How triplets develop. Can you intentionally conceive twins naturally? Type of multiple pregnancy on ultrasound

Pregnancy with twins is an absolutely normal condition in which a woman bears two fetuses at the same time. According to statistics, about 2% of expectant mothers learn about the birth of more than one baby. If a woman is expecting twins, then such a pregnancy has a number of features. In particular, the female body needs more vitamins and nutrients. In addition, the cardiovascular and urinary systems are under significant stress. What happens in the female body when carrying twins?

Twins or twins

In general terms, twin pregnancy does not differ from singleton pregnancy, but, nevertheless, it has its own characteristics. First of all, you should understand the types of twins.

Children born as a result of same-sex pregnancy can be identical or fraternal twins. The second name for fraternal twins is twins. Such babies are born after the fertilization of two eggs at the same time. They have a different genetic makeup and can be completely different in appearance. Twins always have two amniotic membranes, each of the babies has its own placenta.

Identical twins, or simply twins, develop as a result of the division of one fertilized egg into two parts. These babies have the same set of genes, so they are always of the same sex and look identical. Depending on the number of amniotic structures, twins can be:

• bichorial biamniotic - each child has its own chorion and amnion, division occurs 1–3 days after conception;
• monochorionic biamniotic - children have a common placenta, but each of them has its own amnion, division occurs 3–8 days after conception;
• monochorionic monoamniotic - division occurs on the 8-13th day of fetal development, babies have a single system of provisional organs.

Regardless of what type of twins a woman is carrying, a normal twin pregnancy proceeds in much the same way as a singleton pregnancy.

1-2 weeks

If a woman is pregnant with twins, the period of intrauterine development of babies is calculated in the same way as in a singleton pregnancy - from the first day of the last menstruation. That is, in the first two obstetric weeks of pregnancy, the body is preparing for a possible conception.

During this period, the follicle matures in the woman's ovary. Around the middle of the menstrual cycle, the follicle ruptures and the mature egg is released into the abdominal cavity. From here, picked up by the cilia of the fallopian tube, it enters the fallopian tube, where it expects to meet with the sperm.

At the same time, under the influence of sex hormones, the mucous membrane of the uterus gradually thickens. Thus, conditions are created for the implantation of a fertilized egg and the onset of pregnancy.

3-4 weeks

In the third obstetric week of pregnancy, the egg and sperm merge. As a result, a zygote is formed. If one egg has been fertilized, you can expect identical twins, when two are different. After 4-6 days, the embryo enters the uterine cavity, where it is implanted into the endometrium and continues its development - this is the beginning of pregnancy.

From 3 to 8 days of pregnancy with twins, the embryos go through the morula stage. During this period, they look like a mulberry, formed as a result of cell division by mitosis.

From 8 to 13 days of pregnancy, a blastocyst is formed. The morula cells are arranged in one row, and a cavity is formed in the center of the "berry". The next stage of pregnancy is gastrulation - the formation of a cavity two-layer structure. Scientists distinguish between primary and secondary gastrulation.

Initially, blastula cells form two rows. One of them will give rise to trophoblast and amniotic structures. The second row a little later will give rise to three germ layers - ectoderm, mesoderm and endoderm. Organisms of twins will develop from them.

During pregnancy, the nervous system, epidermis, nails, hair, teeth will be formed from the ectoderm. The mesoderm will give rise to the musculoskeletal system, fascia, mesentery, pleura, cardiovascular system. From the endoderm, the epithelial lining of the gastrointestinal tract and parenchymal organs will develop.

At this stage, it is already possible to diagnose twin pregnancy. As with a normal pregnancy, after a positive home test, your doctor will recommend donating blood for hCG and having an ultrasound scan. On an ultrasound scan, the gynecologist will see a fertilized egg and establish that the woman is pregnant with twins.

5-6 weeks

Pregnancy with twins continues to develop actively. By this time, amniotic structures have already been laid. An actively growing chorion gradually replaces the trophoblast, an amnion appears, and the yolk sac is still present. The structure of the embryo is actively changing.

From the 19th day after the onset of pregnancy, the process of neurulation begins in twins - the formation of a neural tube. The neural tube is the precursor to the spinal cord. In addition, the notochord is formed - the phylogenetic precursor of the spinal column. The intestinal tube lies directly under the notochord of the embryos.

Starting from the 22nd day of pregnancy, the body of the embryo is conventionally divided into somites, or segments with a neural tube, chord, coelom and mesoderm. The mesoderm, in turn, is divided into sclerotome, myotome, and dermatome. The sclerotome is the precursor of the skeleton, muscles develop from the myotome, and the dermatome is the dermis of the skin.

7-8 weeks

The term 7-8 obstetric week of pregnancy with twins corresponds to 5-6 weeks of embryonic development of the fetus. During this period, there are certain features of the development of fruits.

The active laying and development of internal organs begins - organogenesis. The earliest of all is the laying and formation of the cardiovascular system. At this stage of pregnancy, twins have their own cardiovascular system, and the heart consists of four chambers lined up in one row. The heart of arthropods has a similar structure.

In the yolk sac, the production of red blood cells of the fetus takes place. In other words, during this period of pregnancy, hematopoiesis is activated. Twins develop limbs. At such an early stage, the handles are still longer than the legs, but soon the proportions will return to normal.

The branchial arches are formed. In the future, they will give rise to the facial skeleton and soft tissues of the face. Violation of the fusion of the gill arches among themselves leads to congenital anomalies - the cleft lip and cleft palate.

At the 5th embryonic week of development, a specific depression appears in twins - the mouth bay. In this zone, the epithelium thickens and plunges into the mesenchyme. In the future, the rudiments of milk and molars will form from it.

Mesonephros appears - collecting ducts along the body of the embryos. Mesonephros is the precursor of the urinary system.

By the end of 8 obstetric, or 6 embryonic weeks of pregnancy with twins, babies have a fully formed cardiovascular system. Despite its immaturity, the small heart is already capable of pumping blood.

9-10 weeks

At this stage of pregnancy, all internal organs of the twins are actively developing. From obstetric week 10, a woman pregnant with twins can have her first pregnancy screening. With its help, the condition of babies, the place of attachment of the chorion, the consistency of the cervix, and the tone of the muscular membrane of the uterus are assessed. Screening involves a biochemical blood test and ultrasound. Considering the results of the examination in a complex, the doctor can draw conclusions about the health of the twins and help the couple make the right decision about the further bearing of children.

11-14 weeks

Starting at 12 weeks, babies have their own placenta, which replaces the chorion. The corpus luteum atrophies. In children, all internal organs and systems are already laid. In the future, they will only grow and improve.

The period from 11 to 14 obstetric week is optimal for the first screening of pregnant women. The survey includes:

• a blood test for beta-hCG;
• blood test for PAPP.

During an ultrasound examination, examining a pregnancy with twins, the doctor measures the size of the tubular bones, the length of the nasal bone, the thickness of the collar space, excludes anomalies of the central nervous system, heart and blood vessels.

A woman who is pregnant with twins should consider the results of biochemical screening only in conjunction with the results of ultrasound.

15-20 weeks

Starting from the 15th week of pregnancy, the genitourinary system completes the formation of children. Thanks to modern ultrasound equipment, a couple can recognize the gender of twins.

The thyroid gland begins to work. It produces thyroid hormones that regulate the basal metabolic rate of the child's body.

Starting from the twentieth week of pregnancy, children can clearly distinguish voices - by this time the inner ear has already been formed.

21-24 weeks

Typically, during this period, women who are pregnant with twins undergo a second pregnancy screening. Like the first screening, the second study consists of ultrasound and biochemical analysis. During an ultrasound examination, the doctor conducts fetometry, assesses the state of the internal organs of twins, and examines the developmental features of babies. Their results should be considered only in conjunction with the results of the first screening.

The main feature in the development of twins at this time is the completion of the formation of the vestibular apparatus and the beginning of the work of the digestive glands.

25-28 weeks

By this time, children from twins have formed eyeballs. They can open and close their eyes, distinguish between light and darkness. A pupillary reflex appears - the pupil narrows when bright light hits it and expands in the dark.

The adrenal cortex starts producing hormones. These are biologically active substances that help babies to overcome stress experienced during childbirth.

The brain is actively growing and developing. New connections are established between neurons, reflex arcs are formed, the convolutions of the brain deepen.

28-32 weeks

The main difference between the third trimester with twins is active weight gain due to an increase in subcutaneous tissue. The deposition of iron in the internal organs begins. Thanks to the large depot, after childbirth, fetal hemoglobin will easily be replaced by type A hemoglobin. The proportions of the body of children are close to those of newborns. The number of vellus hairs gradually decreases. In the natural folds of the skin, a cheese-like lubricant accumulates.

32-34 weeks

During this period, the woman undergoes the third pregnancy screening. In addition, starting from 32 weeks of pregnancy with twins, the patient can take a sick leave for the prenatal and postnatal period.

Prenatal screening consists of two stages:

Cardiotocography is an examination method in which the doctor examines the heart rate of twins, their physical activity, and the tone of the woman's uterus.

An ultrasound examination will provide information on malformations that are determined in late pregnancy, and will allow you to assess the presence of direct indications for a cesarean section. This can be a transverse presentation of one or both fetuses, partial or complete presentation of the placenta, entanglement of the neck of one baby or twins with the umbilical cord.

35-40 weeks

Starting from the 36th week of pregnancy, a psychological generic dominant is triggered in a woman's body. Training contractions, which first appear at 30 weeks, become longer. The first twin fetus is pressed by the head to the entrance to the small pelvis, which causes the bottom of the uterus to sink. The woman has reduced shortness of breath and heartburn. Due to the lack of space, children are not as active as they used to be.

About two weeks before childbirth, the mucous plug that closes the cervical canal leaves. As a rule, it has a yellowish tint, sometimes streaked with blood.

Strong regular contractions lasting at least 1 minute indicate the onset of labor. The normal frequency of contractions is at least one every 5 minutes. In this case, you should immediately contact your doctor.

In addition, you need to call a gynecologist if a twin pregnancy ended in premature rupture of amniotic fluid or bleeding from the vagina.

Childbirth with multiple pregnancies, as a rule, takes place earlier than with normal pregnancies. They should be expected at 36-38 weeks

There is no news for a woman more desirable and joyful than the message about future motherhood. She can become happier only from the news that she has a multiple pregnancy (MP). This means that not one life has arisen in you, but several at once - two, three or more.

Based on the fertilization mechanism, the following may appear:

• Gemini: Monozygous or identical pregnancy.
• Twins: Pregnancy is called dizygotic or twin pregnancy.

In a monozygotic pregnancy, the zygote (fertilized egg) soon after fertilization split into a couple and / or more particles. These babies have an identical set of chromosomes, they look alike like two drops of water.

A dizygotic pregnancy occurs when multiple eggs are fertilized at the same time. These children have a different set of genes. They are, of course, similar, but at the same time they differ in appearance. They can have a different gender, in the first case this is impossible.

Medicine knows situations when a woman safely endured and gave birth to seven babies.

Also, the classification and division of MPs into subspecies also occurs in terms of quantity:

• Fruit:
  • twins;
  • triplets;
  • quadruple, etc.
• Formed placentas and amniotic membranes (AO):
  • bichorial biamniotic: each embryo has its own placenta and AO;
  • monochorionic biamniotic: the placenta is common, but each has its own AO;
  • monochorionic monoamniotic: embryos have everything in common.

But it is not always possible to accurately determine belonging to a particular type.

Signs and diagnosis of twin pregnancy

This phenomenon is not considered very common. There are several factors that can trigger the development of two or more fetuses. Prerequisites:

• The most common is IVF artificial insemination (in vitro). Here it is directly related to the procedure itself. A couple of embryos are specially implanted into the uterus so that at least one embryo "takes root". But very often both survive safely.
• Heredity. If in the families of parents, especially on the maternal side, there have already been cases of the birth of twins, triplets, etc.
• The age of the future mom. The older (from 35 years old), the higher the likelihood of giving birth to 2 toddlers.

Race, discontinuation of hormonal contraceptives, and repeated childbirth are considered less significant.

There are signs of multiple pregnancies in the early stages, by which the woman in labor learns about double or even triple happiness.

The first and main signs lie in the feelings of a woman. Toxicosis begins to torment literally after the first days of the delay in the menstrual cycle. It is accompanied by such unpleasant symptoms as mild dizziness, frequent nausea, vomiting, increased feeling of fatigue and weakness, drowsiness. Also, with MP, increased nervousness and irritability, swelling of the legs, and a sharp increase in weight are noted. Constant constipation appears, but at the same time the appetite not only does not decrease, but, on the contrary, becomes larger.

If we talk about more serious confirmation - a clear severity of the second strip on the test. This is due to the fact that when carrying twins, the level of hCG in the urine is much higher than in a singleton pregnancy.

The gynecologist recognizes twins by the following signs:

• Large size of the uterus and abdomen, which are clearly out of date. So, for example, the tummy is visualized by the 14th week of the "interesting position".
• High blood pressure.
• The concentration of hCG is twice the norm.
• You can clearly hear how two hearts are beating.
• At a later date, a pair of heads is probed during the examination.

But with 100% accuracy, it is possible to talk about multiple pregnancy only after the gynecologist conducts an ultrasound examination. Ultrasound allows you to diagnose babies, determine their size, and identify possible pathologies. For this, a period of 4 weeks is quite suitable. And in the photo it will already be possible to distinguish the tiny outlines of your children.

Features of the course, possible complications

Multiple pregnancies are considered more difficult for the expectant mother and are associated with a high degree of risk. There is an opinion among doctors that this is practically a pathological condition. In such cases, the load on the body is much greater than when only one life grows in the tummy. Almost immediately, shortness of breath, heartburn and constipation begin to torment, the urge to urinate becomes more frequent. More than 4 times more often (in comparison with one embryo) the diagnosis "gestosis", the so-called late toxicosis, is made. It is possible to cope with it only while in a medical institution, therefore, the multiple carp has a high degree of getting to the hospital for preservation.

All this affects the fact that the body's resources are rapidly depleted, and therefore, there are more threats of various complications and the likelihood of their manifestation is higher.

Among the dangers for the mother, one can distinguish the occurrence of anemia, abnormal breech presentation of the fetus (s), premature onset of labor, polyhydramnios, placental abruption and / or its presentation. There is always a risk of miscarriage and the need for an early termination, in other words, an abortion.

In toddlers, however, the degree of developmental abnormalities is high, the likelihood of being born prematurely and / or with low birth weight. They also talk about the possibility of intrauterine death of one of the two, which can entail big problems for the health of the second. For example, to cerebral ischemia, which will lead to serious neurological disorders in the future.

The 30th week of pregnancy with twins is considered a control period. From this point on, it is imperative to undergo weekly examinations with cardiotocography and Doppler ultrasound without fail. These procedures help to monitor the condition of the offspring. If the slightest deviations from the normal development of fetuses are detected, mom is immediately hospitalized.

If you are waiting for a large replenishment in the family, which in itself is more problematic for your body, then you need to monitor your health with redoubled zeal.

Nutrition. Since double happiness lives in you, then you need twice as many calories. But you must get them from the "right" products. In order for the kids to get everything they need, you are allowed to consume 3.5 thousand calories per day. Consume:

• porridge;
• beef;
• salmon;
• liver;
• soy beans;
• jacket potatoes or baked potatoes;
• turnips;
• spinach;
• vegetables;
• dairy products.

You badly need vitamin C. It is found in a lot of tomatoes, vegetable juice, bell peppers, cauliflower.

Add snacks along with your main meals. Nuts, yoghurts, and fruits are great. Moreover, you can always take them with you in your purse. Eat smaller meals more often. Remember the water. It is she who is able to give strength and energy.

But alcoholic beverages, coffee, fatty fried foods, citrus fruits are now taboo for you. The consumption of chocolate should also be limited to a minimum.

Physical exercise. Of course, the body does not tolerate comic stress, but special exercises will not only not harm, but will also help prepare for delivery. Exercise should not be uncomfortable.

You can do:

• aqua aerobics;
• yoga;
• pilates.

Do special sets of exercises at home. Be sure to check with your gynecologist to be sure they are completely safe for you.

Walking and walking in the fresh air will also provide many benefits.

Important! If during exercise you feel the slightest discomfort, dizziness, blurred vision, severe shortness of breath and palpitations, lower back pain, abdominal pain - stop exercising. If you do not feel better after 20 minutes, consult a doctor.

Features of delivery

Until the 40th or 38th week of pregnancy with twins, almost no girl reaches out due to strong pressure and excessive stretching of the uterus. Even with a pathological, normal course of the entire period of gestation, it is recommended that the mother arrive at the maternity hospital at least 2 weeks before the set date.

As for the method of birth, there is a lively discussion here at the present time. But nevertheless, if the state of health is satisfactory, the test results are normal and the little ones are in the correct position, then the obstetricians will allow to give birth naturally.

A controversial issue is the breech presentation (i.e., booty down) of one of them. Some doctors allow you to give birth on their own, others say that babies can catch their heads and then surgery will be required.

The process itself takes place in a standard way and begins with contractions and the discharge of amniotic fluid. Very often, when contractions begin, droppers are immediately placed. This is done in order to immediately begin the administration of drugs in the event of an emergency.

Immediately after the "exit" of the first child, the fetal bladder of the second is opened, and the mother is injected with drugs that stimulate the contraction of the uterus. Usually the difference between senior and junior does not exceed 10-20 minutes. But with dvuyaytsev the difference can reach an hour.

Indications for a cesarean section are the very fact of multiple pregnancies, as well as:

• common placenta;
• transverse position of the fetus;
• complications in the form of preeclampsia;
• large weight of babies;
• polyhydramnios;
• collision (heads clutch);
• mom for 30 years;
• scar formation on the uterus;
• first birth.

The final decision on the method of birth and the moment when you are taken to the delivery room is made by the obstetrician-gynecologist. Everything is decided by the prevailing obstetric situation.

To calm down a little, allay fears and fears, communicate on forums with moms who have already gone this way. They will give a lot of useful information and practical advice.

And remember that most likely the 36th week of pregnancy with twins will be the moments when you see and hug your babies.

For stories of happy parents and doctors' comments, see the video:

Not only joy, but also a huge responsibility is the pregnancy of twins, because bearing two babies at once, twins or twins, is a serious burden on the body of the expectant mother. This situation is not so rare today. Twins are pregnant in about 0.7-1.5% of cases. With multiple pregnancies, a woman requires special attention from medical personnel due to possible complications. Only doctors can take into account the peculiarities of twin pregnancy and proper monitoring of the patient's condition.

What is twin pregnancy

This is the name of one of the varieties of multiple pregnancies (MB), when not one, but two fetuses develop in a woman's fetus. There may be more of them - triplets, quadruplets, etc. When carrying two fetuses, early diagnosis is very important so that in the future the woman's condition is under the strict supervision of a doctor. According to the number of fertilized eggs, multiple pregnancies can be identical or non-identical. In the first case, children are called twins, and in the second - twins.

Fraternal twins

This type of twin pregnancy is more common, in about 70% of cases. It occurs when a woman's body simultaneously ripens 2 eggs (in the ovary or ovaries), which are then fertilized by different sperm during one or two sexual intercourse, provided that no more than a week has passed between them. In this case, two isolated embryos are formed. These twins are called dizygotic or fraternal, and among the people - twins. They only have a general resemblance, as between siblings. Children rarely have the same sex, more often they are born different.

Such a pregnancy with twins can only be bichorionic biamniotic (otherwise - diamniotic dichorial). It is characterized by:

• each baby has his own bag of amniotic fluid (fetal bladder);
• each fetus has its own chorion (hereinafter - the placenta);
• dizygotic twins have 2 sets of membranes that surround the amniotic sac (the inner layer of the amnion and the outer layer of the chorion).

Identical twins

If a fraternal twin pregnancy can only be bichorionic biamniotic, then an identical (monozygotic) pregnancy has several types, depending on the time when the egg divides. This happens after fertilization. The following types of identical MB are distinguished:

1. Monozygous bichorial biamniotic. Occurs in about 1/3 of cases. The separation of the egg occurs during its movement along the tube to the uterus. This is the period during the first three days after fertilization.
2. Monozygous monochorionic biamniotic. It occurs when the egg is dividing from 3 to 8 days after conception. In this case, 2 embryos are formed: each has its own amnion (fetal bladder), but they have a common chorion. This type of connection is typical for every 360 case. Having one placenta for two, these twins are at risk.
3. Monozygous monochorionic monoamniotic. Occurs in every 2400 cases. Separation occurs 8-13 days after conception. In this situation, the embryos have a common fetal bladder (amnion) and a common placenta (chorion). Such pregnancy with twins is considered the most unfavorable. Monoamniotic twins are at risk of death due to possible entanglement of the umbilical cords as babies grow.
4. Siamese twins. Appear when separation occurs later than 13 days after conception. Children can grow together with their coccyx, skull bones, lumbar spine, or rib cage.

Causes of multiple pregnancies

The main reasons for the birth of twins is the maturation of several eggs at once in one uterus or the division of the zygote into two parts after fertilization. Particular factors in the occurrence of multiple pregnancies are:

1. Genetic predisposition. Heredity has a high degree of influence. When spouses in relationship had cases of the birth of twins, then the likelihood of having twins also appears.
2. Age. During the premenopausal period (up to 35 years), not every menstrual cycle ovulates. They alternate with ovulatory ones when there is a surge in hormones. If after this ovulation occurs, then 2 or more eggs mature.
3. Hormonal contraception. Cancellation of such drugs leads to the activation of the synthesis of its own hormones, which leads to the maturation of several eggs.
4. In Vitro Fertilization (IVF). Thanks to modern reproductive technologies, in case of infertility, conception can be artificially stimulated. A woman is implanted with up to 4 eggs, which increases the likelihood of twins.
5. Delivery of twins from a previous pregnancy. If a woman is re-pregnant, she is more likely to have twins.

Signs of twin pregnancy

A woman may suspect she is pregnant with twins at an early stage. The test shows a positive result the first time. Such an unusual condition is also determined by the following signs:

1. Toxicosis with twins. It starts earlier and lasts longer, until about 16-17 weeks. The woman is feeling more difficult. Toxicosis is accompanied by vomiting, increased fatigue.
2. Rapid weight gain of the expectant mother. Body weight increases much faster from the first weeks, which is why a woman needs to strictly monitor her diet.
3. Abdomen with twins. Due to the growth of two babies at once, it begins to grow earlier. The size of the uterus by 12 weeks already almost reaches the navel (with a singleton, it only slightly protrudes above the bosom). Due to the close presentation of the fetuses, the woman feels the movement earlier.
4. Gestosis and anemia. With multiple pregnancies, these conditions are diagnosed in half of the cases. This is due to an increase in the volume of circulating blood and plasma. For the prevention of anemia, iron-containing drugs are prescribed.
5. Swelling and shortness of breath. Due to the high load on all organs, it is difficult to endure twins without complications. The displacement of the diaphragm disrupts the lungs, causes shortness of breath, swelling, fatigue. Due to the heavy load, the risk of varicose veins is high.

How is twin pregnancy diagnosed?

There are several methods and signs that help identify multiple pregnancies. The doctor can determine it already at a gynecological examination, but in addition the woman is assigned several procedures:

1. Blood test. It is necessary to determine the presence of human chorionic gonadotropin. This hormone is secreted by the placenta.
2. Ultrasound procedure. This method is more informative only from the 8th week of gestation. Early ultrasound does not always detect twins, because one fetus can hide behind another.

When examined by a gynecologist in the early stages

During the initial examination, the doctor may note several signs of multiple pregnancy. The gynecologist palpates the soft uterus - in this case, he notes the discrepancy between its size and the period of delay in menstruation. Other signs that the doctor notes if multiple pregnancies are suspected:

• beating of 2 hearts during a Doppler diagnosis;
• overestimated AFP blood test results;
• discrepancy between the size of the head and the volume of the abdomen;
• too fast weight gain;
• persistent constipation;
• severe swelling of the legs;
• excessive fatigue of a woman;
• severe toxicosis and preeclampsia in the early stages;
• high blood pressure.

HCG indicators in a blood test

HCG analysis can confirm the doctor's hypothesis. This indicator has specific values ​​for each week. If, after analysis, it turns out that the level of hCG is too high for a certain period of pregnancy, then this may indicate multiple pregnancies. But this sign is indirect. A high level of hCG is characteristic of some abnormalities in the development of the fetus and ectopic pregnancy. In addition, this method cannot determine how many fetuses are in the uterus, whether they have one fetal bladder and a placenta or several.

Ultrasound diagnostics

The first ultrasound is possible for a period of 4-5 weeks, literally immediately after a delay in menstruation. It does not guarantee confirmation of multiple pregnancies, because one child can hide behind another, but in most cases it confirms the doctor's assumptions. Further planned ultrasounds help the doctor determine how many placentas are, the presence of a septum (one or two amnions), the location and heart rate of the fetus, signs of developmental delay, and fusion between twins.

Development of twins by weeks of pregnancy

Women who are pregnant with twins are at increased risk, so they need special supervision from doctors. To do this, you have to visit the antenatal clinic more often: every 14 days for up to 28 weeks, and then every 7-10 days. The gynecologist at each examination pays special attention to the woman's weight. By the time of delivery, the woman in labor should gain no more than 15 kg. Each extra pound increases the risk of complications in fetal development. In each trimester of pregnancy with twins, characteristic features can be distinguished, which the doctor always notes.

1-10 weeks

At an early stage, the woman's body begins to respond to pregnancy with twins. This is manifested by swelling of the mammary glands, an increase in the level of hCG. By the 8th week, embryos can already be detected on an ultrasound scan - their size reaches 3 cm.The symptoms are the same as for multiple pregnancies, but toxicosis appears earlier. By 10-11 weeks, future babies come to the end of embryonic development:

• their length is about 4.5 cm;
• hearts are formed;
• the weight of the embryos is about 5 g;
• the voice-forming apparatus begins to form;
• faces are distinguishable, the heads are very large.

10-20 weeks

During this period, both fetuses grow rapidly, due to which the uterus greatly increases in size and leaves the pelvic region. This condition requires a woman to wear special clothes for expectant mothers. At 16 weeks, during an ultrasound scan, you can already distinguish the sex of the babies, approximately calculate their weight. Other features of the development of twins at this stage:

• babies can squeeze their pens into fists, they have facial expressions, but they sleep almost all the time;
• children have a reaction to sounds;
• the rudiments of the organs of the digestive and excretory systems appear, the intestines begin to work;
• the baby can swallow a certain amount of amniotic fluid and remove waste products through the bladder;
• from the 16th week, the movement of the babies is felt, from 20 it is already felt very clearly;
• the body length of the babies is about 17 cm, and the body weight is 200 g.

20-30 week

At the next stage, women experience a significant acceleration of their metabolism, due to the rapidly growing uterus, stretch marks appear. The struggle of babies in the womb for the correct position leads to constant tremors. The woman's back begins to hurt again. The inconvenience is the increased frequency of urination, increased fatigue, back pain and severe edema. Other features of fetal development according to the twin pregnancy calendar:

• by the 25th week, the growth of the fruits is 30 cm, and the weight is about 700 g;

• in appearance, babies are already more like newborns, an ultrasound can detect that one is larger than the other;
• by the 28th week, babies are already viable and with preterm birth have a higher chance of survival when compared with premature babies;
• by the 30th week, the growth is about 35 cm, and the formation of the body is almost completely completed.

30-40 weeks

This stage is one of the most important. In the final trimester, babies have a bone skeleton, pancreas develop, and iron and calcium accumulate. The head and body become approximately the same size, so the children appear in proportion. Because of the large belly, the woman is uncomfortable to sleep. In this case, it is recommended to lie on your left side; it is better to purchase a pillow for pregnant women for this.

During this period, a woman should limit physical activity, devote more time to rest. At 36 weeks, the planned hospitalization of the woman in labor takes place. Babies during this period are considered fully term:

• a sucking apparatus is formed;
• growth reaches 45-50 cm;
• the weight is about 2.2-3 kg.

Features of bearing twins

The process of carrying twins depends not only on the type of multiple pregnancy, but also on the woman's history. Here many factors are taken into account - whether the patient is giving birth for the first time or already for the second time, in what way the delivery took place the last time. We should also mention pregnancy after artificial insemination, i.e. IVF when the possibility of multiple pregnancies is high. Each case has its own characteristics of bearing twins.

After a cesarean section

If the previous birth took place by caesarean section, then the next one can have serious complications. Two options for the development of events can be distinguished here:

1. In case of a defective scar on the uterus, doctors may insist on artificial termination of pregnancy. Even if twins develop normally, it is still dangerous.
2. If, after a cesarean, a woman has a scar on the uterus, then the gestation is prolonged up to 30 weeks. Then there is an operative delivery. This is necessary to exclude a possible rupture of the uterus and other negative consequences.

Pregnancy with twins after IVF

In this case, twins are explained by the fact that of the embryos that the doctor inserts into the uterine cavity, two of the embryos can be inserted into the layer of the uterus at once, and not one. They are attached and continue to develop successfully. In rare cases and only at the request of a woman, specialists artificially remove the embryos that have taken root. In some cases, it may be necessary for health reasons. According to statistics, twins are born in 30% of IVF cases. The high percentage is explained by the fact that several embryos are implanted in a woman to increase the chances of getting pregnant.

Delivery in multiple pregnancies

Carrying twins differs in terms and characteristics of the course. In this case, doctors pay special attention to the woman's health, more often inviting them to an appointment. The hospital is admitted to the hospital for a certain period before the appointed date of birth. By this time, the babies are fully formed, even though their weight and height are slightly below normal. If necessary, they are immediately sent to intensive care.

When can twins be born?

A feature of multiple pregnancies is that women rarely walk up to the usual time of 38-42 weeks. Patients who are carrying twins give birth more often at about 36 weeks. For this reason, women are hospitalized at least 14 days before the expected date of birth. In general, a favorable period for the birth of twins is 36-38 weeks. The peculiarity is that twins have a longer adaptation time than one baby. For this reason, even when born prematurely, they can breathe on their own.

Natural childbirth

The tactics of delivery is determined taking into account several factors. The doctor takes into account the position and presentation of the fetus, especially the first baby. No less important are the regularity and intensity of contractions, the presence of water and intrauterine hypoxia of twins, the age of the woman in labor and possible gynecological diseases. Natural childbirth is resorted to if:

• both fetuses are presented with heads;
• the condition of the babies and the mother is satisfactory;
• labor activity is regular.

Natural childbirth in most cases proceeds normally without any ptaologies, but sometimes it can be accompanied by some complications:

• weak labor due to a distended uterus;
• premature rupture of amniotic fluid or placental abruption after the birth of the first fetus;
• fetal hypoxia;
• bleeding;
• prolapse of the umbilical cord.

Indications for abdominal delivery

Doctors with multiple pregnancies often do not take risks and resort to abdominal delivery, i.e. caesarean section. Indisputable indications for a planned operation are:

• extragenital diseases;
• unpreparedness of the birth canal for childbirth after 38 weeks;
• primiparous age;
• the pelvic or lateral position of the first fetus;
• complications during twin pregnancy;
• severe gestosis;
• excessive stretching of the uterus;
• large kids;
• polyhydramnios.

Potential risks and complications

Carrying twins is a serious test for a woman. The risk of complications in these patients is higher than in singleton pregnancies. Potential consequences are classified according to the time of occurrence. They may be:

• intrauterine;
• perinatal;
• postpartum.

Specific intrauterine complications

• reverse arterial perfusion;
• the threat of miscarriage;
• fusion of children (Siamese twins);
• a chromosomal disorder in one of the babies;
• fetal blood transfusion syndrome;
• congenital "deformity" of one of the babies;
• anembryonia - the phenomenon of the death of one of the twins;
• antenatal death of one fetus.

Perinatal

Complications of multiple pregnancy can occur during delivery. Mortality rates are high here - about 5 times higher compared to bearing one fetus. Other serious complications in the perinatal period are:

• hypoxia of one or two fruits;
• slow dilatation of the cervix;
• anomaly of labor;
• premature placental abruption (especially for the second baby);
• bleeding during the separation of the placenta.

Postpartum risks for mother and twins

Due to the high risk of complications, pregnancy with twins is considered a borderline condition between the norm and the pathology. Even after childbirth, the mother and babies are at risk. A woman has a high risk of bleeding, inflammation of the uterine cavity (endometritis) or slowing of its contraction (subinvolution). The woman in labor is monitored for another 2 hours after giving birth. If necessary, uterine-contracting agents are administered.

Multiple pregnancy - photo

Video

The news that a woman will soon become a mother is perhaps the most memorable event in her life. A woman's reaction to multiple pregnancies does not always evoke positive emotions. Most often, a married couple experiences fear, shock and a sense of uncertainty.

Feelings of confusion and discouragement are a completely normal reaction to pregnancy with twins, as parents understand that they have a double responsibility. As a rule, very soon a married couple gets used to this news and is looking forward to the birth of babies.

Multiple pregnancies proceed somewhat differently than a single baby pregnancy. This article will reveal all the features of the course of pregnancy with twins by week. Thanks to the information received, the pregnant woman will feel more confident and know what to expect.

How to understand the term "multiple pregnancy"?

Multiple pregnancy

Many people, hearing the words "twins" and "twins", do not really understand how they differ from each other. If we recall the school course in human biology, then we know that the formation of an embryo occurs after the fusion of two gametes (male and female germ cells).

If, in a woman's menstrual cycle, two eggs ripened at once, which were subsequently fertilized by two different spermatozoa, then we are talking about the conception of twins. It is important to understand that fertilization occurs with two different spermatozoa, which have a completely different genetic set of chromosomes. Twins can be born of different sexes, have different heights, eye and hair color, and be not very similar to each other. This pregnancy is called dizygotic.

If, during the cycle, one egg, fertilized by one sperm, matures, then either one embryo or the conception of identical twins is obtained. Sometimes such hormonal disruptions occur in a woman's body, when the egg is divided into two absolutely identical halves. These two female cells are fertilized by the same sperm, resulting in twins. The set of chromosomes in these children is exactly the same.

These are necessarily same-sex babies, very similar to each other, have a hereditary predisposition to the same diseases, have moles and birthmarks on the same part of the body. Even the personalities of identical twins are very similar. This pregnancy is called monozygous. Obstetricians-gynecologists can easily determine monozygous and dizygotic pregnancies using ultrasound.

Why do multiple pregnancies happen?

Not everyone is given such happiness.

Despite the constant development of obstetrics and gynecology as sciences, doctors and scientists still cannot indicate the exact cause of multiple pregnancies. The predisposing factors for conceiving more than one baby are listed below.

Heredity... This factor is the most important. Most often, multiple pregnancies are transmitted to women through the maternal line, that is, if a woman has had cases of twins and twins in her family. Most often, this feature is transmitted through one generation, but exceptions are possible.

Infertility treatment... After treatment of the secondary form of female infertility, it is common to conceive more than one embryo. This fact is due to the intake of hormonal drugs that stimulate the maturation of several germ cells at once. If they are all fertilized with sperm, then multiple pregnancies result.

IVF procedure... The method of artificial insemination in 60% of cases ends with multiple pregnancies. This factor is due to the transfer of several embryos into the woman's uterus at once. Several embryos do not take root and die, and 2-3 continue to grow and develop successfully in the uterus. Sometimes doctors carry out the reduction (removal) of excess embryos, leaving one or two babies in the uterine cavity.

Despite the constant improvement of scientific methods and deep knowledge of obstetricians and gynecologists, it is not yet possible to accurately predict the conception of monozygotic twins.

How does a multiple pregnancy go?

Carrying twins is associated with certain risks.

Having studied the pregnancy calendar for multiple pregnancies and carrying one child, a woman will not notice much of a difference. The development of babies in both cases occurs at almost the same time. A feature of the difference between multiple pregnancies and normal pregnancies is the development of complications. Mothers carrying several babies at once face complications more often.

Complications:

Iron deficiency anemia is more common with multiple pregnancies. This is due to the increased need for iron in mothers and children. For the prevention of such a complication, the expectant mother, for the purpose of prevention, is prescribed iron preparations from the first days of pregnancy;

Toxicosis in the second half of pregnancy (preeclampsia) - often develops with multiple pregnancies. Protein appears in the urine of the expectant mother, and blood pressure indicators reach high levels;

Placenta previa is a common complication of multiple pregnancies. It is characterized by the location of the placenta in such a way that the entrance to the uterus is blocked;

Fetoplacental insufficiency - since the placenta performs "double work", it prematurely aging and wear out, as a result of which children experience a deficiency of oxygen and nutrients;

Fetal presentation - children in the uterus are positioned in such a way that natural childbirth becomes impossible and the woman is prescribed a cesarean section;

Delayed development - as a result of insufficient blood supply to the placenta and the supply of nutrients to the fetus, the development of children often does not correspond to the gestational age;

Dissociation of development - this complication of multiple pregnancy is characterized by a lag in the development of one of the fetuses. This is due to a kind of deprivation of nutrients in one of the children in favor of the second. If treatment is started in a timely manner, then, as a rule, nothing threatens the life and health of the baby;

The risk of developing anomalies and defects - with multiple pregnancies occurs much more often than when carrying one child;

The risk of premature birth.

In the first trimester of pregnancy (first 12 weeks), a fifth of women with multiple pregnancies experience the phenomenon of the death of the ovum. In this case, one embryo remains in the uterine cavity and continues to grow and develop, while the second freezes, stops developing and decreases in size (involutions). Such involution does not harm the developing fetus at all.

Ultrasound of two fetal eggs

After 12 weeks of pregnancy with multiple pregnancies, the risk of premature birth and amniotic fluid discharge is especially high. One third of all multiple pregnancies end in miscarriage or premature birth.

To prevent miscarriage and premature birth, a woman carrying twins is prescribed medications to relax the muscles of the uterus throughout pregnancy. If the intake of muscle relaxants does not give the expected effect, then the expectant mother is hospitalized in the maternity ward. A woman is in the maternity hospital either until the birth itself, or until her condition stabilizes and the threat of miscarriage disappears.

Often during pregnancy, a woman complains of irregularities and abnormalities in the work of the heart and blood vessels. During the period of bearing one baby, the load on the cardiovascular system doubles, and when bearing two fetuses, it triples! Failures in the work of the heart can lead to negative consequences for babies growing in the womb.

Gynecologists strongly recommend that pregnant women seek medical help in a timely manner for any abnormalities in the work of the heart. A woman should understand that she is responsible not only for her own health, but also for the lives of her children, and the slightest delay can lead to sad consequences.

It was already noted above that with multiple pregnancies, the risk of developing iron deficiency in the blood of the mother increases many times. When carrying several fetuses at once, the tissue of the placenta has a large mass, in contrast to the placenta of a singleton pregnancy. This leads to an increase in placental blood flow and a decrease in the level of hemoglobin in the blood.

In women who carry more than one fetus in the womb, in most cases, labor begins prematurely. Gynecologists believe that the main reason for this complication is the overstretching of the muscle fibers of the uterus. Women carrying twins should be especially careful to monitor their well-being and health, and if there are any complaints, seek immediate medical attention.

Multiple pregnancies are at risk, therefore, gynecologists are especially closely monitored for women carrying twins. Such women need to visit a doctor more often, to have urine and blood tests more often. Many expectant mothers are outraged by the need for frequent attendance at an appointment, but one should not neglect the recommendations of a gynecologist, because the health of babies is much more important than temporary inconveniences.

How is multiple pregnancy recognized?

The main thing is to find out about multiple pregnancies in time.

This question, perhaps, worries many women in whose family there were cases of multiple pregnancies. From the first days of pregnancy, the expectant mother is interested in signs by which you can find out how many fruits she carries under her heart. The most reliable way to determine multiple pregnancies is to visit an obstetrician-gynecologist's office.

An experienced specialist can accurately diagnose multiple pregnancies from as early as the 4th obstetric week of pregnancy. Already from this period, a woman's uterus is enlarged twice as much as during pregnancy with one fetus.

There are wives who are trying to independently determine by some signs whether their pregnancy is multiple. It is important to understand that there are no reliable signs indicating multiple pregnancy. Until the end of the 12th week of pregnancy, multiple pregnancies can be talked about based on the size of the uterus, and already from the 13th week, an ultrasound scan is prescribed for a woman. During this study, you can tell with accuracy how many fetuses are developing in the uterus.

There are cases when, during the first ultrasound scan, the doctor sees two fetal eggs on the monitor screen, one of which subsequently freezes and only one child is born. Less often, it happens that on an ultrasound scan, the doctor sees only one fertilized egg, and on the next study, two fetuses are found. This happens if one fertilized egg overlaps the second, but when the embryos grow a little, they are clearly visible on the monitor screen during an ultrasound scan.

Many women mistakenly believe that multiple pregnancies can be diagnosed if they undergo a blood test for the triple test for hCG, alpha-fetoprotein and estriol. Such a test is done to confirm the fact of pregnancy and early detection of malformations of the embryo, but this analysis does not always help to determine whether the pregnancy is multiple.

How does a multiple pregnancy proceed? Features of childbirth with multiple pregnancies

It has already been said above that when carrying more than one fetus, the expectant mother is forced to visit the gynecologist's office more often. With a successful pregnancy, a woman, starting from the 13th week, should see a doctor every 10 days. Starting from the 28th week of pregnancy, the expectant mother should attend the consultation at least once every 7 days.

Obstetricians-gynecologists pay special attention to weight gain of a pregnant woman. When carrying one fetus, the total increase at the time of delivery is usually about 12 kg. If a woman is carrying twins, then by the time of childbirth, the weight gain should be no more than 15 kg. The expectant mother should carefully monitor the kilograms and in no case should she gain excess weight. Every extra kilogram gained while carrying twins can greatly complicate the course of pregnancy and the condition of growing babies in the womb.

During the gestation of several fetuses, a woman should be prepared for the fact that at any time she may need to go to the maternity ward for storage. Obstetricians-gynecologists prefer not to risk the lives of children and the health of a woman, therefore, at the slightest deviation in the course of multiple pregnancies from the norm, the expectant mother is offered hospitalization in the maternity hospital.

Two weeks before the expected date of birth with multiple pregnancies, a woman is sent to the hospital. The woman is invited to immediately take with her all the necessary things for herself and the children, as well as documents. From the 37th week of pregnancy, labor can begin at any time, and it would be wise if the woman is under the supervision of doctors at this time.

Methods of delivery in multiple pregnancies are still a topic of discussion among doctors. There is no specific method for all women with twins. The method of delivery for multiple pregnancies is selected individually for each pregnant woman, depending on the following factors:

How was the pregnancy?

How does a woman feel;

How the kids developed and grew;

Whether placenta previa or fetuses are present.

Anxious wait

Great attention is paid by obstetricians to the presentation of the baby who should leave the uterus first. If the fetus is in breech presentation, then doctors prefer delivery by cesarean section. With natural childbirth, babies can get stuck with their heads in the birth canal, which often leads to the death of the fetus.

Often with multiple pregnancies during childbirth, an anomaly of labor occurs. This pathology is characterized by the weakness of the generic process, or, conversely, by impetuosity. Both are bad for the mother and children, therefore, to prevent the development of complications, doctors use medications that adjust the intensity of labor.

In addition to medication, there are other methods of managing childbirth. For example, with weakness in labor after the birth of the first fetus, a woman is punctured by a fetal bladder, and then the interval between the birth of twins is significantly reduced. If both fetuses show signs of severe oxygen starvation, then the question arises of an emergency caesarean section.

Unlike pregnancy with one child, childbirth with multiple pregnancies always begins earlier than expected by 2-3 weeks. And in this case, wise nature took care of the kids. During the gestation of two children at once, the formation of a suffractant (a substance that helps the lungs of children to open up after birth) in fetuses occurs earlier than in a singleton pregnancy. This fact suggests that premature birth with multiple pregnancies is less dangerous and risk of complications for fetuses than premature birth when carrying one baby.

In addition, scientists noted an interesting fact. The adaptation period in monozygotic twins is more difficult than in dizygotic children. Identical babies are more likely to suffer from postpartum jaundice and chronic bronchitis against the background of prematurity.

The onset of the birth process with multiple pregnancies is not much different from the usual singleton pregnancy. Most often, a woman leaves amniotic fluid, and their amount is much greater than when carrying one child.

Due to polyhydramnios, the muscle fibers of the woman's uterus are stretched, which subsequently threatens the woman in labor with primary weakness of labor. To prevent this complication, obstetricians try to open the fetal bladder at the very initial stage of labor, when the cervix is ​​ajar a few centimeters.

Due to the fact that childbirth with multiple pregnancies is often accompanied by the risk of complications, doctors prefer to administer epidural anesthesia even with natural delivery. This is necessary in order to be able to urgently carry out a cesarean section if something goes wrong during childbirth, without wasting time on anesthesia.

The postpartum period of a woman with multiple pregnancies is not at all different from the recovery after the birth of one child. And even breastfeeding of both babies is quite possible. A newly minted mother only needs to get used to her new status a little and show patience and dexterity.

Many couples expecting twins often worry about the weight of their babies at birth. All concerns about excessively low birth weight in twins are just exaggeration. If a woman's pregnancy proceeded normally, and the children developed according to the gestational age, then the birth weight differs by only 400-500 grams from a newborn from a singleton pregnancy. The subsequent development of twins is also no different from a newborn from a singleton pregnancy.

The whole truth about government payments for the birth of twins

All expectant mothers know that after the birth of a child, the state provides material assistance for a certain period of time. In multiple pregnancies, women often wonder about the amount of payment at birth.

If two or three children are born in a family at the same time, then a lump sum is paid for each newborn child. In order to receive financial assistance, parents of babies must provide the local labor administration with a certificate stating that at the time of birth, the spouses are not officially employed anywhere.

If during pregnancy a woman worked officially, then in order to receive payments for children, she needs to contact the accounting department of her enterprise. The list of documents and certificates required for payment must be clarified at the place of receipt of material benefits. If the parents are students, then the payment of the allowance is made at the place of study.

In addition to state payments of childbirth allowance, there are also regional payments. Such assistance is provided at a time, and the amount depends on the region of residence. To get a regional benefit payment, you need to contact your local social security agency.

If a woman gave birth to a child out of wedlock and has the status of a single mother, then in order to receive payments, she must provide documents confirming the absence of a father from children. A woman can get such a certificate at the registry office when registering newborns.

Residents of Russia should know that at the birth of the second, third and subsequent babies, the family has the right to receive maternity capital.

Parents must complete all documents on time

With multiple pregnancies, maternity capital is paid for the second baby. To receive this type of material assistance, a married couple must apply to the pension fund located at the place of registration of their residence. The following list of documents must be submitted to the pension fund:

Application for maternity capital, filled out according to the sample;

Original and photocopy of the applicant's passport;

Originals and copies of newborns and existing children;

Child's Russian citizenship certificate;

Original and copy of the pension insurance certificate.

The state does not provide additional benefits for multiple pregnancies, however, if there are other children in the family, in addition to the twins, the family automatically receives the status of having many children and receives all the benefits due in such cases.

Do not worry about unnecessary bureaucratic red tape with documents. The process of registration of all certificates and benefits will end very soon, and you will enjoy parenting. All this will still be, but for now, get used to your position and enjoy every day of pregnancy so that no troubles can darken your happiness from waiting for your babies.

The onset of pregnancy is a very important event in the life of any woman, regardless of whether she was planning to become a mother or so fate decreed. Exciting preparations for the birth of a baby begin. Sometimes it is worth preparing for the appearance of two babies at once. This is a double happiness, but also a double burden and responsibility.

Carrying twins is at the border of normal and pathology due to the increased load on the female body. Multiple pregnancies increase the risks of health problems, termination of pregnancy, complications during childbirth. That is why it requires increased attention and observation.

From the first days of the discovery of the fact of pregnancy with twins, a woman comes under close control from both the medical staff and the relatives and friends.

Multiple pregnancy, early signs

Early diagnosis of twin pregnancy is extremely important for the normal course of pregnancy, because it requires special attention and constant monitoring.

In general, a woman does not initially feel that she is pregnant with twins. Most often, they find out about this at the first ultrasound examination when registering with a antenatal clinic.

Look for some early warning signs that you might have multiple pregnancies:

• Heightened sense of smell, intolerance to aromas, toxicosis
• Pronounced swelling of the mammary glands
• The appearance of age spots on the face and chest
• At the first examination, the presence of two fetuses may be suspected by the gynecologist by the size of the uterus and its rapid increase at the next appointment. Sometimes, at the first appointment, pregnant women are given the wrong deadline due to the fact that the size of the uterus does not correspond to the date
• At 10 weeks, multiple pregnancies can be detected by electrocardiography
• Elevated hCG levels that can be detected with a blood test

Important: The first ultrasound scan does not guarantee the detection of multiple pregnancies, because one fetus can hide behind another.

After 20 weeks, multiple pregnancies can be detected without the help of an ultrasound machine:

• On palpation of the abdomen, four large parts are felt in different places (heads and buttocks)
• The height of the fundus of the uterus and its size are significantly higher than those of a normal pregnancy
• The expectant mother clearly feels the movement of two fetuses
• When listening to the abdomen, two heartbeats are detected

Pregnancy test, twins

• A pregnancy test is the first way to suspect multiple pregnancies.
• In this case, the level of HcG (hCG - human chorionic gonadotropin) is significantly higher, as a result of which the second strip on the test, which indicates the presence of pregnancy, is distinct and bright in color
• In addition, an increased level of hCG helps to determine the presence of multiple pregnancies earlier than detecting the usual

Twin pregnancy - sensations

With multiple pregnancies, a woman's health and feelings are somewhat different from pregnancy with one child. What the expectant mother may face:

• Severe long-term toxicosis
• Varicose veins due to weight gain
• Shortness of breath due to excessive enlargement of the uterus, as a result of which the diaphragm of the fundus is displaced
• Heartburn
• Increased fatigue, drowsiness
• Edema
• Back pain
• Dark spots
• Anemia, dizziness, fainting

A pregnant woman begins to feel fetal movements a couple of weeks earlier than during a normal pregnancy, they are more intense and numerous. This is due to the fact that babies are cramped and they fit closer to the wall of the uterus.

Pregnancy: twins or twins

There are two types of twins: monozygous or dizygotic:

• Monozygous (identical) twins means the birth of very similar babies (twins). They are obtained from one egg and have one set of chromosomes. The egg cell divides at an early stage of development. With such a pregnancy, children of the same sex are born.
• Dizygotic (two-egg) twins develop when two eggs are fertilized with two sperm and have a different set of chromosomes. As a result of such a pregnancy, heterosexual babies can be born. Twins do not imply strong similarities between children.

Interesting: Since ancient times, the birth of twins has been given a mystical coloring. For example, in ancient Greece, such a phenomenon was considered a gift from the gods.

Weight during pregnancy with twins

There is a misconception that weight gain during pregnancy with twins is much higher and can reach 30-40 kg. However, this is not true.

The intake rate depends on the woman's weight before pregnancy and her height. It is from these data that BMI is calculated - body mass index. To calculate BMI, divide your weight (in kilograms) by your height squared (in meters). For example, for a 56kg girl with a height of 1.6m, the BMI will be 21.9.

Based on the initial BMI, it can be assumed how much the expectant mother of twins will gain during the normal course of pregnancy:

• BMI< 20 — набор веса 16-20кг
• BMI 20-27 - set 13-17kg
• BMI> 27 - set 11-13kg

You can use an online calculator to determine the ideal weight for different periods of multiple pregnancies.

Belly during pregnancy with twins

• The abdomen in a multiple pregnancy begins to grow earlier than in a normal pregnancy. Already by the 12th week, it can be quite noticeable due to the increase in the size of the uterus.
• Starting from the 17th week, it already becomes quite difficult to sleep. It is recommended to lie or sleep on your left side with your knees slightly bent. A special pillow for pregnant women or simply a rolled blanket placed under the stomach and between the legs helps to reduce pain
• In the third trimester, the belly begins to grow very actively, which leads to the appearance of stretch marks. It is recommended to use moisturizers or oils from the beginning of the second trimester to increase skin elasticity. For example, wheat germ oil or baby oil
• Around week 20, your doctor may recommend wearing a back and abdomen support

Development of twins by week: first trimester of pregnancy

Multiple pregnancies are slightly different from normal pregnancies. One of these differences is the somewhat accelerated development of the fruit. I offer you an approximate description of what happens to your body and to your babies:

• 4-7 weeks - the growth of fetuses is 20-30mm, the development of the brain and internal organs begins. The expectant mother may feel the first signs of pregnancy: the breast swells, slight nausea appears.
• 7th week - the growth of embryos is 8-10mm, the outlines of the head and limbs appear, eyes, mouth and ears are outlined on the head. There is a possibility of miscarriage, it is determined during the examination
• 12th week - babies grow up to 5-6 cm, the risk of miscarriage is reduced. You can already get to know them by going through an ultrasound scan. The outlines of nails and teeth have appeared in the fruits, their growth can reach 15 cm, and their weight is 1 g. They can already respond to stimuli by clenching their fists and make their first attempts to swallow

Development of twins by week: second trimester of pregnancy

• 20th week - by this time the growth of fruits reaches 25 cm, the weight is already 250-300 grams. Babies begin to respond to sounds, the urinary system and the intestines of the fetus begin to work. The expectant mother already clearly feels the movements and shocks.
• 24th week - height is about 30 cm, weight - 600g, hair appears on the body, the outlines of eyebrows and the first cilia are already visible on the face, noses are formed. The head is still disproportionately large
• 27th week - from this date, the fetuses are considered viable in case of premature birth. Vital processes are formed in the lungs, the weight can reach 1 kg, the height is 35 cm. Since the twins grow quickly, the pregnant woman feels uncomfortable due to the large abdomen and lower back pain. Due to the increased stress on the legs, it becomes difficult to walk a lot

Development of twins by week: third trimester of pregnancy

• 32nd week - the formation of the skeleton is completed. The twins' weight is about 1.5kg, height is up to 40cm. Each fetus has its own sleep cycle. The proportions of the bodies begin to catch up with the head, the pancreas begins to work
• 34th week - the expectant mother feels pain in almost all of her body, and rapid fatigability appears. If one of the babies drops head down, there is a slight relief, because the stomach drops and stops pressing on the diaphragm and internal organs
• 36th week - the nails protrude beyond the edges of the fingers, the formation of fat under the skin ends. Weight 2-2.5kg, height up to 45cm. Twins are smaller in size than one child at this time, but often their lungs and other body systems are more developed

Features of multiple pregnancy

• Prepare for frequent visits to the antenatal clinic, twin pregnancy requires careful monitoring
• Take vitamin complexes and folic acid
• Eat right, stay outdoors more often
• You may have an increased appetite, because carrying two babies requires a lot of energy.
• Your figure may slightly change its shape, in addition, there is a high likelihood of stretch marks in the later stages.
• Get ready for an early birth. Twins rarely wear out before 40 weeks, usually delivery occurs at 36-38 weeks
• There is a high likelihood of a caesarean section

Video: Pregnancy with twins