When you realise you are carrying twins, you might be surprised, excited and even in denial. A twin pregnancy is more complicated than a single pregnancy, so you’ll need more visits to health professionals and more tests and checks during your pregnancy.
When am I likely to get pregnant with twins?
You are more likely to become pregnant with twins naturally when you are in your 30s and 40s. At that phase, ovulatory cycles are no longer regular, and you could be ovulating two follicles simultaneously, leading to a twin pregnancy.
In vitro fertilisation (IVF) can increase the chance of twins, as there is a transfer of more than one embryo.
How do I know I am carrying twins?
You may suspect you are having twins long before a proper diagnosis. Extreme nausea can be one of the first symptoms. It’s as if you can tick all the boxes for early pregnancy symptoms but increase them tenfold.
Smells are more acute, your bladder won’t seem to hold any reasonable urine volume, you’re exhausted, and your breasts may have taken over your chest. This is because the pregnancy hormone, hCG, is being produced in mega quantities, and its effects on your body have become very evident.
You are also likely to “show” much sooner than if you only carry one baby. It makes sense that two babies take up double the room. Pregnancy is usually not obvious until after the 12th week when the uterus starts lifting out of the pelvis. But with twin pregnancies, a little round bulge is often visible long before the end of the first trimester.
You may also learn from an ultrasound and see two babies on the screen. Sometimes pregnant mothers don’t know they have twins until the 18-week screening ultrasound. While for others, as early as 12 weeks. An ultrasound at 12 weeks or earlier can reveal which type of twin a woman carries.
Unfortunately, identical twins are at a higher risk of having congenital abnormalities and complications, such as being small for gestation age. Fraternal twin pregnancies generally only require normal antenatal care but still need careful monitoring, especially when the mother becomes very large and the risk of early delivery increases.
Another way to detect a twin pregnancy is through a doppler ultrasound scan, when two heartbeats are heard.
What do I need during a twin pregnancy?
You may need extra folic acid; 1 milligram of folic acid per day is recommended for twin pregnancies to reduce the risk of neural tube congenital disabilities such as spina bifida.
Prenatal vitamins are important; ensure you get vital nutrients such as folic acid, iron, and calcium.
You must visit the clinic more often because your healthcare provider needs to monitor you.
Type of Twins
There are two types of twins; fraternal twins and identical twins.
Fraternal twins are formed by fertilising two eggs with two different sperm. They are also known as ‘dizygotic twins’ or ‘non-identical twins’. With fraternal twins, the two foetuses (developing babies) each have a separate placenta, inner membrane (the amnion) and outer membrane (the chorion). They don’t usually look identical and sometimes have different sex.
Identical twins are formed from the splitting of one embryo. They are also known as ‘monozygotic twins’. Different types of identical twins exist, depending on their share in the womb.
- Almost one-third of identical twins have their placenta, inner, and outer membrane. The medical term for these twins is ‘dichorionic diamniotic’ or DCDA twins.
- Almost two-thirds of identical twins share the same placenta and chorion but have their amnion. These are ‘monochorionic diamniotic’ or MCDA twins.
- The rest – only about 4% of identical twins – share everything and are called ‘monochorionic monoamniotic’ (MCMA) twins.
Twin-twin transfusion syndrome
Identical twins with the same placenta and chorion can sometimes share a condition called twin–twin transfusion syndrome (TTTS).
In this condition, blood flows from one twin to the other, resulting in one baby getting too much blood and the other not getting enough. This affects the health of both babies, sometimes severely.
Common twin pregnancy complications
For the mother:
- Morning sickness commonly extends to hyperemesis gravidarum (extreme vomiting).
- Gestational diabetes.
- Premature birth.
- Caesarian section delivery – particularly if this is your first pregnancy and your first labour experience.
- Bleeding/placenta praevia/placental abruption.
For the baby:
- Smaller birth weight.
- Problems with feeding.
- A longer stay in the hospital after birth.
- Occasionally the babies have problems maintaining their body temperature and
- stabilising their blood sugar levels.
- Infections and vulnerability due to their size.
- Breathing problems.
Why do the Yoruba tribe have more twin births?
The twin birth rate in Nigeria is four times higher than in other regions of the world. Twin births are more accustomed to the Yoruba tribe in Nigeria. The Yoruba tribe has 4.4% of dizygotic twins in West Africa.
Some scientists believe that consuming a specific type of yam allows their ovaries to produce eggs from each side. A hormone known as phytoestrogen in this yam helps aid this process. However, this lacks enough research, and genetics plays a major role in attributing twins to the Yoruba tribe.
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