Multiple Pregnancies

Multiple pregnancies can be defined as a pregnancy, which involves two or more fetuses. There are many factors and causes, which lead to multiple pregnancies. The naturally occurring factors of multiple pregnancies are as follows are:

• Heredity: If a family has a history of multiple pregnancies then it increases the chance of having twins.
• Older Age: Women who have crossed the age limit of 30 years have a greater chance of multiple pregnancies. Many women in the contemporary times are delaying the process of childbirth, which might lead to the birth of twins as a consequence.
• High Parity: The chance of having multiple pregnancies might result as the consequence of having one or more pregnancies earlier.
• Race: The African-American women always stand a higher chance of having twins more than any other race. The Asian and Native Americans have the lowest twinning rates. The Caucasian women who have especially exceeded the age group of 35 have the highest rate of higher order multiple births.

Other factors, which lead to multiple pregnancies, include the ovulation-stimulating medications such as clomiphene citrate and follicle stimulating hormone and assisted reproductive technologies such as in vitro fertilization. Multiple pregnancy main occurs in a situation when more than one egg is fertilized and gets implanted in the uterus. Multiple pregnancies might be a source of joy to some couples but has its own complications as well. The preterm labor and birth, pregnancy induced hypertension, anemia, birth defects, miscarriage, twin-to-twin transfusion syndrome, abnormal amounts of amniotic fluid, cesarean delivery, and postpartum hemorrhage are some of the common complications related to multiple pregnancies.

There are also some symptoms common to the case of multiple pregnancies. All such symptoms may include:

• Increased morning sickness.
• Excessive gain of weight especially in the stages of early pregnancy.
• Fetal movements felt in different parts of the abdomen at the same period of time.
• The uterus becomes larger than expected for the dates in pregnancy.

There is a certain way by which multiple pregnancies can be diagnosed. Many women can feel that they are carrying more than one child if they have been pregnant before. In the initial stages of pregnancy diagnosis of multiple fetuses can be made especially if reproductive technologies have been used. Besides a complete medical history and physical examination diagnosis can also be made by pregnancy blood testing, ultrasound and alphas-fetoprotein. Special management can also be made for multiple pregnancies after forming basis on the determination of the physician. Management of multiple pregnancies include increased nutrition, referrals, more frequent prenatal visits, increased rest, maternal and fetal testing, corticosteroid medications, tocolytic medications and cervical cerclage.

Delivery of multiple pregnancies also depends on many factors, which include gestational age, fetal positions, and health of mother and fetuses. In case of twins if vaginal delivery is possible if both the fetuses are in the vertex position and there are no additional complications. A special care nursery called Neonatal Intensive Care Unit is also developed to take care of the multiple babies born at the same time.