Twin pregnancy – what do you need to know?

Types of twin pregnancy

Twin pregnancies can be divided in terms of the number of chorionic villi and amniotes into:

• Bicentrifugal dioecious
• Monochorionic dioecious
• Monochorionic monochorionic

Each type of twin pregnancy is associated with different management during the pregnancy and possible complications. The safest pregnancy is bicornuate bicornuate. The babies then have separate amniotic sacs, and each has its own placenta. In a singleton pregnancy, the placenta is shared, which can lead to unequal sharing between the babies and the development of complications typical of this type of pregnancy.

In common parlance, there is a division of twin pregnancies into monozygotic and dizygotic pregnancies. However, this division is not relevant to medical management.

Ultrasound examination in twin pregnancy

Multiple pregnancies are considered high-risk pregnancies. A twin pregnancy therefore requires more frequent examinations, especially ultrasound, than is the case in a single pregnancy. The ultrasound schedule is similar to that of a singleton pregnancy. A change to keep in mind takes place in the second half of pregnancy, when fetal growth should be monitored every 4 weeks in order to possibly quickly detect the difference in the weights of the babies. A singleton pregnancy requires specialized care from the very beginning. As of 16. Weekly ultrasound examinations are performed every 2 weeks. Such management is aimed at detecting complications such as TTTS syndrome or selective growth restriction (sFGR).

Twin pregnancy – complications        

Twin pregnancies are associated with a higher risk of complications than singleton pregnancies. Pre-eclampsia is more likely to occur in an expectant mother. Multiple pregnancies also end in preterm labor in many cases. A special group of pregnancies are singleton pregnancies, where babies “share” a common placenta. They can develop complications such as transfusion-transfusion syndrome (TTTS), reversed arterial perfusion syndrome (TRAP) and the anemia-polycythemia sequence (TAPS). Selective fetal growth restriction (sFGR) can also be a complication of twin pregnancies. For this reason, multiple pregnancies require specialized care, which should be carried out in centers run by experienced doctors who treat the aforementioned complications. Current methods make it possible to perform postnatal transfusions for anemia in children or laser ablation of the connecting vessels in TTTS syndrome, for example.

Read more:
Complications of multifetal pregnancies

What childbirth looks like in the case of a twin pregnancy

The route and timing of delivery for twin pregnancies depends on the type of pregnancy and any complications. In bimonthly pregnancies, delivery should take place between 37. and 38th week, for monochorionic biparental pregnancies around 36. Week, while in monochorionic singletons – in 34. week. If there are complications of multiple pregnancies, it may be necessary to terminate the pregnancy early.

The route of delivery for twin pregnancies should be decided by the gynecologist. Natural childbirth can be given to women with bicornuate and monochorionic bicornuate pregnancies. However, it is necessary to meet specific requirements. The first fetus should be in the longitudinal head position, and the difference in the babies’ weights should not exceed 20%. In monochorionic monochorionic pregnancy, the method of choice is cesarean section.

A twin pregnancy causes anxiety among many moms, but in most cases it also brings double happiness.