ture. This steroid jab is ex­tremely painful, un­for­tu­nately.

Pre­ma­ture ba­bies will have their own set of com­pli­ca­tions, such as jaun­dice, breath­ing and di­ges­tive dif­fi­cul­ties. They are more likely to get in­fected.

Very rarely, one twin is de­liv­ered first, and the other twin con­tin­ues de­vel­op­ing in the womb. This is called de­layed in­ter­val de­liv­ery.

Most twins in the mod­ern world are de­liv­ered via C- sec­tion nowa­days to avoid com­pli­ca­tions, but vagi­nal de­liv­ery is pos­si­ble if the first baby fac­ing is head down.

ma­ter­nal com­pli­ca­tions are in gen­eral more com­mon in mul­ti­ple preg­nan­cies. — TNs

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