Finding Out

How do you know if you’re carrying more than one baby? There are sometimes many, sometimes very few, indications that a mother-to-be is carrying twins. With increased medical technology, incidences of shocked parents and providers in the delivery room are decreasing, but this still happens on occasion. To prevent this surprise, expectant parents and their doctors should be on the lookout for signs of a multiple pregnancy.

Since they have no basis for comparison, first-time mothers may have difficulty identifying the exaggerated pregnancy symptoms associated with multiple pregnancies. Still, severe morning sickness that lasts longer than usual, as well as seemingly excessive weight gain can be telling signs of multiple pregnancy.

Visual and Physical Signs

Body size and weight are not always a strong indicator, since some moms carrying twins may gain less weight than other moms do when carrying singletons. Nonetheless, early “showing” can indicate a multiple pregnancy (however, early showing is more common in women who have had children before, and does not, therefore, guarantee twins).

Your practitioner will also measure the size of your uterus at each prenatal visit. If it seems larger than normal for your dates, you could be carrying multiples — or you could be further along than you originally thought. He or she may also “palpate” your uterus by feeling its shape and contents through the wall of your abdomen. Your practitioner might feel two heads or too many body parts for one fetus and determine that you’re carrying multiples. Most likely, though, you practitioner will already know that multiples exist before he or she feels them; “palpating” is difficult to do until the seventh or eighth month and by then the practitioner would probably already know about the twins from ultrasound.

The mother may also experience greater discomfort in a multiple pregnancy. Lethargy due to the increased risk of anemia is common, as are excessive swelling of hands and feet and fluid retention. The very large abdomen associated with multiples can cause trouble with sleeping or breathing .

Growing fetuses can also announce their presence with great fanfare simply by their abundant activity in the womb, and expectant parents may be able to determine a multiple pregnancy by monitoring fetal movement. This process can take a good deal of time and patience, since active babies in utero can be difficult to differentiate from one another.

Laboratory Tests

Your doctor may run a blood or urine test to determine the level of human chorionic gonadotropin (HCG). HCG is the same hormone used to confirm pregnancy. While a standard pregnancy test determines only the presence of HCG, special testing for high levels can indicate a multiple pregnancy.

Ultrasound is one of the best methods for identifying a multiple pregnancy. A 1983 study in Sweden focused on early detection of twinning. In this study, routine ultrasounds identified 98 percent of the twins by the time the fetuses were seven weeks old. Such early diagnosis has also been shown to increase the probability of healthy babies at birth. With early knowledge of multiples, moms can get a jump-start on nutrition and rest.

The one drawback of early detection is that it can sometimes lead to disappointment if there is any difficulty later on in the pregnancy. Ultrasound technology has allowed doctors and scientists to surmise that many more pregnancies start out as multiples than reach fruition. In fact, it is estimated that one eighth of pregnancies start out as twins. Other studies estimate that in utero loss of one twin occurs in as many as 80 percent of twin pregnancies.

Doctors identify this phenomenon as the “Vanishing Twin Syndrome.” The disappearance of one twin takes place early in the pregnancy, and often goes undetected by both the mother and the doctor, but can be determined by ultrasound and other laboratory tests. Often the most pronounced sign can be vaginal bleeding, while many mothers may experience nothing at all, and it is assumed that the “vanished twin” is simply assimilated by the womb. Some expectant parents are not made aware of this risk when the pregnancy is diagnosed, and are understandably disappointed and saddened when later ultrasounds show only one pregnancy.

If you have an inkling that you’re carrying multiples, be sure that you’re conclusively proven right or wrong as soon as possible, since you’ll need to start caring for more than one baby if your suspicions are confirmed.

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July 29th, 2011 - Posted in Women's Health | | Comments Off

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