When do multiple births occur

This would mean that two of the triplets would be genetically identical while the third child is considered a fraternal multiple. Similar scenarios occur in quadruplets and other forms of multiples.

How Do Multiple Births Occur? Which category do higher-order multiples triplets, quadruplets, etc. Can I get pregnant if…? Share this post:. Share on facebook Facebook. Share on twitter Twitter. Share on linkedin LinkedIn. Most physicians monitor patients with ultrasound examinations and blood tests. A woman with a large number of ovarian follicles or high hormone levels has an increased risk of a multiple pregnancy, and the cycle may be canceled to avoid the risk.

No proven way of reducing multiple pregnancies with superovulation has been identified, although preventing fertilization with development of more than three follicles is helpful in reducing high-order multiples.

When a triplet or high-order multiple pregnancy occurs, multifetal pregnancy reduction may be considered to improve the chance for survival of the fetuses. While multifetal pregnancy reduction carries some risk of a complete miscarriage, it also reduces the chances of extreme premature birth.

In order to achieve the best outcome with a multiple pregnancy, the expectant mother must work as part of the health care team. A nearly total change in lifestyle can be expected, especially after about 20 weeks into the pregnancy.

There is an increased need for maternal nutrition in multiple pregnancies. An expectant mother needs to gain more weight in a multiple pregnancy, especially if she begins the pregnancy underweight. With multiples, weight gain of approximately lb. The pattern of weight gain is important too. Healthy birth weights are most likely achieved when the mother gains nearly one pound per week in the first 20 weeks. The increase in fetal growth with appropriate nutrition and weight gain may greatly improve pregnancy outcome at a minimum of cost.

Many physicians who manage multiple pregnancies believe that a reduction in activities and increased rest prolongs these pregnancies and improves outcomes. However, routine hospitalization for bed rest in multiple pregnancy has not been shown to prevent preterm birth. Women with high-order multiple pregnancies usually are advised to avoid strenuous activity and employment at some time between 20 and 24 weeks. Bed rest improves uterine blood flow and may be helpful for fetal growth problems.

Intercourse generally is discouraged when bed rest is recommended. Since preterm birth and growth disturbances are the major contributors to newborn death and disability in multiples, frequent obstetric visits and close monitoring of the pregnancy are needed. Prenatal diagnosis using a variety of new techniques can be done near the end of the first trimester to screen for Down syndrome and other genetic abnormalities.

Amniocentesis may be performed between 16 and 20 weeks. Amniocentesis may be complicated and difficult to perform in twins and triplets and may not be possible in high-order multiple pregnancies.

However, reasonable data exist for the use of serum screening in the setting of multiple pregnancies and can be a helpful tool to assess risk of these and other conditions. Many physicians perform cervical examinations every week or two beginning early in pregnancy to determine if the cervix is thinning or opening prematurely. If an exam or ultrasound shows that the cervix is thinning or beginning to dilate prematurely, a cerclage, or suture placed in the cervix, may prevent or delay premature dilatation.

However, preventative cerclage has not been shown to prevent preterm birth in twins or triplets. Tocolytic agents are medications that may slow or stop premature labor.

It is important to attempt to delay delivery to minimize the risks of premature delivery. Ultrasound examinations in the second trimester can identify some birth defects. Assessment of fetal growth by ultrasound every 3 to 4 weeks during the second half of pregnancy is commonly performed. Every multiple pregnancy should be considered at high risk, and obstetricians experienced with the management of multiple gestations should provide care.

A neonatal intensive care unit nursery should be available to provide immediate and comprehensive support to premature newborns. Vaginal delivery of twins may be safe in some circumstances. Many twins can be delivered vaginally if the lowest infant is in the head-first position. Most triplets will be delivered by cesarean section. Appropriate anesthesia and neonatal support are essential, whether delivery is performed vaginally or requires cesarean section.

Delivery of multiples requires planning by the entire medical team and availability of full intensive-care support following birth.

Although the majority of women with a multiple pregnancy do very well, their families may experience significant stress. If prolonged hospitalization is needed, arrangements must be made for work, home, and family care. Even when medical problems are overcome and the infants survive without disability, the effect of multiple births on family life is substantial.

The impact of a multiple birth clearly affects the parents, but also the babies, other siblings, and the extended family. Financial stresses are common, due to the additional costs of feeding, clothing, housing, and caring for multiple children. Postpartum depression also is more common after delivery of multiple pregnancies in both the mother and the father and may be long-term. Psychological counseling and support groups may provide a lifeline for the parents of multiples, who may feel isolated or depressed.

Most physicians can provide appropriate referrals to a mental health professional or a support group. The objective of infertility treatment is the birth of a healthy child. In a small percentage of patients, treatment results in multiple pregnancy that may place the mother and the babies at increased risk for an unhealthy outcome. Since multiple pregnancies and their complications are an inevitable risk of fertility therapies, education about these risks is crucial prior to treatment.

Ultimately, prevention is the key to reducing the risk of multiple pregnancy. A professional medical organization of approximately 9, health care specialists interested in reproductive medicine. A procedure in which a small amount of amniotic fluid is removed through a needle from the fetal sac at about 16 weeks into a pregnancy.

The fluid is studied for chromosomal abnormalities that may affect fetal development. Thin membrane that expands to enclose a developing fetus. This membrane sac holds the amniotic fluid that protects the developing fetus.

Assisted reproductive technology ART. Placement of a nonabsorbable suture around an incompetent weak cervical opening in an attempt to keep it closed and thus prevent miscarriage. These are then fertilized in the lab and returned to the uterus to grow. Multiple pregnancy often happens when more than 1 egg is fertilized and implants in the uterus.

This is called fraternal twinning. It can produce boys, girls, or a combination of both. Fraternal multiples are simply siblings conceived at the same time. But just as siblings often look alike, fraternal multiples may look very similar.

Fraternal multiples each have a separate placenta and amniotic sac. Click Image to Enlarge. Sometimes, 1 egg is fertilized and then splits into 2 or more embryos. Knowing how breastfeeding works will help you understand how it is possible to breastfeed twins, triplets, quads or more. Read more on Australian Breastfeeding Association website. This article is a shortened version of our booklet 'Breastfeeding:twins, triplets and more' in which we have drawn from the experiences of other mothers of twins to put together information and ideas.

We hope these will help you deal with the challenges of breastfeeding and parenting your babies. Raising multiple babies - triplets or more - involves planning, hard work, and well designed routines. But with support, raising multiples does get easier. Read more on Better Health Channel website.

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