Throughout human history, multiple pregnancies (twin and triple pregnancies) have aroused interest and have been the subject of many legends. This situation, which is becoming more common today with the increasing prevalence of assisted reproductive techniques, is a surprise for most families. Due to the special risks they carry, they require more careful and close monitoring throughout pregnancy.
Two thirds of multiple pregnancies occur as a result of the fertilization of more than one egg cell (oocyte) by the same number of sperm. In this case, popularly known as fraternal twins, there are embryos that are genetically different from each other. One third of multiple pregnancies are known as identical twins; When a fertilized egg undergoes division during its development, more than one embryo with the same genetic characteristics is formed. This situation is also known as identical twins among the public.
Multiple pregnancies, which are considered as a very pleasant surprise and are seen at a rate of approximately 1 percent of all pregnancies, are a serious situation for gynecologists in terms of the risks they may bring and are risky pregnancies. It is examined in the location. Since it is considered in the risky pregnancy category, it is recommended that multiple pregnancies be followed by a perinatologist (high-risk pregnancies specialist).
A family history of multiple pregnancy, maternal age over 35, social characteristics (e.g. ; It is 5 times higher in African society), the number of pregnancies (the probability of twin pregnancy increases 2 times after 4 births) and ovulation stimulating drugs are among the factors that increase the possibility of multiple pregnancy.
Nausea, vomiting, fatigue, Symptoms such as drowsiness, urinary complaints, and appetite changes may be more severe in most pregnant women. Apart from these, the expectant mother gains more weight during her pregnancy (18 - 20 kg on average), anemia is more common during pregnancy, and the risk of bleeding and miscarriage is higher in the first period of pregnancy.
Among the risks it poses for the mother. Compared to single pregnancies; Approximately 10-fold increase in the possibility of premature birth, high blood pressure, preeclampsia (pregnancy poisoning), risk of congenital anomalies in babies, failure to develop in one or both babies in the womb. There is an increased risk of premature birth, placental anomalies (partner problems - placenta previa, placenta abruption, vasa previa), gestational diabetes, invasive birth and postpartum hemorrhage.
Due to such increased risks, this is a pleasant situation for the family. Surprise is a condition that requires attention, effort and close follow-up from the physician from the first weeks of pregnancy. Repeating routine blood and urine tests at regular intervals, supplementing iron, folic acid and calcium, increasing the frequency of periodic follow-ups, monitoring the growth of babies in accordance with the gestational week and each other, performing detailed ultrasound to diagnose possible anomalies in babies, periodic application of fetal well-being tests, close monitoring in terms of premature birth. Follow-up and timely intervention in risky situations during the follow-up process will increase the probability of the pregnancy going smoothly. Considering all these reasons, it would be appropriate for multiple pregnancies to be followed up by a perinatologist (high-risk pregnancies specialist).
While a happy ending is approaching for the family, considering the risks of the baby and the mother, cesarean section is generally the preferred delivery method. However, if the first and second baby are in the head position, vaginal birth may be preferred. If the first baby is cephalad and the second baby is not cephalad; If the second baby is breech following the birth of the first one, vaginal delivery can be achieved. The second baby can be delivered vaginally with the help of maneuvers performed into the uterus in the side posture. In both cases, if there is not enough experience and suitable conditions, cesarean section may be preferred. In cases where the first baby is not cephalic, birth by cesarean section is preferred.
Read: 0
