Carrying a twin pregnancy is not an uncommon event. It occurs when the uterus carries two fetuses simultaneously rather than one. Having twins runs in some families and age also appears to be a contributing factor. Women in their late 30s have a higher chance of having twins, usually due to release of more than one egg during the menstrual cycle. But with increasing use of assisted conception, there is a trend towards a disproportionate number of twin pregnancies.
When two eggs are released, both can get fertilised by different sperms. This results in the so-called fraternal twins. Such twins are no more alike than siblings conceived and born at different times. Fraternal twins can be of the same sex, or a boy and a girl. Identical twins on the other hand result when one fertilised egg splits and develops into two fetuses. Identical twins are of the same sex and have the same blood type, hair colour and eye colour. They usually look very much alike.
You may suspect you have a twin pregnancy either from a strong family history, or due to exaggerated symptoms in early pregnancy. However, the diagnosis is best confirmed by ultrasound, preferably done in the first trimester of pregnancy. Such an early scan is important in determining several aspects of the kind of twins you may be carrying, and informs on the planning for antenatal care and delivery.
Whereas you may desire to have a twin pregnancy and get over with child-bearing once and for all, it is important to realise that you are likely to experience more pregnancy complications. The risk of almost all pregnancy-related complications is increased in women with twins. This ranges from pre-eclampsia (high blood pressure in pregnancy), to premature deliveries. Your antenatal care will thus be completely different compared to women carrying a single pregnancy.
It’s best to start your clinics as early as possible. In addition to routine screening tests, you can get early screening for fetal abnormalities. Birth defects are twice as common in twins compared to single babies, and this risk also increases with your age.
Twins demand more resources as well, and you will need routine supplementation with iron throughout the pregnancy. Monitoring for fetal well-being is best done by ultrasound. You should expect to have growth monitoring scans every 2 to 4 weeks depending on the type of twins and any ongoing complications.
It is very unlikely you will reach your due date. More than half of all women with twin pregnancies go into premature labour before 37 weeks. Some precautions will be put in place if labour occurs too early. The chance of needing a Caeserean delivery is higher, but some types of twins can be delivered safely vaginally. After delivery, you will need substantial help in caring for two babies.