Complications
Possible Complications
This section is not here to deliberately cause panic but to give you the information which I have read myself on the internet, in books or have been given during my twin pregnancies.
Remember that there are many successful, trouble free twin pregnancies resulting in healthy twin births. I have two twin pregnancies and four healthy children under my belt!
Pre Term Labour
You will be told of the risks of premature labour and whilst this is not always the case there is a possibility that the babies will want to arrive early.
It is vital to do everything you can to avoid premature labour so take it as easy as possible and try and keep as comfortable as you can.
Women carrying multiples face an increased risk of pre term labour and giving birth to premature babies. Pre term labour is the term used for a woman who has contractions associated with the dilation of the cervix before the babies have reached full term.
Full term for a singleton pregnancy is 40 weeks whereas for multiples it is believed to be 37-38 weeks. So, in medical terms premature is for babies delivered before 37 weeks.
There are occasions why a woman shouldn’t carry her babies to full term. Sometimes if the babies’ aren’t growing properly it is advised the mother doesn’t carry to full term or if a medical condition is apparent that could put both the mother and babies at risk. At these times it may be that your doctor will decide to induce labour before term or a C Section will be performed before term. The babies rely on the placenta for nourishment and there is some evidence to suggest that placentas in a multiple pregnancy do not work as efficiently after the 39th week thus putting the babies at risk.
The babies position is also a factor and how far dilated the cervix is and the position of the cervical opening in relation to the first babies presenting part.
The main aim for a multiple pregnancy is to get your babies as close to term as possible. Low birth weights are normally the result of a premature birth. A baby delivered at 36 weeks, whilst small will normally be fine and unlikely to have any problems. Babies born before this time still have lots of growing to do and their internal organs need to mature. A steroid injection may be administered if preterm labour looks likely to help with maturing the internal organs. Even babies born as early as 22 to 25 weeks now stand a good chance of survival.
Multiple pregnancies are at particular risk of premature labour due to overly distended uterus and extra amniotic fluid causing the body to read the pregnancy as being further along than it actually is. This leads to premature rupture of the Membranes. There are extra risks of hypertension and incompetent cervix. Pregnancy induced Hypertension is more common in twin pregnancies than in singleton pregnancies. An incompetent cervix can lead to its dilation prematurely which can then lead to premature delivery. If this condition is diagnosed a cervical stitch may be put in place to prevent dilation.
It is really important to take care of your nutritional needs so that early and adequate weight gain is achieved – this is one of the key ways to nurture your unborn babies. Extra folic acid is recommended especially during the first 12 weeks of pregnancy. Make sure your body is hydrated as dehydration is associated with early contractions and often this can settle by increasing your fluid intake.
Emotional stress should be avoided which is easier said than done when dealing with the increased responsibilities of day to day life. It may be the case that you already have a job, young children and a partner to deal with! Under stress, the body tends to release extra adrenaline which constricts bloody vessels and can reduce the blood supply to the uterus which could then stimulate preterm labour.
If you have previously had a premature labour or delivery you are at a higher risk of repeating it.
Congenital Anomalies are associated with a higher risk of pre term labour and are more common in multiple pregnancies.
Placenta Previa is where the placenta is attached to the lower half of the uterus where it covers partially covers or just touches the edge of the cervical opening. In many cases it gradually moves upwards as the pregnancy goes on towards the later stages. However, if the placenta is blocking the cervical opening you won’t be able to deliver vaginally.
Twin to Twin Transfusion Syndrome (TTTS)
Twin to Twin Transfusion Syndrome (TTTS) is a disease of the placenta which affects 15% of Monochorionic twins. That is identical twins who share a placenta. If the condition is evident there are medical procedures that can be carried out.
Fortunately, I did not experience TTTS during my identical twin pregnancy although I was monitored very closely for it and have a brief understanding of the condition. There is a website which I have listed below which can assist anyone wanting to know more about the condition.
Disclaimer: The information on this website does not constitute medical advice, it is for your reference only from my personal experience of delivering twins twice. Always seek professional and current advice from a registered medical practitioner.
