Twin pregnancies are the most common among multiple pregnancies. Twin pregnancies occur in 1 in every 89 pregnancies that occur naturally. This rate increases even more in those who receive drug treatment for pregnancy, especially in in vitro fertilization applications.
Twins are divided into two groups: identical twins (monozygotic) and fraternal twins (dizygotic). 1/3 of all twins are monozygotic, that is, one egg, and 2/3 are dizygotic, that is, fraternal twins.
Dizygotic twins (fraternal twins): Here, two egg cells are fertilized by 2 sperm at the same time. Their genetic structures are not the same, so their gender and appearance may be different. They are like two separate siblings in the womb at the same time. 70% of the time, their genders are the same, 30% are different.
They always have two placentas. Their placenta and amnion are different.
Monozygotic twins (Identical twins): Here, like singleton pregnancies, 1 egg is fertilized by 1 sperm, but will later be divided into two. The genders are always the same. Their genetic structure is the same. If this division occurs within the first 3 days after fertilization, diamniotic dichorionic (two amniotic sacs, two placentas), if it occurs between days 4-8, diamniotic monochorionic (two amniotic sacs, one placenta), if it occurs after the 8th day, diamniotic dichorionic (two amniotic sacs, two placentas). ) twin pregnancy occurs. The most common diamniotic is monochorionic. In later divisions, the result of divisions after this period is Siamese twins (or conjoined twins).
In the follow-up of twin pregnancy, it is very important to have one or two placentas (monochorionic-dichorionic). It is important. Ultrasound performed around 13-15 weeks can be very useful to distinguish this.
In multiple pregnancies:
- Premature birth is more common.
- High blood pressure (preeclampsia and eclampsia) is more common during pregnancy.
- Nausea and vomiting are more common.
- Placental anomalies are more common. Placenta previa, such as placental abruption.
- Anemia is more common.
- The risk of congenital anomalies is higher.
- Cerebral palsy (spastic disabled) babies are more common. .
- twin-to-twin transfusion syndrome may be observed.
- vanishing twin syndrome ome) can be seen.
One of the twins is dead and the other is alive - Intrauterine death of the twin partner (twin ex)
It is the situation where one of the twins dies in the womb. It is seen in 3-5% of twin pregnancies. The fact that one of the babies is dead may also pose some risks for the living baby.
In this case, especially if the twins are monochorionic (two babies have a common placenta), the risk is higher for the living baby and serious neurological damage may occur in the living baby compared to dizygotic twins. It consists of 3-4 times more. In this case, it is difficult to decide when to give birth; situations such as how many weeks old the live baby is and whether it has completed its development or not affect this decision. Whether the twins are monochorionic (two babies have a single placenta) or dichorionic (two babies have separate placentas) is also a criterion that will affect the birth decision. The fact that one of the twins is dead does not always mean that the live baby should be delivered immediately; the decision may vary depending on the obstetric condition of that patient. However, in general, in monochorionic twins, the living baby is at higher risk and is delivered without much delay. In dichorionic twins, the birth is postponed further if necessary because the risk of harm to the living baby is low
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