Multiple births pregnancies

1. Premature/preterm labour or birth

Multiple pregnancies often end earlier than single birth pregnancies. The result is that the babies are born before all their organs are fully developed. They usually have low birth weight and on many occasions require aided breathing and feeding. Such babies need additional care after delivery but unless they have any other complications they grow well.

2. Pregnancy-induced hypertension

Multiple pregnancies increase the chances of developing high blood pressure in women. This may at times lead to placental abruption (early detachment of the placenta from its normal position in the uterus). This poses a great risk of the babies dying in the uterus (or intrauterine death) once the placenta detaches itself from the uterine wall. The mother-to-baby connection is disrupted and the baby may not get enough oxygen, nutrients, and other important elements do not flow from mother to baby.

3. Miscarriage

A woman carrying multiple foetuses at once is more likely to miscarry. The two foetuses are diagnosed in the womb but one of them suddenly ‘vanishes’ in the first three months after failing to develop further.

4. Twin-to-twin transfusion syndrome

This is a dangerous condition that occurs when a placenta is shared by two foetuses. When blood vessels connect within the placenta, they divert blood from one foetus to another. This situation is known as twin-to-twin transfusion syndrome. This condition eventually leads to one foetus receiving excess blood that may overload its cardiovascular (heart and blood) system. It may also lead to formation of excess amniotic fluid. In some rare cases, early in a multiple pregnancy, one of the foetuses may die and become flattened, an incidence referred to as foetus papyraceous. The flattened twin is discovered at birth.

5. Caesarean delivery

Multiple pregnancy is more likely to lead to Caesarean delivery in comparison with single deliveries. This is usually due to abnormal foetal position during labour as well as other obstetric complications.

It is important to note that multiple pregnancies can present with any of the known pregnancy complications. Therefore close follow-up is essential to forestall and treat these complications as they arise.

END: PG05/29