Twins are produced when a single fertilized ovum divides early to form two identical embryos out of one (monozygotic) or when two or more eggs are released...
“Normally, twins occur in 1 of 80 pregnancies and
triplets in 1 of 8000 pregnancies.”
Is your belly larger than it ought to be in your
week of pregnancy? Does your gynecologist feel more fetal parts than
are normal for one baby?If so, you ought to get an ultrasound scan performed
for there may be more than one in your womb.
What is a Twin
Twins are produced when a single fertilized ovum
divides early to form two identical embryos out of one (monozygotic) or when
two or more eggs are released and fertilized by two sperms (dizygotic).
In a monozygotic pregnancy,the two embryos share
the same placenta and chorion, the outer membrane of the embryo that
allows for the transfer of nutrients from the mother to the foetus blood.
However, they have separate amnions, inner membranes of the embryos that help
in development, for the most part. The amnion and chorion together form the
In a dizygotic pregnancy, each twin has its own
placenta and amniotic sac, leading to their growth being better than that in a
monozygotic pregnancy. Additionally, in monozygotic pregnancies where the
embryos have separate amnions, there are better survival rates than those in
which the two embryos share both the amnion and chorion.
What Are the
Chances of Having Twins?
Normally, twins occur in 1 of 80 pregnancies and
triplets in 1 of 8000 pregnancies. Now, however, infertility treatments, such as
IVF and ICSI, have increased the percentage of conceiving twins or other
in Dizygotic and Monozygotic Twins
Up to 30% of twin pregnancies result in a twin-twin
transfusion. In a twin-twin transfusion, one foetus becomes the donor, leading
to them potentially having a low amount of amniotic fluid, anemia, and growing
less than the other. The other foetus becomes the recipient, leading to them
potentially having an excessive amount of amniotic fluid inside the womb and
developing more than the other.
Additionally, the recipient foetus may
retain a high blood volume and face cardiac failure.Occasionally, due to this
situation, the donor recipient dies early in the pregnancy for they do not
receive the proper nutrition. However, generally, if both children survive
until birth, each individual baby tends to be smaller than in a pregnancy with
one child due to the nutrients being shared between the two embryos.
Proper monitoring and regular visits to the doctor
have improved the survival rates of both babies in a twin pair. Ultrasound
scans find the presence of multiple pregnancies early, before twins begin to
face complications or before one of the two babies die inside the womb,
which in and of itself can harm the other foetus.
in the Womb
Twin pregnancy is usually detected around 18-20
weeks when an ultrasound is first offered by doctors.
After twins are detected, pregnant women with twins
must be reviewed twice weekly and an ultrasound scan must be conducted
after every 2-3 weeks from the thirtieth week of pregnancy to prevent
of Expectant Mother of Twins during Pregnancy
Death incidences in twins have high percentages
after 35-38 weeks. Hence, proper and frequent monitoring is required for
the stable and healthy delivery of the babies and the maintenance of the
mother.For one, anemia must be ruled out in an expecting mother. Additionally,
the risk of cardiac failure and high blood pressure ought to be dealt with.
Overall, pregnant women may require extra amounts of nutrients
to fulfill the demands of her twins and need special antenatal care.
In terms of actual labour, both
cesarean section and vaginal birth are options for delivery. However,
depending upon the risks and presenting condition of the case, one option may
prove to be better than the other.
Twins in Labour
The actual birth of twins needs proper monitoring
and an assessment of the mother (vitals, etc.) and of the foetuses (position,
lie, etc.) before initiating any mode of delivery.
It is crucial to analyse the position of the babies
and the lies. To determine the position and the lies, the doctor does an
abdominal examination followed by a vaginal exam. In 45% of multiple
pregnancies, the babies are in cephalic position, where the head is towards the
pelvis, and in 30%, they are in breech and cephalic position, where one foetus
has feet towards pelvis and other foetus has head towards pelvis. In
around 10% of multiple pregnancies, both foetuses are breech presenting, which
generally causes there to be a need for a caesarean section. For the most part,
a cesarean section is performed when the feet of the baby are presented first.
It is also important to look for a prolapsed umbilical cord if a vaginal birth is
being done. The umbilical cord can be checked only
once the membranes of the amniotic sac rupture.
The first foetus is a little complicated to deliver
since the location of the other baby is unknown and space is limited. Due to
limited space, an episiotomy, a surgical cut at the vagina to aid in the
delivery of the baby, may be required.After the delivery of the first foetus,
uterine contractions may decrease. If they do not return within a few minutes,
the pregnant mother may be injected with oxytocins to increase uterine
contractions. Luckily, the birth of the second
foetus is usually uncomplicated.
After the birth, the most common complication faced
by a mother is a haemorrhage for which a medical team ought to be prepared.
Additionally, the mother must decide whether she wishes to preserve the umbilical cord blood for future
therapeutic use. Learn more about umbilical cord banking here.
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