A twin pregnancy is less common than a singleton pregnancy, and you carry two fetuses in the uterus. Pregnant women expecting twins may be concerned about the risks involved in pregnancy and delivery. Healthy lifestyle modifications and regular medical supervision are a must for pregnant women with multiple babies due to higher risks of complications, including early labour, preterm birth, gestational diabetes, and pre-eclampsia. Continue reading to know about special prenatal care and twin pregnancy care guidelines for a safe and healthy twin pregnancy.
A twin pregnancy is a rare condition where two fetuses are formed in the uterus. This type of pregnancy is different from a single pregnancy, as you carry only one fetus in the uterus. You may experience intense pregnancy symptoms, including severe morning sickness, extreme fatigue, and rapid weight gain, thereby demanding special prenatal care and frequent medical supervision. Also, the pregnancy risks are higher in a twin pregnancy compared to a single pregnancy, making it necessary to follow twin pregnancy precautions.
Twin pregnancies are usually classified into two types: fraternal, where two eggs are fertilised by two sperm, forming two separate embryos, and identical, where one fertilised egg splits into two separate embryos. Clinically, twin pregnancies are classified based on chorionicity, i.e., the number of placentas. If each fetus in a twin pregnancy grows with a separate placenta, it is called dichorionic, and if the fetuses share a single placenta, it is called monochorionic. You may need special prenatal care and follow specific pregnancy safety guidelines, as high risks are involved in a monochorionic twin pregnancy, to avoid twin pregnancy complications.
Prenatal care is crucial in a twin pregnancy as it significantly reduces the risks, including preterm birth, gestational diabetes, pre-eclampsia and growth issues. So prenatal care mainly includes more frequent medical visits than in a single pregnancy, specialised ultrasound for early detection of growth disorders of the fetus, checking amniotic fluid levels and the type of placentation, and assessing pregnancy-related complications. It also includes targeted supplements to meet the nutritional requirements of the twin-pregnant mother.
You must be aware of the increased need for calories, proteins, fat, calcium and other essential nutrients during twin pregnancy. There is an increased risk of anaemia, preterm birth and Intrauterine Growth Restriction (IUGR) due to insufficient nutrient intake during twin pregnancy. So, the food you eat must support the growth of two babies in a twin pregnancy. You may need an extra 600 calories and supplements like iron, folate, calcium, vitamin D, omega-3, zinc and magnesium based on the recommendation of your healthcare provider. Proper twin pregnancy diet and care can help reduce the common risks of twin pregnancy.
Regular fetal growth monitoring via ultrasound can help detect early growth discordance, including fetal Growth Restriction (FGR) and Twin-to-Twin Transfusion Syndrome, and assess fetal growth patterns. It also helps assess placental function and risk levels by identifying the type of chorionicity.
Frequent and specialised prenatal care includes frequent medical check-ups, regular ultrasound monitoring, cervical length monitoring, and checking blood pressure and sugar levels. This helps in managing risks of twin pregnancy, including preterm birth, pre-eclampsia and gestational diabetes.
In addition to the prenatal care tips for a twin pregnancy, pregnant women must follow specific safety guidelines and precautions during physical activity to avoid risks and complications. Low-impact exercises are safe during a twin pregnancy. However, start with regular physical activities like swimming, walking, and stationary cycling only with your doctor's approval. Avoid strenuous exercises, do not lie on your back, and a big no to lifting heavy weights during twin pregnancy.
Women in twin pregnancy must look for specific warning signs listed below
● Severe abdominal pain
● Unusual vaginal discharge
● Excessive bleeding
● No or fewer fetal movements
Visit your doctor without delay if you notice any of the above symptoms, as they may lead to serious complications affecting both the mother and the baby.
Physical recovery after twin delivery is usually more intense and longer compared to delivering a single baby. Adequate rest, eating nutritious food, and gentle physical activities can help restore your body after twin delivery. Getting help from others and delegating baby care work to your partner or others can help support your physical and emotional health after pregnancy.
Twin pregnancy is usually characterised by high-risk complications including fetal growth restriction, early labour, pre-eclampsia and gestational diabetes. However, early detection and specialised monitoring play a crucial role in preventing the major risks and complications of twin pregnancy. With proper medical care and nutritional support, there is a higher chance of healthy outcomes.
Yes, twin pregnancy is considered high risk, as carrying two fetuses at the same time increases the risk of complications for both the baby and the mother. Common risks of twin pregnancy are preterm birth, gestational diabetes, early labour, pre-eclampsia and diabetes.
Prenatal care is different in a twin pregnancy compared to a single pregnancy, as they may need more frequent medical visits to track the baby’s growth and assess the health of the mother, and frequent ultrasound scanning to monitor fetal growth to prevent complications. Calorie and nutritional need is also high in a twin pregnancy compared to a single pregnancy.
In a twin pregnancy, you may need frequent checkups and scans based on chorionicity. In the case of a monochorionic pregnancy, i.e., sharing a placenta, you may need intensive monitoring every 2- 4 weeks from mid-pregnancy and 1- 2 weeks in the last stages of pregnancy. In case of dichorionic, i.e., separate placenta, you may need scans every 4 weeks in the initial stage of pregnancy and scans every 2 weeks from the third trimester.
For a healthy twin pregnancy, you may need a diet providing extra calories and food rich in iron, protein, folate, omega-3, healthy fats, and calcium. So include foods like whole grains, fruits and vegetables, eggs, lean meat and nuts.
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