Alia Bucciarelli, MS
A multiple pregnancy is when a woman is pregnant with two or more fetuses. Twins are the most common type of multiple pregnancy. So-called “higher-order” pregnancies (when a woman is carrying triplets, quadruplets, quintuplets, or more) are less common.
The risk for certain complications during and after pregnancy is higher in multiple pregnancies. To lessen these risks your doctor will see you more often than a woman carrying one baby.
Multiple pregnancies occur when a single fertilized egg divides and develops into two or more fetuses (identical twins) or when more than one egg is fertilized by a different sperm (fraternal twins). Triplets, quadruplets, and quintuplets can be identical, fraternal, or a combination of both.
A risk factor is something that increases your chances of getting a disease or condition. The following factors increase your chance of having a multiple pregnancy. If you have any of these risk factors, tell your doctor:
If you experience any of these symptoms do not assume it is due to a multiple pregnancy. These symptoms may be caused by other health conditions. If you experience any one of them, see your physician.
Symptoms include the following:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. Your doctor may refer you to a healthcare professional who has experience with multiple pregnancies.
Most multiple pregnancies are discovered during an
examination. An ultrasound examination is a test that uses sound waves to see how the fetus is developing. An ultrasound can detect more than 95% of multiples by the second trimester of pregnancy.
Other tests that may detect a multiple pregnancy include:
Multiple pregnancies have a greater risk for certain complications. If you experience any of these conditions, your doctor will discuss the best treatment plan for you.
Most multiple births are preterm (before the end of 37 weeks of pregnancy). Babies born preterm have a higher risk for many health problems. To delay preterm birth, your doctor may suggest bed rest at home or in a hospital or prescribe certain drugs. If labor threatens to occur before 34 weeks of pregnancy you may be given steroid medication to help your babies’ lungs mature.
is a disorder in which the body becomes less sensitive to insulin resulting in high blood sugar levels. Gestational diabetes treatment aims to return blood sugar levels to normal through diet, exercise, blood sugar level testing, and sometimes insulin shots.
is a condition occurring during pregnancy when a woman has high blood pressure and more than normal amounts of protein in her urine. Treatment may include drugs, rest, and early delivery of the babies.
More than one fetus in the uterus increases the chance that one of them will be unable to turn head down. A
or transverse presentation increases the chance of needing a
Twins sometimes share vessels in the placenta. If this sharing is unequal, this syndrome can develop. In TTTS, one twin transfuses (donates blood) to the other. The donor twin becomes anemic and the receiving twin develops problems of having too much blood and fluid in its body.
More than one fetus in the uterus increases the chance of
postpartum hemorrhage. This is heavy blood loss in the mother after delivering the babies.
To help reduce your chance of having health problems during a multiple pregnancy, take the following steps:
American Congress of Obstetricians and Gynecologists
March of Dimes
The Society of Obstetricians and Gynaecologists of Canada
Having twins. American College of Obstetricians and Gynecologists website. Available at:
http://www.acog.org/~/media/For%20Patients/faq092.pdf?dmc=1amp;ts=20130827T0952000318. Accessed August 2, 2005.
Multiple births. National Center for Health Statistics website. Available at:
http://www.cdc.gov/nchs/fastats/multiple.htm. Accessed August 2, 2005.
Multiple Gestations: complicated Twins, Triplets and High-Order Multifetal Pregnancies.
The American congress of Obstetricians and Gynecologists, Practice Bulletin No. 56. October 2004 (Reaffirmed 2009).
Multiples: twins, triplets, and beyond. March of Dimes Birth Defects Foundation website. Available at:
http://www.marchofdimes.com/pregnancy/multiples-twins-triplets-and-beyond.aspx. Accessed August 2, 2005.
Preparing for multiple births. KidsHealth–Nemours Foundation website. Available at:
http://kidshealth.org/parent/pregnancy_newborn/pregnancy/multiple_births.html. Accessed August 2, 2005.
Last reviewed May 2015 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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