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Today twins or triplets do not evoke such emotions as they used to. And caring for the future mother and her pregnancy makes her develop without any serious problems and the children are born he althy. What do you need to know when you are pregnant with multiple births?

You will give birth to more than onechild- you feel great joy, but also anxiety - after all, it'spregnancyhigh risk. Multiple babies puts a lot of strain on the body. They need more nutrients than one fetus, take up a lot of space in the abdomen, putting pressure on organs, weigh more.

Multiple pregnancy is a special distinction. The frequency of its occurrence, as a result of the action of nature itself, is determined by the formula (according to the so-called Hellin's rule) - 1:85 (x) (x - means the number of fetuses).

It follows that twins are born once in 85 births, triplets - once in 7225, and quadruplets - once in 614 125 births. This principle, however, does not take into account the interference of modern medicine, including hormone therapy and in vitro fertilization in women undergoing infertility treatment.

If a woman has used clomiphene (clostilbegyt) to ovulate, the probability that she will give birth to more than one child is several percent, and after taking gonadotropins it is even higher.

According to statistics, nature most often chooses women between the ages of 31 and 39 who have already given birth to at least two children.

The chances of twins or triplets also increase when the family has had multiple pregnancies before or the woman is already a mother of twins.

It is known that genetics is of great importance in these matters. Multiple pregnancy is also easier when: the woman is black, has higher education, conception took place in the summer.

On the other hand, scientific research has ruled out a relationship between the use of hormonal contraception and the birth of multiple babies after its completion, suggested not so long ago by many doctors.

The fact is that it is easier to get pregnant after stopping the pills, but the number of babies does not depend on it.

Multiple pregnancy - you will have more trouble

Additionally, babies may be born a little earlier. This does not mean, however, that everypregnancypluralinvolves complications (but the possibility of their occurrence increases with the number of children). If you take care of yourself, are constantly under the care of an experienced obstetrician and follow his recommendations, your pregnancy does not have to be more difficult than "normal".

Multiple pregnancy: identical twins or not

Monozygotic twins, which were created as a result of fertilization of one egg by one sperm, and the division into two embryos took place later, are genetically identical - this happens in every fourth twin pregnancy. Then children of the same sex are born, difficult to distinguish. Identical twins share more than just looks. They have separate umbilical cords, but often a common placenta, the organ through which they take up food and oxygen supplied with the mother's blood. The amniotic sac (the amniotic sac that protects the baby against injuries, temperature fluctuations, drying out and vaginal microbes) and the chorion (the outer fetal membrane that protects the amniotic sac) may also be common.

Fraternal twins are made when two eggs are combined with two sperm. Children do not have to be similar to each other, they can also be different genders. Fraternal twins always have separate placenta and function almost independently in the mother's womb. From a medical point of view, this is a more favorable situation, as the little ones do not interfere with each other until they grow up and complain about the crampedness. Monozygotic twins can also function in harmony, especially when they have separate placenta and fetal membranes.

Multiple pregnancy: together or separately

The presence of two placentas can be found at the beginning of pregnancy, when ultrasound examination shows two separate gestational sacs, one embryo in each of them. This situation is the safest for twins and their development is then similar to fraternal twins. A shared placenta may result in the "stealing" of nutrients between fetuses, so doctors look at them more closely and the expectant mother has to visit more often, especially for ultrasound examinations. If there are blood vessels in the common placenta through which blood flows from one fetus to another, a so-called transfusion syndrome, which can lead to complications in both children. When toddlers not only have a common placenta, but are also in one amniotic sac, then the umbilical cord may become entangled, for example.

Multiple pregnancy: see a specialist doctor

Once you know there are more fetuses, you probably wonder where and how to find the doctor who will best handle your pregnancy. It's a good idea to sign up for a clinic at the hospital where yours will be born in a few monthstoddlers, or choose a doctor recommended by other happy mothers of multiple babies (ask your friends, look for information on online forums for mothers). For your own good and your pregnancy, make sure that the hospital where you want to give birth is prepared to conduct a twin pregnancy: it has modern ultrasound equipment and a special CTG device for twins, i.e. a device for monitoring the heart rate of two fetuses simultaneously with a recording of contractions. uterine muscle (this test is performed in the last weeks before delivery). The institution's experience in managing multiple pregnancies is also important, as is good care for children after delivery, especially if they were to be born earlier.

Multiple pregnancy: frequent examinations

The tests for multiple pregnancies are basically the same as for single pregnancies. However, their frequency is different, because your body is additionally burdened. You are at greater risk of iron deficiency anemia (anemia), urinary tract infections or high blood pressure caused by pregnancy (formerly known as gestosis or pregnancy poisoning). In order to detect these problems early and avoid complications connected with them, you will have to do frequent blood tests, urine tests, blood pressure tests and weigh yourself. In single pregnancy, these checks are usually performed once a month, in your case it will depend on your pre-pregnancy state of he alth, your current state of well-being and the results of your tests. You will also have more frequent ultrasound scans, usually every 4 weeks. Safe for you and your pregnancy, they will allow you to make sure that the fetuses develop properly and catch any potential threats in time, such as growth inhibition in one or both twins, reduction in the amount of amniotic fluid or excessive shortening of the cervix. It is extremely important to perform an ultrasound between the 11th and 14th week of pregnancy. Such a test, in conjunction with a specialist blood test, is likely to exclude Down's syndrome in a child (PAPP test). If you are over the age of 35, you may consider having a prenatal test, such as an amniocentesis, which is an amniotic fluid collection. You will be calmer - babies coming from multiple pregnancies, especially monozygotic ones, are slightly more susceptible to genetic defects.

Multiple pregnancy: diet

Multiple pregnancy means increased caloric requirements. However, do not eat for three or four, because there is no such need. Each fetus requires an extra approx. 500 calories a day, so your meals should increase by about 40%. So do not overeat unless you were underweight before pregnancy and your doctor specifically told you to do so. Increased body fat in a woman is said to affectextension of the duration of multiple pregnancy. However, don't be particularly concerned about this fat. Rather, eat small portions, but more often (this way you will avoid heartburn and vomiting), providing the twins with the necessary building blocks from dairy, fish, lean meat, groats and whole grains. Also remember about vegetables and fruits, you can eat them practically without restrictions. Your doctor will probably advise you to use calcium, magnesium and zinc, because the deficiency of these elements most often affects women with multiple pregnancies, and their quantity with meals is sometimes insufficient. Remember to take them - they reduce the risk of pregnancy complications and increase the chance of giving birth to he althy babies.

Multiple pregnancy: rest

In multiple pregnancies, pregnancy symptoms are usually more intense, because more children means a greater burden on the body: the kidneys and the heart work more intensively, and the legs bear less weight to bear. Therefore, rest, rest, rest. If your vomiting is severe and the swelling does not go away after a night of rest, or if your face or hands are also affected, be sure to discuss it with your obstetrician.

Multiple pregnancy: when to childbirth

As much as 75 percent twins are born ahead of time, but there is no clear difference between the condition of babies born in labor and those who will be a bit rushed, as long as it happens after the 36th week of pregnancy. If this happens, do not despair, it is not a problem for obstetricians today, because newborns at this age usually have all organs developed (mainly the lungs) and are capable of independent existence. Sometimes they just require a little help or longer follow-up after birth. If there is a risk that the babies will be born even earlier, the doctor supervising your pregnancy will try to prevent it at all costs. He certainly makes you rest more, he can prescribe medications to counteract premature contractions. If the risk of premature birth is high - you need to lie under a drip in the hospital. You may be given glucocorticoids to help speed up the maturation of your children's respiratory system. It is also possible that in order to closely monitor the fetuses and ensure their fullest safety, you will be admitted to the hospital earlier, i.e. before any problems arise, and wait there for a solution. This is especially true if you are expecting triplets or quadruplets. Basically, the greater the number of pregnancies, the sooner this can happen, sometimes even around the 28th week.

Multiple pregnancy: natural birth oremperor

If you are expecting more than two babies, you will have a caesarean section. This is the safest solution for you. When you are expecting twins, natural delivery is possible as long as both babies are placed upside down (about half the time) and you are in good shape. In vaginal delivery, the period of cervical dilatation is prolonged as a result of weakened contractile function, caused by excessive stretching of the uterus by developing babies. On the other hand, the delivery of the second child is almost lightning - it takes place 15-30 minutes after the birth of the first child. If one of the babies is positioned incorrectly (e.g. buttock or crosswise), or if you or your children are at risk of complications (e.g. severe prematurity, large weight difference between babies, physical exhaustion of the mother as a result of prolonged labor), doctors will most likely conduct Caesarean section. Don't be afraid of it, you will have a small scar after the procedure. Enjoy - you will soon become a mom.


Vanishing twin

About 20 percent In cases, one embryo dies at an early stage of its development, which does not affect the development of the other. For this reason, a reliable diagnosis of twins can be made only after the 12th week of pregnancy, when the risk of this phenomenon is significantly reduced.

Why are they developing at a different pace?

Often, multiple females, viewed on ultrasound, are not of the same size, because each fetus is different and has the right to its own development rhythm. A mother who gives birth to two children individually, is not particularly surprised that one baby was born weighing almost four kilos, and the other barely exceeded three. It's the same with the twins. Importantly - in their case, the low birth weight is not as worrying as in the case of singleton pregnancy. Nature (with the help of not fully understood mechanisms) limits the growth of children, allowing them to stay longer inside the body of the future mother. And despite lower weight at birth, babies develop just as well after birth and catch up quickly, catching up with their peers. Ask your ultrasound doctor if the developmental differences between the twins are actually worrying. Fortunately, it happens extremely rarely, especially among twins who share a chorion, that one baby develops at the expense of the other. At birth, such babies may differ in weight by up to two kilograms. They often require treatment while still in the womb and are born much earlier. Then it is necessary to provide care and childbirth in a specialized institution.

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