Choose the content to read

• How does a multiple pregnancy happen?
• Factors that increase the chances of a twin pregnancy
• What are the signs of a twin pregnancy?
• What are the complications of a multiple pregnancy?
• What are the delivery methods for a multiple pregnancy?
• A note from MedPark's doctor

Multiple Pregnancy

Multiple pregnancy refers to a pregnancy in which a mother is carrying two or more fetuses. The greater the number of fetuses, the higher the chance of complications and problems.

How does a multiple pregnancy happen?

There are two ways a multiple pregnancy can happen:

• A fertilized egg splits after the first cell division before implanting on the lining of the uterus, resulting in identical twins.
• Two eggs are fertilized with different sperms simultaneously, leading to fraternal twins.

A multiple pregnancy with triplets or more can consist of identical twins, fraternal twins, or a combination of both, depending on whether one or more eggs are released and fertilized.

Is it true that identical twins are always the same sex?

Identical twins arise from the same fertilized egg, which means they have the same genetic materials. Thus, they are always of the same sex. The sperm fertilizing an egg predetermines the sexes of the baby, depending on whether it is a sperm carrying an X or a Y chromosome. When an X chromosome-carrying sperm fertilizes an egg, which always carries an X chromosome, the baby is female. If a sperm carrying a Y chromosome fertilizes an egg, the result will be a male baby.

Causes or factors that increase the chances of having a multiple pregnancy

Several factors can contribute to multiple pregnancies, such as

• Female in their mid-30s have a higher chance of having multiple pregnancies due to the quality of eggs.
• Conceiving mothers have twins in their family.
• Fertility drugs.
• Fertility treatment, such as IVF, because the doctor may transfer more than one embryo to the uterus for implantation.

What are the signs of a multiple pregnancy?

Multiple pregnancy symptoms can be more pronounced than those of a singleton pregnancy and may include

• Severe nausea and vomiting
• High levels of hCG (Human chorionic gonadotropin) when compared to normal singleton pregnancy.

What are the complications of a multiple pregnancy?

Although mothers with multiple pregnancies may have a higher risk for complications than those with a singleton pregnancy, it doesn’t mean that complications will always happen to them. Some examples of complications of multiple pregnancy include:

• Premature birth: This is the most common complication as mothers with a multiple pregnancy have heightened chances for premature labor than those with a singleton pregnancy.
• Gestational hypertension and preeclampsia: Hypertension during pregnancy can lead to a severe condition like preeclampsia, which usually happens after 20 weeks of pregnancy. Mothers with multiple pregnancies tend to have more severe preeclampsia than those with a single pregnancy.
• Gestational diabetes: This is due to increased levels of placental hormones and the size of the placenta.
• Fetal growth restrictions: This problem happens when the fetus has an improper growth rate. Premature birth or low birth weight can occur due to this problem. Nearly half of multiple pregnancy mothers experience this problem.
• Twin-anemia-polycythemia sequence: This problem can happen to monochorionic twins. One twin will have low red blood cells, while the other has too many.

How to take care of yourself to stay healthy during a twin pregnancy?

What is crucial for pregnant women with multiple pregnancies is receiving sufficient nutrients. It is advisable to focus on protein intake and staying hydrated. Try to gain an extra 300 calories per 1 baby. In addition, get enough rest to relieve the stress and see the doctor regularly to ensure the best care for babies.

Are exercises allowed during a multiple pregnancy?

Exercise is allowed during a multiple pregnancy. It is advisable to do low-impact exercises to maintain a healthy body and stay in shape. Recommended low-impact exercises include:

• Swimming
• Prenatal yoga
• Walking

All exercises should be under the guidance of the doctor.

What are the delivery methods for a twin pregnancy?

Factors that a doctor considers when choosing a delivery method include the mother’s health status, the health and position of the fetus, and gestational age.

There are two methods of delivery, namely:

1. Vaginal delivery
   In cases of mothers expecting twins, the first baby may be in the vertex position for a vaginal delivery, but the second baby may not be and may require a c-section. Because of this, vaginal delivery is not usual for a multiple pregnancy. There can be emergencies that arise during the birth of twins, such as a prolapsed cord, which can lead to complications.
2. Cesarean section. A doctor may consider cesarean section if:
   • Pregnancy with more than 2 fetuses
   • Fetuses are in abnormal positions.
   • Conceiving mothers have certain conditions that prevent vaginal delivery.
   • Fetuses experience fetal distress.
   • Mothers have monochorionic pregnancies.

A note from MedPark's doctor

A multiple pregnancy can give rise to more risks and problems compared to a single pregnancy. An example is premature birth, which can put fetuses in danger. Therefore, it is advisable to see a doctor regularly to track the developmental progress of the fetuses, as well as the health of the mother and her babies.