Twin Pregnancy: Types, Causes, Symptoms, and Complications

Twin pregnancy indicates the presence of two foetuses in the uterus. This is a rare phenomenon that may be brought on by genetics, fertility treatments, or other circumstances. Using ultrasound, medical professionals can identify twins at an early stage. More frequent prenatal care is required in twin pregnancies since they have a higher risk of problems for both the mother and the fetus.

What Are The Types Of Twin Pregnancy?

Twin pregnancies can be categorised in a variety of ways. These incorporate:

• Dizygotic and monozygotic- Dizygotic twins develop from different zygotes, which is the medical term for a fertilised egg. Monozygotic twins develop from the same zygote. Genetic twins are produced when the zygote divides into two. Dizygotic twins come from two different eggs and are not genetically identical; they are no more alike than other siblings.
• Monochorionic and Dichorionic-  "Chorion" refers to the placenta. Some sets of twins share a placenta, whereas others do not. Monochorionic twins have one placenta, whereas dichorionic twins have two placentas.
• The distinction between monoamniotic and diamniotic refers to whether or not identical twin foetuses share a single amniotic sac.

Also Read: Placenta Accreta: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

What conditions can lead to Twin Pregnancy?

Conditions which can lead to twin pregnancy are:

• Age: Multiple eggs are more likely to be released during ovulation in people over 35.
• Family history: There is a possibility that you might conceive twins naturally if your mother's side of the family has a history of fraternal twins.
• Treatments for infertility: People who get fertility treatments, such as in vitro fertilisation (IVF), are more likely to become pregnant with twins.
• Obesity: Twin conception is more common in people whose body mass index (BMI) is higher than 30.
• Personal history: Your chances of getting pregnant with twins again are increased if you previously carried twins

Also Read: Epistomy: Uses, Procedure, Types, Complications, Prevention

Signs Of Twin Pregnancy

Multiple foetuses can be carried under certain conditions. But showing indicators of a twin pregnancy doesn't always indicate that a woman is carrying two embryos.

These signs, some of which start in the first few weeks of pregnancy, consist of:

• An early foetal movement.
• Multiple directions of foetal movement.
• The fundal height exceeds the gestational age. The pregnancy bump is bigger than expected.
• A rapid increase in weight.
• High concentrations of the pregnancy hormone hCG or the fetus's liver protein alpha-fetoprotein (AFP).
• Observing many heartbeats on a foetal Doppler.

Also Read: Menstrual Cramps: Causes, Symptoms, Risk Factors, Diagnosis, Treatment

Symptoms Of Twin Pregnancy

Several indicators of a twin pregnancy could be:

• Gaining weight, especially early in pregnancy
• Higher appetite
• Increasing nauseousness
• Feeling distinct foetal movements in various places of the stomach, more severe symptoms than in prior pregnancies or singleton pregnancies

Also Read: Hydrosalpinx: Causes, Symptoms, Diagnosis, Treatment and Complications

Diagnosis Of Twin Pregnancy

Twin pregnancies are typically detectable by ultrasonography. However, ultrasonography is not flawless. Rarely, especially early in pregnancy, a sonographer might not spot a second foetus.

Blood testing can also be used to identify a twin pregnancy. If a woman is carrying twins, her HCG levels may be greater than typical in the early stages of pregnancy.

• If the growing foetuses are well-positioned for the ultrasound in the second trimester, it is usually possible to tell the sex of each one by looking at its genitalia. Additionally, ultrasound sex determination is occasionally wrong.
• When one twin passes away in the uterus and is partially or completely absorbed by the body, this occurs. This appears to be one twin disappearing on scans. In 36% of all twin pregnancies, vanishing twin syndrome occurs, according to a 2021 article.
• Stillbirth: Occasionally, one twin dies during pregnancy, causing the other to be born alive while the other foetus is stillborn.
• Although twin pregnancies have a higher risk of difficulties, some of them can be treated to lower the risk. For instance, those who have gestational diabetes can manage their disease with medication and dietary or lifestyle adjustments.

Also Read: Fibroid Uterus: Causes, Symptoms, Pathology, Classification, Diagnosis, Treatment

How Delivery Is Conducted For Twin Pregnancy?

There are a number of ways that giving birth to twins can be different from giving birth to one child. These comprise:

Earlier or induced labour

Premature birth affects just over half of all twins. This might occur naturally, though a doctor could advise inducing labour on a particular day if there are advantages to doing so. They might advise induction, for instance, if letting the pregnancy progress poses a risk.

In circumstances of high risk, an induced birth might enhance long-term results. In the short term, nonetheless, it might need that the infants remain in a neonatal intensive care unit. Additionally, some twins may experience issues including low birth weight. A prolonged hospital stay could happen if labour is induced.

A person could require a specialised delivery team if a doctor advises induction. It will also be safer to give birth at a hospital with access to emergency care rather than a birth centre or at home.

Delivery method

The delivery process may not always need to change when twins are born. According to a 2021 article, vaginal delivery is an option and is recommended when both foetuses are head-down and there are no other safety issues.

An earlier 2013 study compared the results of caesarean deliveries versus vaginal deliveries in twin pregnancies, and it found no appreciable differences between the two groups.

A significant procedure called a caesarean delivery involves removing infants from the uterus through an abdominal incision. Contrary to vaginal births, caesarean deliveries take longer to recuperate from and have a larger risk of complications.

Caesarean sections are very beneficial as an emergency operation and for lowering the risk of complications. If both foetuses are head-down during pregnancy, they might not be required for twin deliveries.

Uncertain explanations for the rise in twin elective caesarean deliveries have been noted in a Medical Journal of Australia editorial piece. People should consult with their doctor and consider the risk and benefits of the process.

Also Read: Cervical Mucus: Role in Fertilization, Types, Uses

Complications Of Twin Pregnancy

Complications associated with twin pregnancies include:

• Anaemia.
• Congenital problems, such as spina bifida.
• Diabetes during pregnancy.
• Preeclampsia is high blood pressure while pregnant.
• IUGR (intrauterine growth restriction).
• Oligohydramnios, or low amniotic fluid.
• Abruption of the placenta.
• Premature delivery.
• Polyhydramnios is an excessive buildup of amniotic fluid.
• Only one twin receives adequate blood flow while in the womb due to the twin-to-twin transfusion syndrome.

Premature twins run the chance of developing extra problems, which could include:

• There is bleeding in the brain.
• Breathing problems from underdeveloped lungs, such as apnea.
• Keeping warm is difficult.
• Problems with feeding.
• Low birth weight
• Vision issues (premature retinopathy).

Also Read: Ovarian Cancer: Symptoms, Causes, Risk Factors, Prevention, Diagnosis, Staging, Treatment

To scale up your NEET PG preparation with the best-in-class video lectures, QBank, Mock Tests and more, download the PrepLadder App!
Download PrepLadder's NEET PG preparation app for Android
Download PrepLadder's NEET PG preparation app for iOS