Pregnancies in which more than one baby is carried in the womb are called multiple pregnancies. Multiple pregnancy, which is an unexpected surprise for some couples, can be a source of great happiness for some couples. The vast majority of multiple pregnancies are twin pregnancies involving two babies. However, although rare, it is possible to encounter pregnancies with more babies such as triplets and quadruplets. Although it can be blissful, multiple pregnancies mean increased risks for mother and baby. For this reason, many issues such as a tighter follow-up and a higher risk of preterm birth come up for mothers who are expecting more than one baby. From the moment they learn that they are expecting twins or triplets, expectant mothers should be more careful than other expectant mothers on various issues and show the necessary sensitivity to the recommendations of their doctors.
What is Multiple Pregnancy?
Expecting more than one baby is called a multiple pregnancy in medicine. Approximately one out of every sixty pregnancies develops as a multiple pregnancy, and some factors such as advanced maternal age, getting pregnant with IVF treatment increase the likelihood of multiple pregnancy. The vast majority of multiple pregnancies consist of twin babies. Twin babies can occur in two different ways: identical twins and fraternal twins. Identical twins are formed by the splitting of a fertilized egg into two, and fraternal twins are formed by the fertilization of different eggs and sperm. Apart from this, another issue that differs between multiple pregnancies is chorionicity. Chorionicity is the condition in which babies are attached to a single or double placenta. The presence of each baby's own placenta is called dichorionic or trichorionic pregnancies, depending on the number of babies. However, if babies share a single placenta, it means monochorionic twins or triplets. When there is more than one placenta, it is not usually the case of identical twins. However, although rare, the presence of two different placentas can be seen in identical twins. Likewise, the development of babies in a single amniotic sac is monoamniotic, and the presence of a separate sac for each baby is triamniotic for diamniotic or triplet pregnancies. e is named. Sharing a single placenta or being in the same amniotic sac increases the risk of complications. All of these conditions are evaluated and detected in the first ultrasound imaging.
Twin Pregnancy
A mother who learns that she is expecting twins may be pregnant with identical or fraternal twins. The characteristics of these twinning types, which differ according to the way they are formed, are as follows:
- Identical twinning: 75% of multiple pregnancies consist of fraternal twins. Identical twins are formed when a single egg fertilized by a sperm splits into two after fertilization. Because these twins have the same genetic sequence, they are the same sex and look the same except for very minor differences. They can also be called monozygotic twins.
- Fraternal twins: Fraternal twins are formed by the maturation of more than one egg cell in one menstrual cycle and the development of more than one zygote as a result of their fertilization with different sperms. These pregnancies can also be called dizygotic twinning. Due to the fact that they are composed of different eggs and sperm, the babies in multiple pregnancies in this group have different genetic sequences and may be of different sexes. They are also as similar to each other as siblings born to the same mother and father at different times.
Triplets Pregnancy
Triplet baby pregnancy is only one of every 7000 pregnancies. It is an extremely rare occurrence. However, in IVF treatment, if more than one embryo is transplanted and each of them adheres, it is possible to have triplet pregnancies. Likewise, pregnancies with more babies such as quadruplets and quintuplets can also be encountered, although much rarer. Triplet pregnancies, just like twins, are fertilized by more than one egg with more than one sperm. trizygotic triplets develop. Just as in fraternal twins, the genetic makeup of trizygotic twins is different from each other and the sexes of the babies may be the same or different from each other. If monozygotic triplets develop after a single egg is fertilized with a sperm, this is called monozygotic triplets. In this case, all three babies have the same genetic makeup and will be of the same sex. Due to the simultaneous development of three different babies, the risk of complications and the possibility of premature birth are much higher in triplet pregnancies than in twins. Multiple pregnancy symptoms are among the topics that are frequently researched and wondered for father-to-be and father-to-be. For the early weeks, the most common twin and triplet baby symptoms in pregnancy is that the level of beta-HCG hormone is much higher than in other pregnancies and gestational weeks. Although this hormone is several times higher than expected before the weeks where ultrasound examination can be performed, it strengthens the possibility of multiple pregnancy, but the definitive determination can be made by ultrasound examination. In addition, some pregnancy symptoms may be felt more severely in multiple pregnancies than in women who are pregnant with a single baby. Some of the conditions that can be defined as twin pregnancy symptoms or triplet pregnancy symptoms are:
- Very severe nausea (morning sickness) and vomiting
- Fast than expected weight gain and earlier clarification of the abdomen, especially in the first trimester of pregnancy
- Very tender or painful breasts
- Very high levels of beta-HCG hormone
- High levels of alpha-fetoprotein in the blood
- During fetal doppler detection of multiple heartbeats
- Seeing two different babies or more than one gestational sac during ultrasound examination
Risks of Multiple Pregnancy
Multiple Women who have had a pregnancy can generally have a healthy pregnancy and give birth as a result of taking care of their health and complying with the instructions of the physicians. However, in multiple pregnancies, there are some complications are more likely to develop. All pregnancy symptoms such as morning sickness, edema, heartburn, varicose veins, back and waist pain, and fatigue may be more severe in multiple pregnancies. However, the increased risks of complications that can be defined as multiple pregnancy risks include:
- Anemia (anemia)
- Vitamin and mineral deficiencies
- High blood pressure in the mother and protein in the urine preeclampsia developing with symptoms such as (pregnancy poisoning)
- Premature (premature) birth
- More bleeding than expected after delivery
- Cesarean section increased due to the difficult and risky nature of normal delivery probability of delivery
- Probability of the baby being born with a low birth weight
- Some complications specific to multiple pregnancies, such as twin-to-twin transfusion syndrome
Multiple Pregnancy Delivery Process
Premature birth before 37 weeks in pregnancies in which a single baby develops is 8%. rate is seen. For twin pregnancies, it is expected to start before the 37th week with a 60% probability, and with a 75% probability for a triplet pregnancy, before the 35th week. Therefore, the probability of premature birth is high. For multiple pregnancies, cesarean delivery is generally preferred as normal delivery can be difficult or risky. However, in some cases, assisted vaginal delivery may be preferred for twin babies, if the physician deems it appropriate, considering the mother's body structure, the size of the babies or the course of the pregnancy. However, a cesarean section may be required at any stage of birth, even for the delivery of the second baby after a baby is born. During normal (vaginal) delivery, the umbilical cord is clipped after one of the babies is born, but the placenta must remain in the uterus until the other baby is born. The second baby is usually born within 30 minutes to 1 hour after the birth of the first baby. During the whole birth process, the heartbeats of the babies are followed with the help of a special device called the CTG device, and any problems are detected. In case of failure, necessary interventions are made. In cesarean delivery, the operation is performed in the same way as other births, and babies are brought to the world. The process for the mother after the birth proceeds in the same way as for the mothers who gave birth after a single pregnancy, but the bleeding intensity may be higher. Because of this possibility, various medications can be given to help reduce bleeding. If babies are born prematurely, they should stay in an incubator, which is a supported living area, for a while and should be kept under observation. After completing the targeted development process, the babies are discharged.
If you have learned that you are expecting twins or triplets, you can have a healthy pregnancy process without interrupting your follow-up appointments. You can have a healthy birth by carefully complying with your doctor's recommendations; You can hold your babies in your arms.
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