Posts Tagged ‘twins’

IVF, triplets and more

Monday, April 21st, 2014

In this video, Dr. Siobhan Dolan talks with a woman about fertility treatment and how to lower one’s chances of getting pregnant with twins, triplets or more.

Study shows progesterone shots do not reduce preterm delivery in twin pregnancies

Friday, February 22nd, 2013

While 17P, a form of progesterone, has been shown to prevent premature delivery among about one-third of women who are pregnant with a single baby and who have experienced a prior preterm delivery, the latest research shows that 17P prescriptions can’t do the same for moms having twins.

“Twins are very high risk for preterm delivery, in fact, 60 percent of twins are born too soon. We can’t assume that what works for singleton pregnancies will work with multiples such as twins or triplets,” says Edward R. B. McCabe, MD, PhD, March of Dimes senior vice president and medical director. “This research finding is valuable because it will guide the care of women with a multi-fetal pregnancy, and highlights the need to better understand how to prevent preterm births for multiples.”

“We found that 17P was not effective in women with twin pregnancies and a short cervix (defined as less than 25 mm between 24 and 32 weeks),” says Philippe Deruelle, MD, with the Department of Obstetrics and Gynecology at Hôpital Jeanne de Flandre, Université Lille 2, France, and one of the study’s authors. “We actually seemed to have found an increase in the rate of preterm delivery before 32 weeks in the treatment group when compared to the non-treatment group.”

For the study, Dr. Deruelle and his colleagues conducted their trial on 165 women over the age of 18 at 10 university hospitals between June 2006 and January 2010. Outcome data was available for 161 of the 165 (97.6%) women. (The study’s title is Prevention of preterm delivery by 17 alpha-hydroxyprogesterone caproate in asymptomatic twin pregnancies with a short cervix: a randomized controlled trial, and was presented at the Society for Maternal-Fetal Medicine’s 33rd annual meeting last week.)

Dr. Deruelle recommends that women who know they are pregnant with twins get an ultrasound to measure their cervical length, as this factor has shown to predict which women with twins are at higher risk for premature pregnancy.

Hopefully, future research will help to shed light on ways to prevent pretem births for women who are pregnant with multiples.

Pregnant with multiples

Thursday, November 8th, 2012

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.

Fertility and multiples

Wednesday, August 22nd, 2012

In this video, Dr. Siobhan Dolan talks with a woman about fertility treatment and how to lower one’s chances of getting pregnant with twins, triplets or more.

Twin births on the rise

Thursday, January 5th, 2012

twinsThe number of twins born in this country has been multiplying for thirty years. Although the twin birthweight has slowed some since 2005, in 2009 1 in every 30 babies born in the United States was a twin, compared with 1 in every 53 babies in 1980.

A new report from the Centers for Disease Control shows the twin birth rate has risen significantly since 1980. Here are some key findings from the report:
 
- The twin birth rate rose 76% from 1980 through 2009, from 18.9 to 33.3 per 1,000 births.
- If the rate of twin births had not changed since 1980, approximately 865,000 fewer twins would have been born in the United States over the last three decades.
- The increase in twinning over the three decades has been widespread, occurring across age and race and Hispanic origin groups, and in all states within the United States.
- The rise in twinning has increased the rates of preterm birth and low birthweight. More than half of twins born over the last three decades were born low birthweight and 1 in 10 were born very low birthweight.
- Over the thirty years, twin birth rates rose by nearly 100% among women aged 35–39 and more than 200% among women aged 40 and over.
- The older age of women at childbirth in 2009 compared with three decades earlier accounts for only about one-third of the rise in twinning over the 30 years. The increased availability and use of infertility treatments likely explains much of the remainder of the rise.

“The unintended consequences of increasing multiple birth is not a good thing and one needs to find a way of controlling that,” says Dr. Michael Katz of the March of Dimes. Those unintended consequences, including low birthweight and pre-term birth, have greatly elevated the health risks to these babies and the accompanying health care costs. The March of Dimes supports a number of grants aimed at improving understanding of the causes of premature birth. Although these studies generally focus on singleton pregnancies, the largely unknown mechanisms leading to preterm birth of singletons and multiples may be much the same.

What is the difference between identical and fraternal twins?

Monday, August 23rd, 2010

twinsIdentical twins (also called monozygotic twins) occur when one fertilized egg splits and develops into two (or occasionally more) fetuses. The fetuses usually share one placenta. Identical twins have the same genes, so they generally look alike and are the same sex. A woman’s chances of having identical twins are not related to age, race or family history.

Fraternal twins (also called dizygotic twins) develop when two separate eggs are fertilized by two different sperm. Each twin usually has its own placenta. Fraternal twins (like other siblings) share about 50 percent of their genes, so they can be different sexes. They generally do not look any more alike than brothers or sisters born from different pregnancies. Fraternal twins are more common than identical twins.

Triplets and other higher-order multiples can result from three or more eggs being fertilized, one egg splitting twice (or more), or a combination of both. A set of higher-order multiples may contain all fraternal siblings or a combination of identical and fraternal siblings.  Read our fact sheet if you want to know more about being pregnant with multiples.

Twins & triplets have greater odds of needing a NICU

Thursday, August 12th, 2010

tripletsToday, 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). 

About 60 percent of twins, more than 90 percent of triplets, and virtually all quadruplets and higher-order multiples are born premature. The length of pregnancy decreases with each additional baby. On average, most singleton pregnancies last 39 weeks; for twins, 35 weeks; for triplets, 32 weeks; and for quadruplets, 29 weeks.

More than half of twins and almost all higher-order multiples are born with low birthweight (LBW), less than 5½ pounds or 2,500 grams.  LBW can result from premature birth and/or poor fetal growth. Both are common in multiple pregnancies.

LBW babies, especially those born before about 32 weeks gestation and/or weighing less than 3 1/3 pounds (1,500 grams), are at increased risk of health problems in the newborn period as well as lasting disabilities, such as mental retardation, cerebral palsy,  and vision and hearing loss.   While advances in caring for very small infants has brightened the outlook for these tiny babies, chances remain slim that all infants in a set of sextuplets or more will survive and thrive.

Preeclampsia and diabetes  in the mother are two conditions that, for the safety of the mother and baby, can lead to an early delivery. Women expecting twins are more than twice as likely as women with a singleton pregnancy to develop preeclampsia. Gestational diabetes can cause the baby to grow especially large, increasing the risk of injuries to mother and baby during vaginal birth and making cesarean delivery more likely.  Babies born to women with gestational diabetes also may have breathing and other problems during the newborn period.

Have you or someone in your family had twins or triplets?  Were they in the NICU?

Fertility pills increase chances of twins and more

Friday, January 15th, 2010

twinsMost of us know the story of Nadya Suleman. She’s the woman in California who had high-tech fertility treatments and wound up having eight babies.

Such sophisticated treatments increase the chances of multiple pregnancy (twins, triplets or more). They also can lead to health problems for mom and babies.

Did you know that fertility pills also increase the risk of mutiples

If a woman is having trouble getting pregnant, doctors often begin fertility treatment by giving her a prescription for pills. These pills help her body release eggs (ovulate). Some of the names of these types of pills are Clomid, Serophene and clomiphene.

These pills are used much more commonly than high-tech fertility procedures. They probably play a major role in the serious problem of premature birth in the United States. Multiple pregnancy can be riskier for a woman and her babies than a pregnancy with only one baby.

If you are thinking about fertility treatment or are already taking the pills, talk to your doctor to learn more about their risks and benefits. For more info, read today’s news release from the March of Dimes.

Child proofing your home

Friday, November 6th, 2009

Our daughter is on the verge of crawling. I’m excited, but nervous at the same time. Everywhere I look around our house I see a potential hazard — the stairs, furniture, cabinets, outlets, lamp cords and book cases. We have a lot of work to do! We plan to go through one room at a time on our hands and knees to make sure we don’t miss anything, remove/secure potential risks and make a shopping list as we go.

A close friend of mine (hi Tricia!) appeared on the evening news a couple of days ago. Her home was assessed by a professional who offered some great recommendations on making her home safer for her toddler twins.  Click here to watch the clip.

According to Safe Kids Worldwide more than 4.5 million children are injured in the home every year. Taking simple prevention measures and closely supervising your children can help protect them from common household hazards, such as fires, burns, drowning, suffocation, choking, firearm injury, poisoning and falls. A few easy, relatively inexpensive steps – locking household cleaning materials in a cabinet out of reach, installing carbon monoxide detectors and smoke alarms, blocking stairways with baby gates – can greatly reduce your child’s risk of injury in the home.

The March of Dimes and Consumer Reports have worked together to produce a helpful online guide called, Safe Products for Baby. It includes shopping and safety tips for car seats, strollers, cribs, changing tables, play pens, clothing, bathtubs and more. Click here to check it out.

Please feel free to share any safety tips that you may have!

Wordless Wednesday

Wednesday, October 14th, 2009

Twins in Leaves