pregnancy

Antenatal care with twins

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If you’re expecting three or more children, it’s crucial to attend all of your appointments due to the increased risk of this kind of pregnancy.

The antenatal team you choose should have experience in the care of those who have triplets or twins.

Scans and checks in the case of twins

The number of scans and tests you’ll get will be contingent on the kind of triplets or twins you’re experiencing.

Women who have multiple pregnancies must be given an ultrasound scan between 11 and 14 weeks. It is crucial to make the appointment.

It is the perfect opportunity to discover what kind of placenta or membranes the twins have (chorionicity) and also check the dates of birth.

It is also possible to take a test of nuchal translucency for Down’s syndrome simultaneously If you’d like.

Find out more information about testing for Down’s Syndrome

You’ll also get scans, also known as anomaly scans, around 20 weeks, to make sure whether your babies are developing normally.

Twins of different types

To make medical sense There are three kinds of twins. They also apply to triplets however, a triplet’s pregnancy is more complicated than a twin pregnancy.

Three types of them are:

  • Dichorionic diamniotic (DCDA) twins Each has a separate placenta, as well as a separate sac
  • Monochorionic Diamniotic (MCDA) twins have a common placenta, but each has its own sacs
  • monochorionic, monoamniotic (MCMA) twins have both a placenta as well as an amniotic sac. This is a rarer form of pregnancy.

Any twins that are not identical to each other count as DCDA.

The majority of identical twins will be MCDA however some might be DCDA. Rarely, identical twins will be MCMA.

What extra attention might I require?

If your twins are MCDA then you should expect more monitoring and scans, since this type of twin has the highest risk of twin-twin syndrome (TTTS) which is an abnormality in the placenta.

You might be referred to an area centre for foetal medicine, where you will consult with a specialist doctor.

If your twins are MCMA they’ll also be having frequent scans. When twins are this kind of, there’s a tendency to have cord entanglement which could result in complications.

The twins that are described above are not common, and you should expect to receive specialized medical attention and continuous monitoring.

If your children are DCDA then the dangers to their health during the womb are lower. The typical scan will be each week for 4 weeks.

It is essential to keep all appointments to ensure that any issues are identified promptly and addressed if needed.

The risks of twins pregnancies

Although most multiple births are healthy and yield healthy children There are some risks worth being aware of if you’re pregnant with two or more infants.

If you’re expecting more than one baby is a higher chance of developing complications during pregnancy including the anaemia of iron or Pre-eclampsia.

It is important to attend every appointment for your antenatal care so any issues can be picked up before they become serious and treated should they arise.

Premature birth

Triplets and twins have an increased risk to be prematurely born (before 37 weeks) and also having a low birth weight.

The majority of twins and triplets are born early.

Six out of 10 triplets will be born prior to 37 weeks. Nearly 8 out of 10 triplets are born prior to 35 weeks.

Birth plan

If you’re expecting triplets or twins you can request an appointment for a planned birth:

  • For twins, 37 weeks, with the same placenta
  • 36 weeks of identical twins who share an ovum
  • 35 weeks of pregnancy for an uncomplicated triplet pregnancy
  • The 32 and 33 weeks range for MCMA twins

It is risky for triplet and twin pregnancies to continue to grow beyond the birth date planned. The plans for birth should discuss with you, taking into consideration of your requirements and preferences.

If you decline the possibility of having the planned birth then you’ll be offered regularly scheduled appointments with an obstetrician, weekly ultrasound scans and foetal growth scans every two weeks.

The obstetrics team will closely work with you during your entire pregnancy as well as after the birth of your children to ensure that you and your children are healthy and safe.

Twin-twin transfusion syndrome

Transfusion-related twins (TTTS) is a condition that affects identical twins with a placenta (monochorionic).

The risk is greater in MCDA twins, however, it is possible to have MCMA twins too.

It’s caused by the abnormal connection of blood vessels within the placenta of twins.

This leads to an imbalance in blood flow between one twin (known as the donor) to the other (recipient) which leaves one baby with a higher quantity of blood than either.

TTTS can affect 10 to 15 per cent of monochorionic twins. This can cause serious harm.

It is important to discuss your specific situation with a physician since what works for one TTTS pregnancy might not work for another.

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