You Ask , They Answer
Q
: How common are twin pregnancies and what are the main causes ?
A
: A twin pregnancy is a multiple pregnancy that occurs when more than one egg is fertilised . There are two types of twins :
• �dentical t�ins
Also known as monozygotic twins , these are formed when one fertilised egg splits into two babies with the same genetic information . Identical twins may share a placenta and an amniotic sac , or they may share a placenta and each have their own amniotic sacs .
• �on��dentical t�ins
Also known as dizygotic twins , these are formed when two eggs are fertilised by two sperm , producing two genetically different babies .
It ’ s estimated that one in 250 pregnancies results in twins naturally .
The chances of having identical twins is very rare , around 3-4 per 1,000 live births .
The causes of twin pregnancies are :
• Hereditary — family history is the most common cause .
• Age — Older women , women older than 35 years .
• History of twin pregnancies .
• Artificial �eproductive Technology � I�F � IUI .
• Ovarian stimulation drugs — helps produce more eggs .
Q
: Are there higher chances of complications ( for the babies or the mother ) and of preterm delivery ?
A
: All multiple pregnancies are considered high risk and therefore have higher chances of complications .
Three out of five twin pregnancies will end up with premature deliveries .
The most common complications for twin pregnancies are premature deliveries , i . e ., before 37 weeks . Premature babies are small , and their delivery can lead to low birth weight and breathing and feeding issues , leading to higher risk of infections . Many of these premature babies will need to be managed at a Neonatal Intensive Care Unit ( NICU ), which is very expensive .
Other complications to the mothers include a higher risk of pregnancy-induced hypertension , anemia , gestational diabetes , post-partum haemorrhaging , and a higher risk of miscarriage .
Q
: Do women who are pregnant with twins require more frequent check-ups and gain more weight ?
A
: Antenatal care for twin pregnancies , as these are considered high risk , will require more frequent visits to the doctor , including the requirement that care take place at a tertiary centre . The hospital care of these pregnant mothers has to consist of senior obstetricians , neonatologists , blood banks , and a hospital with operating theatre facilities .
The antenatal visits will usually take place every two weeks to assess foetal growth ( both babies ) as well as to screen the mother for any complications , as mentioned above . The mother needs to be closely monitored for any early signs of complications or premature delivery . These antenatal check ups should be done by an obstetrician well-versed with high risk pregnancies . The mother will be required to take extra folic acid and iron supplements to prevent anemia . Routine blood pressure monitoring , as well as weight gain , has to be documented .
The pregnant mother has to also increase her protein and calorie intake .
Pregnant mothers with twin pregnancy are expected to gain about 16-24KG ( normal weight gain for a singleton pregnancy is about 11-15KG ).
Q
: How can prospective parents reduce the risk of complications ?
A
: Twin pregnancy mothers must have regular antenatal care at a specialised hospital with a dedicated team of doctors .
These mothers must maintain a healthy diet and a healthy weight . They need to be aware of medical complications such as hypertension , diabetes , anemia , preterm delivery , and risks of miscarriage . They also need to take adequate prenatal supplements , such a folic acid , calcium , vitamin D , and iron , while avoiding alcohol , smoking , and drugs . They need to know the risks of possible complications as well as the symptoms of those complications . Finally , they need to visit their obstetrician regularly .
Dr Somaskandar Sivasuntharam
Dr Somaskandar Sivasuntharam is a specialist in obstetrics and gynaecology at Gleneagles Hospital Penang .
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