What are the risks of twin pregnancies?
Twin pregnancy is like two people traveling on a long-distance bus in one seat. Although pregnancy is designed for a single baby in humans, it is possible for two or more babies to be born without any problems. However, multiple pregnancies are pregnancies where the probability of all problems increases. Most doctors are concerned when monitoring a twin pregnancy. And they are right to be concerned. Because premature births, miscarriages in early pregnancy, gestational diabetes and hypertension problems are more likely to occur. The most important one is the increase in the risk of premature birth and the subsequent need for a neonatal intensive care unit. Sometimes births that occur very early, between 20-24 weeks, greatly reduce the chance of survival. In babies born around 24 weeks and living, severe mental and neurological complications can be observed due to prolonged stays in intensive care and being born very early.
Apart from these, problems can also be observed depending on the way twin pregnancy occurs. In order to understand this problem called twin-to-twin syndrome (twintotwin), we must first talk about the types of twin pregnancy;
If a twin pregnancy occurs from a single embryo, it is called monozygotic twins . The two babies have the same genetic structure and look similar to each other. The medical name for this is monochorionic twin pregnancy. The water sacs of the babies can be separated by a membrane or both are in the same sac. The most dangerous and risky situation is when they are in the same sac. Twin-to-twin syndrome can be seen in the most severe form. Since the babies have a common placenta, blood distribution may not be equal. While one baby is fed more, the other can receive less blood. As a result, both can be damaged.
If two embryos create separate pregnancies, this is called fraternal twins. The medical name is dichorionic twin pregnancy. Both babies have different genetic structures. Their genders may be different, and even if they are the same, they do not resemble each other. In this case, since the placentas and water sacs are separate, the risk of twin-to-twin syndrome is less.
Excessive weight gain, hypertension and gestational diabetes are common problems in twin pregnancies. Anemia due to iron deficiency increases when the mother's iron stores are not enough for two babies. Excessive distension of the uterus and excessive growth of the uterus can delay the uterus from returning to its original size after birth. This can cause postpartum hemorrhage, which doctors worry about. Extra medication is often required after birth to allow the uterus to recover.
Are there any differences in the follow-up process in twin pregnancies?
Twin pregnancies are special in terms of their occurrence and problems. Although doctors advise their patients that this situation is natural, it is clear that they are worried. Bleeding and the risk of miscarriage/birth in the first and last three months make the pregnant woman and her doctor nervous. Therefore, the follow-up process varies depending on the presence of these problems. Another important factor that determines the frequency of follow-up is the anxiety of the pregnant woman, her partner and even the doctor. While monthly follow-ups are generally recommended after the first three months, the visit intervals, which start at once every three weeks in the last three months, become more frequent and decrease to weekly.
Apart from the timing, there is no difference in the follow-up examination of twin pregnancies. The medications and vitamins used are similar to those of singleton pregnancies.
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