Multiples may mean more ...of everything

Multiple births are on the rise. According to the National Center for Health Statistics, about 3 percent of babies in this country today are born in sets of two, three or more, and about 95 percent of these multiple births are twins. The reason can be attributed to women having babies later in life (after age 30), where chances for conceiving multiples are higher. Also, more couples are participating in fertility-stimulating treatments or undergoing assisted reproductive techniques (ART) like in vitro fertilization (in which eggs are removed from the mother, fertilized in a laboratory dish, and then transferred to the uterus). Of these procedures, 56 percent result in multiples, according to U.S. statistics. Although multiples are becoming more commonplace, many pregnant women, couples or families know little about what to expect in regards to a pregnancy where multiples are involved. Although each pregnancy is unique, here are some things you may expect. How are multiples conceived? There are many scenarios for multiple conceptions. In some cases, several eggs are fertilized by different sperm cells. This can result from the body’s release of multiple eggs (either naturally or as a result of fertility drugs) or by the implantation of a few fertilized eggs during a fertility procedure. Multiple fertilized eggs produce dizygotic twins/multiples (fraternal). When one fertilized egg splits into two or more, this produces monozygotic twins/multiples (identical). What are the differences between fraternal and identical multiples? Fraternal multiples are more common than identical, accounting for two thirds of all multiple births. They can also be accredited to fertility treatments. The cause of identical multiples is largely unknown. Fraternals typically have two different placentas (the organ that nourishes the fetus), while identicals may have one or two. Identical twins often grow inside one protective sac, while fraternals may each have their own sac. Fraternals share 50 percent of the same genetic makeup (roughly the same percentage of non-multiple siblings) and can have the same or unique blood types. Identicals share 100 percent of the same genetic makeup, which accounts for their similar or identical appearance. They will also have the same blood type. What are the signs of a multiples pregnancy? Some women do not experience anything out of the ordinary when it comes to multiples and do not learn of the news until an ultrasound is taken. Obstetricians may detect multiple heartbeats late in the first trimester with a Doppler system. However, this is not always reliable because a single heartbeat may be detected in several areas of the mother’s abdomen. Women carrying multiples may have elevated levels of hCG, the pregnancy hormone, but this isn’t always a reliable indicator. An abnormal AFP (alphafetoprotein) screening, also known as a triple marker test, conducted in the second trimester, may also be a key. Extreme fatigue from the body feeding more than one fetus could also result. Are there any risks inherent to carrying multiples? When carrying multiple babies, there is a greater risk of miscarriage of one or more of the fetuses. That’s because chromosomal abnormalities - the culprit in most miscarriages - are higher when multiples are present, according to BabyCenter.com, an online parenting resource. There is also the risk of going into preterm labor. Here are some other concerns: · Fetal growth restriction: When one or both twins isn’t growing at the proper rate. This may cause the babies to be born prematurely or at a low birth weight. Up to almost half of pregnancies with more than one baby have this problem, compared with slightly more than 10 percent of single pregnancies. · Placental abruption: This is a condition when the placenta detaches from the uterine wall before delivery. It is also more common when you’re carrying more than one baby. But the condition is mostly linked to malnutrition and smoking, and is rare in well-nourished expectant mothers. · Pre-eclampsia: This is a pregnancy-induced high blood pressure disorder that develops in about 10 to 20 percent of women carrying twins - twice the rate in women pregnant with one baby. The condition also tends to develop earlier and be more severe in women carrying twins or more babies. Should I expect more morning sickness? Only 50 percent of all pregnant women experience morning sickness, say experts, therefore, you may not experience any at all. Morning sickness does not directly relate to the number of fetuses you’re carrying, which is to say more babies don’t necessarily mean more sickness. What you may expect is your doctor’s insistence that you consume more calories to feed the multiples, about 300 extra calories per fetus. Also be sure to drink an abundance of water to stay hydrated and supply fluid to the fetuses. Dehydration can cause fatigue, sickness and possibly push the body into premature labor. What type of special care should I expect? If your pregnancy goes on without a hitch, expect to receive the same advice mothers of singletons receive. This includes participating in activities in moderation, eating in moderation, and recognizing any symptoms of complications - pain, cramping, bleeding, etc. - early on. If you are having complications, your doctor may prescribe medications or bed rest. In most cases, once you pass the 36th week of pregnancy, many doctors consider you out of the danger zone. Will I need a cesarean section? In many cases, twins are delivered vaginally. However, triplets and multiples of higher numbers are commonly delivered by cesarean section, through an incision in the mother’s lower abdomen and uterus.