Multiple pregnancies may occur when 2 or more ova are fertilized to form dizygoticcalled as non-identical twinsora single fertilized egg which divides to form monozygotic called identical twins.

In dizygotic multiple pregnancies, each of the fetus has its own placenta either it can be separate or fused, amnion & chorion. In monozygotic multiple pregnancies, the condition will be more complex depends on the timing of the division of ovum.

In monochorionic twin pregnancies, one of the twins may receive a reduced blood supply & have slower growth rate (twin-twin transfusion). Rarely, one fetus dies & forms a mummified fetus of papyraceous.

Triplet pregnancies will be monochorionic, dichorionic or trichorionic. Chorionicity & amnionicity in the multiple pregnancies affect the risks & hence management of the pregnancy & so are assessed in the early scans.

CAUSES:

There are so many factors which are related to have a multiple pregnancy. Factors that are occurring natural those factors include the following:

  • Heredity– A family history of the multiple pregnancy raises the chances of having twins.
  • Older age– Women age over 30 yrs will have a greater chance of getting multiple conceptions. Many of the women today were delaying childbearing till later in life, & will have twins as a result.
  • High parity By having one or more previous pregnancies, particularly a multiple pregnancy, raises the chances of getting multiples.
  • Race– African-American women were most likely to have twins compared to any other race. Asian & Native Americans will have the lowest twinning rates. Caucasian women, particularly those over age 35, have the maximum rate of higher-order multiple births such as triplets or more.

Other factors which are greatly increased the multiple birth rate in past and recent years include reproductive technologies, including the following:

  • Ovulation stimulating medications like clomiphene citrate & follicle stimulating hormone (FSH) will help produce so many eggs, which, if fertilized, may also result in multiple babies.
  • Assisted reproductive technologies like in vitro fertilization (IVF) & other techniques will help couples to conceive. These technologies usually use ovulation stimulating medications to produce the multiple eggs which were then fertilized & returned to the uterus to develop.

SYMPTOMS:

The following were the most common symptoms of the multiple pregnancies. Even though, each woman will experience symptoms differently. Symptoms of the multiple pregnancies may include:

  • Uterus is larger than expected for dates in pregnancy
  • Increased morning sickness
  • Increasing of appetite
  • Excessive weight gain, particularly in early pregnancy
  • Fetal movements felt in different parts of the abdomen at same time

DIAGNOSIS:

Many women will suspect they are pregnant with more than one baby, particularly if they have been pregnant before. Diagnosis of the multiple fetuses can be made early in the pregnancy, particularly if the reproductive technologies have been used.

Ultrasound is used to diagnose the multiple pregnancies. Early ultrasound will be so helpful in diagnosing cholionicity & amnionicity. Once diagnosis of the multiple pregnancies is made, doctor may ask you to come for the check ups & ultrasounds made frequently.