Multiple Pregnancies

Multiple Pregnancy

What is Multiple Pregnancy?

A multiple pregnancy is when a woman carries a two, three, or more babies in the mother’s uterus in one pregnancy. More than three babies are  termed higher-order pregnancy.

Best scan center for Multiple pregnancy scans in Salem

Mediplus scans & labs at Fairland’s, Salem offers  best services under the care of Dr.Nivethitha, who got trained under the pioneers of fetal medicine Dr. Suresh S., Dr. Indrani Suresh and Dr. Sudarshan Suresh -Mediscan systems ,Chennai.Here, we take the utmost care to keep yourself and your baby’s safety as our priority

Why pregnancy scanning by expert is preferred in case of Multiple pregnancy?

Because this is very important that to determine the type of the Multiple pregnancy (Chorionicity). The whole pregnancy management will depends upon it.

Can you brief the types of Multiple pregnancy?

It is depends upon the number of placentas that nourishes the babies and the number of sacs around the babies. The most common Multiple pregnancy is twin pregnancy.

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Let’s see the common terms and their meaning before moving on to the types of twins,
Chorion means placenta,
Amnion means fluid containing Sac around the baby
Dichorionic  means – Both babies having separate placentas
Monochorionic means – Both babies sharing common single placenta
Diamniotic means – Both babies having separate sacs
Monoamniotic means – Both babies sharing common single placenta
For Example in case of twins (two babies ) , these are possible types :
Dichorionic Diamniotic twins – Two babies having separate placenta and separate sacs
Monochorionic Diamniotic twins – Two babies having common single placenta and separate sacs
Monochorionic Monoamniotic twins -Two babies having common single placenta and  common sac Conjoint twins – Two babies having common single placenta and  common sac with both babies physically connected to each other.

Why the exact type of the multiple pregnancy to be ascertained in pregnancy?

Different types of multiple pregnancy have different risks and problems attached to them. Antenatal care is therefore different depending on which type of multiple pregnancy the patient has. Generally, the more babies there are, the higher the risk and the common sharing placenta also higher the risk.

When the exact type of the multiple pregnancy can be diagnosed?

Ideally it can be done by ultrasound scans between 10 weeks to 22 weeks. After that, it becomes very difficult to categorize them by imaging.

What Is Meant By A Non-Identical And Identical Twin?

In some cases, more than one egg is released during the menstrual cycle, and each is fertilized by a sperm resulting in more than one embryo getting implanted and growing in the uterus.
This type of pregnancy results in fraternal twins (non-identical).
A single fertilized egg splits in the other case, resulting in multiple identical embryos. This type of pregnancy results in identical twins (or more). Identical twins are less common than fraternal twins.

Difference Between Identical And Non-Identical Twins

Identical babies are called monozygotic:

Monozygotic siblings come from one egg. In this case the egg has been fertilised by one sperm and then split into two or more embryos. These babies will all be the same sex. They will all have identical genes.

Non-identical twins are called dizygotic:

Triplets or higher multiples are polyzygotic. In this case each egg is fertilised by a separate sperm. The babies are not  necessarily the same gender and they have different genes.

Is The Risk Of Complications Higher With Multiple Pregnancy?

The risk of certain complications is higher with multiples such as:
  • There is an increased risk of stillbirth.
  • There is an increased risk of preterm birth.
  • Twin-twin transfusion syndrome (TTTS) occurs commonly in monochromic twins. But it also occurs in monochromic and dichoriomic triplets.
  • There is an increased risk of umbilical cord entanglement, mainly in monochorionic monoamniotic twin pregnancies.
  • There is an increased risk of IUGR.
  • There is an increased risk of congenital abnormalities.

Type Of Scans Done In Multiple Pregnancies

The extra scans are recommended for multiple pregnancies :
  • A chorionicity scan at the same time as the dating scan and combined screening test. This is to check whether the babies share a placenta, or have one each.
  • Growth scans in the third trimester will check that the babies are growing normally. Babies sharing a placenta will be scanned every two weeks from 16 weeks. Those with their own placenta will be scanned every four weeks from 20 weeks.

Why extra scans compared with singleton are recommended in multiple pregnancies?

For early detection of complications related to the multiple pregnancies extra scans are recommended. According to the complications, the treatment protocol can be modified which can avoid unwanted pregnancy outcome.

What are the practical difficulties in imaging the multiple pregnancies?

Scanning twins is more of a challenge than scanning one baby, because one twin is often behind the other.
If one baby’s head is low in the pelvis, it would be diffcult to get any measurements. The scans will take more time than   they would for a single pregnancy.

Despite an increased number of scans, it has to be noted that there is no increased risk to the mother or the babies.

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