Tell me about… Risks of having twins and multiple pregnancies

My cousin just gave birth to twins. This is so exciting! How do twins happen?

There are two different types of twins. Fraternal twins are the most common kind. They occur when two different eggs are fertilised by two different sperm.

Each twin has his or her own placenta, attached to the mother’s womb, and amniotic sac. The twins can be two girls, two boys, or a boy and a girl. They are usually not very alike, no more than you are like your sibling. Identical twins happen when a single egg becomes fertilised. It then splits up and develops into two babies. Identical twins share a single placenta, but each baby usually has a separate amniotic sac. The two babies have identical genes. They share the same sex and the same physical traits.

Interesting. My cousin has no history of twins ever being present in her family. How is it that she had twins?

Sometimes, twin pregnancies just happen spontaneously. Twin pregnancies are more likely to happen when you get older, especially when you get pregnant when you are in your 30s or 40s.

This is because your menstrual cycles are not as regular anymore, and you are more likely to ovulate more than one egg at a time.

In the US, approximately three in every 100 pregnant women give birth to twins or triplets. They are actually becoming more common in the world as women opt to give birth at an older age.

At other times, especially these days, use of in-vitro fertilisation and other reproductive boosting techniques often result in twin pregnancies.

The fertility drug, clomiphene, results in a higher rate of twin and multiple pregnancies compared to if you don’t take fertility drugs.

You often hear of many female celebrities having twins when they get older. They are very likely to have taken fertility drugs.

What about triplets, quadruplets and higher multiples?

The same rule applies. They can be identical, fraternal or even combinations of both, depending on how many eggs were fertilised or how they separated. Rarely, a fertilised egg that is supposed to result in twins can fail to completely separate into two individuals. These babies are known as conjoined or Siamese twins. They can be separated after birth through surgery.

Are having twins the same as having a single baby in the womb? Anything I should watch out for?

There are many differences, actually.

You will have to go for more frequent check-ups, and certainly more frequent ultrasounds and tests. An ultrasound will be able to pick up twins as early as five to six weeks into your pregnancy. Some even claim to have picked them up at four weeks.

You’ll need more folic acid, calcium, iron, protein and other essential nutrients.

If you’re already eating a healthy diet, keep it up – and be sure to take a daily prenatal vitamin. Your healthcare provider might recommend an iron supplement as well.

You will experience more weight gain than with a single pregnancy. You might be required to eat an extra 600 calories a day.

You will also have to limit some activities like work, travel, and exercise as your pregnancy progresses.

You are also very likely to give birth prematurely, or be asked to consider a labour induction.

Your doctor may recommend inducing labour or doing a Caesarean section when you are 38 or 39 weeks into your pregnancy.

I have heard that there are more complications with twin pregnancies. I am worried. Is this true?

It is true. But remember, these complications are the rarity, not the norm. Many twins are born without any complications to either mother or babies every day.

You are more likely to get pregnancy complications if you have twins, such as high blood pressure during pregnancy and protein in your urine. This is a condition known as pre-eclampsia. It has to be managed carefully with certain medications.

In the womb, there is a phenomenon known as twin-to-twin transfusion. This happens when one baby receives more blood than the other baby, leading to difference in sizes and development.

You are also more likely to give birth prematurely. The more babies you are carrying, the more likely you are to give birth before term.

Naturally, if the babies are premature, the more they have to fight to survive. Therefore, many doctors give you a steroid jab these days to let the lungs of the babies in your womb mature. This steroid jab is extremely painful, unfortunately.

Premature babies will have their own set of complications, such as jaundice, breathing and digestive difficulties. They are more likely to get infected.

Very rarely, one twin is delivered first, and the other twin continues developing in the womb. This is called delayed interval delivery.

Most twins in the modern world are delivered via C-section nowadays to avoid complications, but vaginal delivery is possible if the first baby facing is head down.

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Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

Source : Star2.com