| Twins and multiple babies | 357.000000000000 | Twins and multiple babies | Twins and multiple babies | T | English | Pregnancy | Adult (19+) | Body | Reproductive system | NA | Prenatal
Adult (19+) | NA | | 2009-09-11T04:00:00Z | | | | | | 10.5000000000000 | 49.6000000000000 | 1364.00000000000 | | Flat Content | Health A-Z | <p>Learn about pregnancy with twins or multiple babies, including diagnosis and effects during pregnancy. Care during pregnancy is also discussed.</p> | <p>There are two types of twins: identical twins and fraternal, or non-identical, twins. The majority of twins are fraternal, and they result from the fertilization of two different egg cells by two different sperm cells. Identical twins are formed from one single fertilized egg cell that subsequently divides into two identical cells and forms two identical babies. Either of these processes can lead to triplets, quadruplets, or other multiple babies. </p> | | <h2>Key points</h2>
<ul><li>About one of every 250 births is a set of identical twins.</li>
<li>If there is a family history of twins, you have an increased chance of giving birth to twins yourself.</li>
<li>Twins and multiple births are prone to congenital abnormalities and many are born prematurely, particularly multiple births.</li>
<li>Special attention needs to be paid to diet, preventing hypertension and fetal monitoring for women pregnant with twins or multiple babies.</li></ul> | <h2>Frequency of twins and multiple babies</h2>
<figure>
<span class="asset-image-title">Fraternal </span>
<span class="asset-image-title">Twins</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Fraternal_twins_MED_ILL_EN.jpg" alt="Progression of two eggs and two sperm to two blastocysts with one inner cell mass each to two amniotic sacs and two placentas" />
<figcaption class="asset-image-caption">Fraternal</figcaption>
<figcaption class="asset-image-caption"> twins develop from the fertilization of two different eggs by two different sperm. After fertilization, cells in each zygote continue to divide to form a blastocyst. Both blastocysts implant into the uterine wall, and cells continue to divide and form each baby. Fraternal twins can be the same or opposite sex, and may not look alike.</figcaption>
</figure>
<p>About one of every 250 births is a set of identical twins. This rate is basically the same throughout the world and is largely independent of race, age, and heredity. The frequency of fraternal twins, on the other hand, is influenced by race, heredity, the mother’s age, how many previous babies the mother has had, and especially fertility drugs. Reproductive technology has led to an increased incidence of twins. </p><p>The frequency of twins and multiple babies varies between races and ethnic groups. In white women, the rate is one of every 100 births; in black women, one of every 80 births. The rate increases dramatically in some parts of Africa and is less common in Asia.</p><p>The likelihood of having twins runs in the family. If the pregnant mother has a family history of twins, they have a one-in-58 chance of having twins themselves. If her partner has a history of twins in the family, the chances are one in 116. Also, the older the mother is, and the more children they have already had, the higher the chances are that they will have twins. </p><p>Infertility therapy and assisted reproduction have a major impact on the chances of having twins or multiple babies. During infertility therapy, ovulation is stimulated with hormones. These hormones are known to increase the incidence of twins. For example, after treatment with the hormone gonadotropin, there is a 20% to 40% chance of having twins. Assisted reproduction involves inducing ovulation, collecting all the egg cells, fertilizing them, and implanting a number of fertilized egg cells in the uterus. This, of course, results in a number of growing embryos in the uterus. Some of these might miscarry, and others will survive and thrive. </p><h2>Diagnosis of twins and multiple babies</h2>
<figure class="asset-c-80">
<span class="asset-image-title">Identical </span>
<span class="asset-image-title">Twins</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Identical_twins_MED_ILL_EN.jpg" alt="Diagram of separation of identical twins at three different stages" />
<figcaption class="asset-image-caption">Identical</figcaption>
<figcaption class="asset-image-caption"> twins develop from the fertilization of one egg by one sperm. After fertilization, cells continue to divide to form a blastocyst. There are three stages where separation can occur and this determines whether the twins share an amniotic sac, a placenta, or both. Both cell masses continue to divide and form each baby. Identical twins are the same sex, and are genetically identical.</figcaption>
</figure>
<p>A woman who is carrying twins or multiple babies will have a larger uterus than the average pregnant woman. However, a larger uterus could indicate other complications such as a pregnancy that is farther along than originally thought, too much amniotic fluid in the uterus, a large baby late in pregnancy, or other concerns. Therefore, the suspicion of twins or multiples in pregnancy should be properly diagnosed. </p><p>Ultrasound has become a useful tool in the diagnosis of twins and multiple babies. Very early in pregnancy, the separate embryo sacs can be seen. Soon after, the bodies of each baby can be seen. The presence of twins can usually be identified at the pregnant woman’s first routine ultrasound. </p><p>There are other techniques used to diagnose twins and multiple babies. Late in the first trimester, it may be possible for the doctor to hear the different heartbeats using Doppler ultrasound. </p><h2>Effects on mother and babies</h2><p>Twins and multiple babies have a number of effects on the woman during pregnancy. Normally in pregnancy, the amount of blood circulating in the woman’s body increases to meet the needs of the baby. This blood volume is increased even further in women carrying twins or multiple babies, and there is a higher chance of anemia. Also, the heart needs to work that much harder to pump the higher volume of blood, leading to an increased heart rate. Women who are carrying twins and multiple babies need to take extra folic acid and iron because of the increased blood volume and chance of anemia. </p><p>The uterus can become very large, and excessive amounts of amniotic fluid may develop in the uterus. As a result, the woman's abdominal organs and lungs become even more squished than in normal pregnancy. The size and weight of the uterus can cause some women carrying twins and multiple babies to lead a very sedentary existence. Too much amniotic fluid can also cause the pregnant woman to develop problems with her kidneys. In severe cases, some amniotic fluid can be removed by amniocentesis if required. </p><p>Twins and multiple babies are more prone to congenital abnormalities, fetal growth restriction, premature birth, low birth weight, and death of one or more of the babies. In general, the more babies in the womb, the higher the chance of fetal growth restriction. Also, there may be differences in the birth weights of each twin or multiple baby. </p><p>About half of all twins deliver at 36 weeks or less. Half of triplets deliver before 32 weeks. Premature birth is the major cause of newborn death and illness in twins. However, premature twins do not seem to have more health problems than premature single babies. Many mothers of twins and multiple babies go into premature labour spontaneously. Others may need to have premature labour induced because of fetal growth restriction, hypertension in the mother, or a condition called placental abruption where the placenta comes away from the walls of the uterus. </p><h2>Care during pregnancy</h2><p>In a pregnancy with twins or multiple babies, the goals of care are to prevent very premature delivery, identify and deliver any babies that are failing to thrive in the womb, eliminate trauma to the babies during labour and delivery, and provide expert care for the newborn babies. During pregnancy, special attention should be paid to the woman’s diet, prevention of hypertension, and monitoring of the unborn babies. </p><h3>Diet</h3><p>Pregnant women are advised to take in an extra 300 kcal (kilocalories) per day compared with women who are not pregnant. Note that kcal are often referred to as "calories" on food product labels. Women who are carrying twins or multiple babies should double that amount in order to meet the needs of their developing babies. They should receive iron supplements in a dose of 60 mg to 100 mg per day, and folic acid 1 mg per day. </p><h3>Preventing hypertension</h3><p>Hypertension, or high blood pressure, occurs more often in women carrying twins or multiple babies, and their hypertension develops earlier and is more severe than in women carrying just one baby. Special measures may need to be taken if a woman develops hypertension during pregnancy. </p><h3>Fetal monitoring</h3><p>Fetal growth is slower in multiple pregnancies, and the growth of one twin may be faster than the other. Because of this, a number of ultrasounds may be done throughout the third trimester to make sure that the babies are growing properly. The volume of amniotic fluid in the womb may also be checked regularly. An ultrasound may also be used to evaluate how well the babies are doing. </p><h2>Delivery of twins and multiple babies</h2><p>For information, see
<a href="/Article?contentid=411&language=English">Delivery of Twins and Multiple Babies</a>.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/twins_and_multiple_babies.jpg | | | | | | | Twins and multiple babies | | False | | | | | | | | |
