Multiple pregnancy can be defined as the formation of more than one fetus in the uterus. The vast majority of multiple pregnancies are twin pregnancies. It can be said that twin pregnancies generally occur once in 90 pregnancies, if they occur spontaneously. However, today, as assisted reproductive techniques such as insemination and in vitro fertilization have begun to increase, the possibility of multiple pregnancies has increased. Roughly, it can be said that twin pregnancies occur in 25-30% of in vitro fertilization applications.
Twin pregnancies are identical twins, in which a single egg is fertilized by a sperm and then split into two during the division phase, or a double, which is formed by the fertilization of two separate eggs by two separate sperm. may be in the form of identical twins. Identical twins have the same genetic load and are the same sex, while fraternal twins can be different or the same sex. Almost all of the twins seen in in vitro fertilization are fraternal twins.
If we talk about identical twins; They are very similar in appearance. In an identical twin pregnancy, the fertilized egg cell divides again in the first three days after fertilization and turns into two separate embryos, and these embryos continue to develop separately. In this case, each baby's placenta, from which it is nourished, and the water sac it contains are different. Sometimes, because the placentas are in close contact with each other, they may appear united on ultrasonography. When post-fertilization separation occurs between the fourth and eighth day, two babies with common placentas but separate water sacs begin to develop.
Post-fertilization separation can sometimes occur after the eighth day. In this case, both their placenta and the water sac they are in are the same. So these two babies share exactly the same environment. The probability of experiencing problems in this type of twins is higher than in other types. Physicians distinguish the type of twin pregnancy at the very beginning of pregnancy and continue their observations accordingly throughout the pregnancy. Sometimes (very rarely) division occurs after the formation of a structure called the embryonic disc. In this case, since the embryo is actually formed, division cannot occur completely and conjoined twinning (so-called Siamese twins) occurs.
What are the risks in twin pregnancies?
• From the beginning of pregnancy, complaints of nausea and vomiting are more common than normal. It can also be said that the probability of miscarriage is slightly higher. • Preterm birth and the risk of premature babies are among the most common problems. While it takes 39-40 weeks for pregnancy to terminate in a normal singleton pregnancy, the average delivery time for twin pregnancies is around 37 weeks. • Birth weights are generally lower than single babies. It is also possible for one of the twins to have more nutritional risk and the other to have less nutritional risk, and therefore a significant weight difference between them.
• Risks such as anemia and hypertension (preeclampsia) are also more common in twin pregnancies.
Twins The respiratory, circulatory and digestive systems have to meet a much greater demand than during pregnancy with a single fetus. Therefore, twin pregnancies need to be monitored more closely. While it is necessary to monitor once a month in normal pregnancies, it is necessary to examine twin pregnancies at least every 3 weeks.
In the following weeks, the pregnant woman's gait and balance are affected more than in single pregnancies. Shortness of breath is observed. Problems such as hemorrhoids and varicose veins are more common. Excessive load can also cause strain and pain in the spine. Again, the rate of hospitalization in recent weeks is more common than in singleton pregnancies.
Birth of Twins
Most twins are born some time before the appointed time. Twin normal birth usually proceeds smoothly. However, cesarean section is more common in twin births. One or both babies may be in the wrong position because that's the only way they can find space. One or both babies may be upside down, meaning they come feet first. Often, a baby stretches crosswise into the uterus, in which case a cesarean section is necessary. In addition, babies may be weaker and smaller than a single baby, so cesarean section is often chosen as the least tiring method for them. During a twin pregnancy, you will see your gynecologist more often and every aspect of the pregnancy, prenatal and birth will be carefully examined.
• One of the feared issues is that postpartum bleeding is more in twin pregnancies. However, if necessary precautions are taken, this risk does not become dangerous.
Twins need more time for postnatal care. Even if your twins are healthy, you may need to stay in the hospital longer. This allows you to feed them more comfortably and gain the confidence to deal with their daily care.
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