Why Women Pregnant with Twins Need Extra Care

By Dr. Okechukwu Amako, MBBS (Ibadan)
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Being pregnant with more than one baby (twins or more) is associated with higher risk factors compared to one-baby pregnancies because the extra baby puts more demand to the mother in every aspect.

So once a woman confirms by ultrasound during the first antenatal clinic visit that she is pregnant with more than one baby, her doctor will extensively discuss with her on the need to go the extra mile in taking care of herself, attending antenatal clinic regularly and ensuring that she gives birth to her babies in a hospital that has senior obstetricians and is equipped with all the necessary obstetric facilities needed to manage any possible complications that could arise during the delivery of the babies.

Women carrying multiple babies are at a higher risk of developing the following complications.

1. A woman pregnant with more than one child is much more likely to witness regular and severe vomiting (called hyperemesis gravidarum) which can lead to a massive loss of body fluids and minerals, predisposing her to kidney injury if she is not hospitalized. And this vomiting may persist after the first 3 months. Also, if a woman begins to experience this severe vomiting just after her pregnancy test is positive, it may likely be a pointer she is pregnant with more than one baby even before an ultrasound scan is done.

2. A woman pregnant with more than one baby is about 5 times more likely to develop hypertensive disorders during such pregnancy, which can lead to convulsion if she doesn't receive immediate expert obstetric care. A high blood pressure and high amounts of protein in the urine of such a woman in a urine test indicate she has developed a hypertensive disorder (called preeclampsia). To prevent her from having convulsions, she will need to visit her obstetrician more frequently and may need to be admitted in the hospital for closer monitoring especially some weeks before her expected date of delivery.

3. These women are more prone to having anaemia due to a higher nutritional (iron and folate) demand from two or more developing babies in the womb. Hence, they must be faithful in taking their folic acid supplements and should ensure they eat very well so as to have enough nutrients for themselves and their unborn babies.

4. A woman pregnant with more than one baby has a higher risk of bleeding during pregnancy, especially after 5 months. This is because there is a higher tendency of the placenta attaching towards the opening of the womb into the vagina if more than one baby is developing in the womb, and there is also a higher risk of premature separation of the placenta from the wall of a womb carrying more than one baby. Regular antenatal clinic visit and an ultrasound scan during the second and third trimesters will reveal an abnormally attached placenta, enabling the obstetrician to keep a closer eye on the woman. Moreover, these women should never hesitate to report to their obstetrician once they notice any bleeding.

5. When a woman is pregnant with more than one baby, one or both of those babies may not grow adequately. This can result from a situation where one of the babies sucks more blood from the other one. And this will lead to one or both babies having low birth weight. But if the woman is under the care of a senior obstetrician right from her first antenatal clinic visit, the likelihood of this happening will be lower.

6. When two or more babies are growing in the womb, there is a risk of them being joined together at the head, hip, tummy or any other part of the body, especially if in the case of a twin they are enclosed in one amniotic sac.

7. One or both of the babies growing in the womb are at a higher risk of developing one physical deformity or the other especially when the woman is not under the care of any doctor. Also, one or both babies may die leading to stillbirth.

8. The commonest danger for women pregnant with a set of twins or more babies is labour occurring prematurely (occurring before the right time) leading to premature delivery. However, if such women register for antenatal care at a hospital with senior obstetricians and equipped with the necessary obstetric facilities, they and their babies will be in good hands.

Women pregnant with a set of twins or more babies can go through pregnancy and deliver naturally and at the right time without having any of these problems. Nevertheless, it is strongly advised they register for antenatal care and delivery in a very good hospital that has senior obstetricians and all the necessary obstetric facilities to manage any form of complications that can arise during pregnancy or delivery.

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Published Tuesday, February 28th 2017

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