Pregnant with multiples

tripletsBeing pregnant with one baby has its ups and downs, but twins, triplets and up can be a big challenge.

Today, more than 3 percent of babies in this country are born in sets of two, three or more; about 95 percent of these multiple births are twins. The high number of multiple pregnancies is a concern because women who are expecting more than one baby are at increased risk of certain pregnancy complications, including premature birth (before 37 completed weeks of pregnancy).

Women who are expecting multiples generally need to visit their health care providers more frequently than women expecting one baby. These extra visits can help prevent, detect and treat the complications that develop more often in a multiple pregnancy. Health care providers may recommend twice-monthly visits during the second trimester and weekly (or more frequent) visits during the third trimester.

Starting around the 20th week of pregnancy, a health care provider monitors the pregnant woman carefully for signs of preterm labor. He/she may do an internal exam or recommend a vaginal ultrasound to see if the woman’s cervix is shortening (a possible sign that labor may begin soon).

Even if a woman pregnant with multiples has no signs of preterm labor, her provider may recommend cutting back on activities sometime between the 20th and 24th weeks of pregnancy. She may be advised to reduce her activities even sooner and to rest several times a day if she is expecting more than two babies.

As a multiple gestation progresses, the health care provider regularly checks the pregnant woman’s blood pressure for preeclampsia. He/she also may recommend regular ultrasounds starting around 20 weeks of pregnancy to check that all babies are growing at about the same rate.

During the third trimester, the provider may recommend tests of fetal well-being. These include:
    -  The non-stress test, which measures fetal heart rate when the baby is moving
    -  The biophysical profile, which combines the non-stress test with an ultrasound

The chance of a cesarean birth is higher in twin than in singleton births. However, a pregnant woman has a good chance of having a normal vaginal delivery if both babies are in a head-down position and there are no other complications. When a woman is carrying three or more babies, a cesarean birth usually is recommended because it is safer for the babies.

To learn more about multiples, read this article.

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