What are Multiple Pregnancies?
Twins, triplets or more are conceived by the Fertilization of single Ovum or more than 1 ovum.
The incidence of the multiple is increased in the recent years. This increase is caused due to the use of Fertility Drugs and the development in the Assisted Reproductive Technology (ART).
A multiple Pregnancy is identified as a high-risk Pregnancy due to the risks to the mother and the babies. The incidence of premature birth mostly has many complications.
Careful monitoring is needed throughout the Pregnancy, in order to minimize the chances of complications and to make safe delivery of the babies.
Pathogenesis of Multiple Pregnancies
Monozygotic or identical twins are produced from the fertilization of Single Ovum by a single Sperm and the Fertilized Ovum later divides to produce 2 Embryos.
This process is not influenced by the factors like race, maternal age or heredity.
The Fertility treatments including Fertility Drugs like Clomiphene Citrate and ART like Vitro Fertilization have increased the chance of multiple pregnancies.
Properties of Identical Twins
- They are always of same Sex.
- The Fetuses may share 1 Placenta but they usually have their own Amniotic Sac.
- They usually have the same physical appearance including Hair, Eye Color, Skin and Build.
- They have the same Genetic features such as Blood Type.
- They may be “Mirror Images” of each other like 1 can be left-handed while the other may be right- handed.
- The one difference may be their Finger Prints do not match.
Dizygotic or Fraternal Twins develop by the Fertilization of 2 Ova by 2 different Sperms.
Fraternal Twins are more common than Identical Twins.
Properties of Fraternal Twins
- They may or may not be of same Sex.
- Each Fetus has their own Placenta and separate Amniotic Sac.
- They resemble to each other but they are not identical.
- They may or may not have the same Blood Type.
Following factors may influence the Dizygotic Twins
It is common in Africans; it is least common in Asians.
Family history of Twins
It is inherited from the Mother’s side of family.
- The incidence may increase with the higher Maternal Age, ranging between 35 and 45 years of age.
- Fertility Stimulating Drugs
- In-Vitro Fertilization
• Monozygotic Triplets occur from repeated twinning or super twinning of single Ovum.
• Trizygotic Triplets develop by the individual Fertilization of 3 at the same time expelled Ova.
• Triplets can also occur due to twinning of 2 Ova, with the elimination of 1 of the 4 Embryos.
Symptoms of Multiple Pregnancies
- The Uterus may be very large for the date.
- Excessive Vomiting of Pregnancy.
- Rapid weight gain during first trimester.
- Higher Human Chorionic Gonadotropin.
- Large for date uterine size.
- Excess of Amniotic Fluid
- Excessive weight gain
- More than 2 Poles may be felt, on examination
- Multiple Fetal parts may be felt
- 2 or more than 2 Fetal Heart may be heard.
Maternal Health Issues, Risk and Complications
The multiple Pregnancy is identified as High-Risk pregnancy due to following complications
The greater demand of Iron by the Fetuses may cause Maternal Anemia.
- Urinary Tract Infection
- Gestational Diabetes
- Pressure SymptomsThe large size of Uterus due to the Multiple Pregnancy can put pressure on the Pelvic Blood Vessela.
- Ovarian CystsOvarian Cysts may occur from abnormal high level of Chorionic Gonadotropin.
- All systems of mother including Cardiovascular, Respiratory, Renal, Muscles and Gastrointestinal system are under stress in Multiple pregnancy.
- The nutritional requirements are increased both for the mother and the Fetuses.
- Increased risk of Hemorrhage before, during and after Pregnancy.
- Uterine Inertia
- Increased risk of Cesarean Section.
- Premature separation of membrane.
- Greater risk of Preterm delivery.
- The care of the 2 or more child after the delivery is very challenging and difficult.
- There is a greater risk of death of 1 baby.
- Breastfeeding to more than 1 child is difficult.
Following can be the Fetal Complications during multiple Pregnancies
- Low birth weight
- Increased risk of Prenatal mortality
- Cord prolapsed
- Growth restricted babies
- Chances of disability
- Abnormal position
- Intermingling Blood supply.
The above mentioned is some useful information about Multiple Pregnancies, maternal health issues and the Fetal complications. These issues may not relate to your life but will surely increase your information.