For those who want to have a number of children, the idea or possibility of a multiple pregnancy is something that many couples secretly wish for and want to happen. From another perspective, however—a medical perspective—a multiple pregnancy is also considered a high-risk pregnancy.
This is a matter of parental opinion and how they feel about it. For people who want to have many children or who want to have twins in particular, they may see it as a good and positive thing. However, from a medical perspective, doctors will tell you that while multiple pregnancies are not considered abnormal pregnancies in any way, they are, nonetheless, considered to be high-risk. This is because the human uterus is designed to support just one pregnancy at a time, and so a multiple pregnancy can mean a number of issues or problems, as a result, some of which could be dangerous to both mother and child.
In the past, the rate of multiple pregnancies was about 3 in 1,000, but presently, it has been observed that the rate of multiple or twin pregnancies is steadily increasing. This can be attributed to a variety of factors, but there are two main reasons for an increased chance of having a multiple pregnancy. These are:
There are three main types of multiple pregnancies;
Each of these types of multiple pregnancies carries with it different risks, but the type that is known to be most high-risk and that your doctor will be most concerned about is type 3. Pregnancies in this particular group can be accompanied by a number of different problems, including that of conjoined bodies or other conjoined organs, which is, of course, always considered high-risk. Or, in cases of non-conjoined bodies or other organs, the babies are separated normally, but one of the babies may move a lot, causing umbilical cord entanglement and, finally, possibly causing fetal death in one or both babies. Another risk is known as, ‘unequal placental sharing’—this is a problem because there are two fetuses sharing the one placenta, and one fetus may get less of a ‘share’ or portion of the placenta than its co-twin, resulting in less nutrition to one and causing problems with the baby’s weight and growth being slower than normal. This is called Twin-to-twin transfusion syndrome (TTTS) which result in an intrauterine blood transfusion from one twin (donor) to another twin (recipient) and the donor twin is often anemic.
For mothers who have conceived naturally, in the beginning, your symptoms may not be all that different from those of a normal singleton pregnancy. There are two main possible ways, however, that you may be able to tell. First, do you have more morning sickness than usual? If you have excessive morning sickness, it is possible you may be carrying a multiple pregnancy. The reason for this sickness is likely due to the rapid increase in hormones during the first trimester of pregnancy. Second, is a large belly size. Take note of whether your belly is unusually large for the gestational age of your baby, as with a multiple pregnancy the uterus will, of course, be larger than normal to accommodate the fact that there are two babies present instead of just one. Our best advice, however, is to visit a doctor for your prenatal screening and tests, as even a larger uterine size can be indicative of a number of factors, whether of a multiple pregnancy, or because the mother is overweight or has a large amount of abdominal fat, or because there is more amniotic fluid than usual. It is always best to see a doctor before making any assumptions. For mothers who have struggled with infertility and received treatment from doctors using assisted reproductive technology, they will already know from the onset whether or not they are pregnant with twins, as in this case, doctors will have been monitoring the mother via regular ultrasound examinations.
M.D., Faculty of Medicine, Chulalongkorn University, 2003. Faculty of Medicine Chulalongkorn University