Are you also having twins? (Multiple Pregnancy) Let's talk about everything!

If your doctor suddenly said, "I see two little hearts beating here," during an ultrasound scan, how would you feel? Surprise, joy, maybe a little fear and excitement... It's normal to feel all of these at the same time. Having two or three babies instead of one means that the joy is doubled, but with that comes the responsibility and the things you need to know. So today, let's talk about everything about this period of pregnancy when you have twins or more children (Multiple Pregnancy).

What is 'Multiple Pregnancy'?

Simply put, a 'multiple pregnancy' means having more than one baby in your uterus, meaning two, three, or even more babies developing at the same time.

• Twins: The conception of two babies during the same pregnancy.
• Triplets: The conception of three babies during the same pregnancy.

This way, when you conceive multiple babies, the pregnancy period can be a little riskier than if you conceive just one baby. But there's no need to be afraid of that. If you follow your doctor's instructions carefully and stay healthy, you can successfully complete this period.

How are twins born like this?

There are two main ways to conceive twins. These two methods are what we call "identical twins" or "fraternal twins."

1. Splitting of a single fertilized egg: This is when a single egg is fertilized by a single sperm and the resulting embryo splits into two (or more) parts before it is implanted in the uterus. The babies that develop this way have completely identical genetic information.

2. Two separate ovums are fertilized: This is when more than one egg (e.g. two eggs) is released from the mother's ovary at the same time, and those two eggs are fertilized by two separate sperm. The genetic information of these babies is different.

Let's understand the differences between twins born using these two methods a little more clearly.

When triplets or more are conceived, the babies can all be identical, all be fraternal, or a combination of both.

What factors increase the chance of having twins?

Generally, anyone can have twins, but certain factors increase this chance slightly.

• Age: Women in their 30s are more likely to release more than one egg at a time. So if two eggs are released, there is a higher chance of having fraternal twins.
• Family history: If there are twins in your family, especially on your mother's side, you are more likely to have twins too.
• Fertility Treatments: Some fertility treatments can cause multiple eggs to be released from the ovaries at once. Also, treatments like IVF (In Vitro Fertilization) can increase the chances of having twins by transferring more than one embryo to the uterus to increase the success rate.
• Height and weight: Some studies have shown that women who are taller than average or have a higher body mass index (BMI) are slightly more likely to have twins.

Are there any signs that you are having twins?

In fact, the only way to know exactly how many babies you are having is to have an ultrasound scan. However, sometimes the symptoms can be a little more severe than if you are having just one baby.

• Frequent morning sickness: Vomiting and nausea can be very severe due to high hormone levels.
• Rapid weight gain in the first trimester.
• Increased pain and sensitivity in the breasts.
• Very high levels of the hormone `hCG` (human chorionic gonadotrophin) in the blood and urine.
• Hearing more than one heartbeat when the doctor listens to the baby's heartbeat (fetal Doppler scan).

What are the possible complications of a twin pregnancy?

Complications can occur during any pregnancy. But when you're carrying twins or more, doctors consider that pregnancy to be "high-risk." That's because the chances of complications are slightly higher than with a single baby. But don't worry. "High-risk" doesn't mean you'll definitely have a problem. It just means that doctors will be monitoring you and your baby more closely and more often .

Here are some of the most common complications:

• Premature labor and birth: This is the most common complication seen in twin pregnancies. The goal is usually to complete 37 weeks. If the babies are born before that, they are more likely to have low birth weight and other health problems.
• Gestational Hypertension and Preeclampsia: Mothers with twins are at increased risk of high blood pressure during pregnancy . If left untreated, this condition can develop into a dangerous condition called ``Preeclampsia.''
• Gestational Diabetes: The risk of this condition is higher due to the increased amount of hormones released by the placenta.
• Placenta Abruption: This is when the placenta separates from the uterine wall before the baby is born. This is an emergency.
• Fetal Growth Restriction (IUGR): One or all of the babies do not grow at the right rate. This can cause babies to be born with low birth weight.

Complications specific to identical twins

If identical twins share the same placenta (monochorionic), they may experience several complications that are specific to them.

• Twin-to-Twin Transfusion Syndrome (TTTS): This occurs when too much blood passes from one baby to the other through the blood vessels in the placenta. This causes one baby to not get enough blood and nutrients, while the other baby gets too much. This can be dangerous for both babies.
• Twin Anemia Polycythemia Sequence (TAPS): This is a condition similar to ``(TTTS)``. In this case, one baby suffers from anemia (low blood count) while the other baby has an excess of red blood cells in their blood.
• Selective IUGR: One baby grows well while the other baby grows very slowly.

The doctor monitors all of these conditions through ultrasound scans and refers them for the necessary treatment.

Is it necessary to have a cesarean section (C-section) when having twins?

It's not necessarily necessary, but there are several reasons why a cesarean section is more likely to be performed in twin births.

• Often, both babies are not in the correct position ( head down) for delivery.
• A normal delivery may be risky for the mother or baby due to complications during pregnancy.

As you approach your due date, your doctor will examine you and discuss with you what method is safest for both you and your baby.

How to stay healthy throughout this pregnancy?

Having twins means you have to think twice about your body.

• Nutrition: You need more nutrition than a single mother. As a rule of thumb, one baby needs about 300 extra calories per day. That means if you're carrying twins, you need about 600 extra calories per day. Eat plenty of protein-rich foods, vegetables, and fruits. And drink plenty of water throughout the day.
• Rest: You will feel very tired. So get as much rest as possible. Take a nap during the day. If your legs are swollen, keep them elevated.
• Medical checkups: You will need to see the doctor and have scans more often than a mother with one baby. Don't miss any of these clinics and go regularly. It is very important for your safety and that of your baby.
• Exercise: Exercise is good, but you should definitely ask your doctor about it. Light exercise like swimming and walking is usually fine. But it's wise to stay away from strenuous exercise like running and jumping.