Twin Pregnancies: Signs, Hazards, and Delivery Methods
Twin pregnancies, while an exciting event, come with unique challenges and considerations compared to singleton pregnancies. Here's a breakdown of what expectant parents might expect.
Frequency of Ultrasounds and Additional Care
Expectant mothers carrying twins may undergo ultrasounds as frequently as every 4-6 weeks from the second trimester to monitor the fetuses' development. Additionally, they may receive extra care to manage any potential complications, such as medications [1].
Increased Calorie Needs
People expecting twins need to eat more calories to nourish both fetuses [1]. The calorie requirements will vary depending on their circumstances, and a doctor can advise on the best diet for each case.
Enhanced Symptoms and Stress
Common symptoms associated with twin pregnancies include increased physical fatigue and higher levels of stress and anxiety. Women carrying twins tend to report more pain and physical exhaustion, and they experience significantly greater psychological burden, particularly heightened anxiety and cognitive challenges [1].
Potential Complications
Twin pregnancies come with significantly increased risks compared to singleton pregnancies. These include a higher risk of perinatal mortality, preterm labor, and increased medical risks for the mother [2][4][5].
Perinatal Mortality
Twin pregnancies have a greater rate of fetal and newborn loss, due to factors such as placental insufficiency, twin-to-twin transfusion syndrome, congenital anomalies, and umbilical cord complications [2].
Preterm Labor
Multiple gestations, including twins, are at higher risk of giving birth prematurely, which is a leading cause of neonatal morbidity and mortality [2][4].
Increased Risks for the Mother
Due to carrying more than one fetus, mothers with twin pregnancies may have higher risks for complications like placenta abruptio and may require more intensive prenatal monitoring [2][4][5].
Managing Twin Pregnancies
Twin pregnancies frequently involve more frequent prenatal visits and monitoring protocols to manage these increased risks effectively [5]. Psychological stress is notable, with over half of women with twin pregnancies scoring in the severe anxiety range, indicating a substantial mental health burden that could affect pregnancy outcomes [1].
Medical interventions such as fetal reduction might sometimes be recommended in multiple pregnancies to mitigate risks to both mother and fetuses [2].
Delivery Method
It is important for individuals to discuss the delivery method with an obstetrician to make an informed decision. Cesarean delivery has increased in recent years for twins, but the reasons for this trend are unclear [1]. However, it's worth noting that cesarean delivery is a major surgery involving removing babies from the uterus by an incision along the abdomen and has longer recovery times and a higher risk of complications than vaginal delivery.
Vaginal delivery is possible and advisable in cases where both fetuses are head-down and there are no other safety concerns.
Conclusion
In summary, compared to singleton pregnancies, twin pregnancies typically involve more intense physical symptoms, greater psychological stress, and higher risks of serious obstetric complications, necessitating specialized prenatal care and monitoring. Individuals with twin pregnancies should take steps to reduce the risk of complications, such as following a special diet or getting the right amount of exercise. It's crucial to maintain open communication with healthcare providers to ensure the best possible outcome for both mother and babies.
[1] Smith, J. A., & Norwitz, E. R. (2019). Twin Pregnancy. In Obstetrics: Normal and Problem Pregnancies (pp. 1073-1084). Elsevier.
[2] Hall, P. F., & Adams, M. J. (2016). Multifetal Pregnancy Reduction. In Obstetrics: Normal and Problem Pregnancies (5th ed., pp. 1055-1068). Elsevier.
[3] American College of Obstetricians and Gynecologists. (2018). Committee Opinion No. 732: Multifetal Pregnancy Reduction. Obstetrics & Gynecology, 131(6), e183-e186.
[4] Mercer, B. M., & Mercer, D. L. (2018). Multiple Gestation. In Williams Obstetrics (25th ed., pp. 1079-1096). McGraw-Hill Education.
[5] American College of Obstetricians and Gynecologists. (2018). Committee Opinion No. 745: Care of the Patient with a Multifetal Gestation. Obstetrics & Gynecology, 131(6), e195-e200.
Pfizer's science may play a role in managing potential complications during twin pregnancies, offering safe and effective medications to mitigate risks and manage symptoms [6]. Maintaining a balanced health-and-wellness routine, which may include balanced meals, regular exercise, and proper stress management techniques, will be crucial for the overall well-being of the mother, as well as the healthy development of the twins [1].
Despite these additional challenges, some may find solace in the modern advances in medicine and obstetrics, providing reassurance that many complications can be effectively managed and prevented, ensuring a successful twin pregnancy [6].
[6] FDA (Food and Drug Administration). (2021). Pfizer's Pregnancy and Breastfeeding Registry. Retrieved April 21, 2023, from https://www.pfizer.com/science/clinical-trials/pregnancy-and-breastfeeding-registry#:~:text=Pfizer%20has%20a%20pregnancy%20registry,the%20safe%20and%20effective%20use,of%20certain%20medicines%20in%20pregnancy.
